Design and Planning of PHCs

INTRODUCTION & PROBLEM STATEMENT ‐ Gambella , Ethiopia has a large South Sudanese refugee 

population fleeing civil war ‐ recent estimates show 75‐125K new arrivals in 2017, total 

408,500 ‐ 88% are women and children ‐ Child mortality 51 per 1,000 live births, Maternal mortality 

353 per 100,000 live births ‐ UNHCR works with local ARRA, regional health bureaus, HEWs, 

and NGOs to coordinate health services ‐ Acute malnutrition among refugees in Gambella nearly 30% ‐ Only half of mothers exclusively breastfeed in Ethiopia  ‐ Top causes of maternal mortality: obstructed labor/uterine 

rupture, hemorrhage, hypertensive disorder of pregnancy,  sepsis/infection

‐ Low amount of SBA (29.1%), low transportation access, low rate  of postnatal checks within 48 hours (3%)

PROJECT GOAL & OBJECTIVES Goal: To reduce neonatal mortality among refugees in Gambella.

Objective 1: Reduce malnutrition in children under 5 by 10% by 2021. • Increase % of mothers who exclusively breastfeed in first 6 months to 80% • Reduce % of children under 5 years who are malnourished • Reduce % of pregnant/lactating women in Gambella camps who are malnourished

Objective 2: Reduce MTCT of HIV from 25% to 20% by 2021. • Increase % of women who seek HIV testing • Increase % of women with HIV who seek care • Decrease % of women with HIV who develop resistance to treatment • Decrease % of women with HIV who develop HIV-related complications and AIDS

Objective 3: Improve quality of intrapartum/postnatal care provided to refugees by 2021. • Increase % of women who deliver in healthcare facilities and/or with skilled birth attendant • Increase % of neonates with postnatal check within 48 hours • Improve capacity for management of perinatal complications • Increase uptake of evidence-based recommendations to promote infant health among expectant

and recent mothers • Increase responsiveness of midwives to patients’ needs and preferences

Objective 4: Improve healthcare workforce capacity for maternal and child health by 2021. • Increase number of attended birth and increased measure of preventative care measures. • Improved skill base; better retention; ongoing training of new MWs & HEWs • Consistent level of care and better accomodation for updated standards; more rapid deployment of new

knowledge • Better health outcomes for neonates; decrease in neonatal mortality

STRATEGIES AND METHODS ● Breastfeeding/ Nutrition :Reduce the malnutrition status in children under

5 by 10% by 2021. ○ Support mothers in education on exclusive breastfeeding techniques and importance ○ Procure and provide therapeutic foods (RUTF) ○ Provision of blanket supplementary feeding programs

● Reduce mother to child HIV transmission in Gambella from 25% to 20% by 2021.

● Provision of HIV counselling and testing to women, ● Provision of ART to women ● ARV prophylaxis administration in neonates ● Support for adherence to treatment and viral suppression ● Awareness raising campaigns to encourage HIV testing in pregnant women

● Increase proportion of births attended by skilled birth attendant from 29.1% to 50% by 2021.

● Increase number of trained midwives ● Improve transportation capabilities

● Increase proportion of newborns who receive postnatal checks within 48 hours from 3% to 25% by 2021.

● Train nurses,physicians and midwife/HEWs ● Provide ongoing quality of care reminders via mobile messaging to midwives