1. Integrated approach to deliver MNCH-FP-Nutrition services: MCHIP-MaMoni case study from Bangladesh CORE meeting – Baltimore May 12, 2011 Winnie Mwebesa

3. Why MaMoni in Sylhet.. 11% 18% Skilled attendance at birth Home: 91% Home: 85% Place of delivery 47% 60% At least one ANC attendance with trained provider 26% 18% Unmet need for family planning 32% 56% CPR 3.7 2.7 Total fertility rate 53/1000 63/1000 (2004) 37/1000 41/1000 ( 2004) Neonatal mortality rate Sylhet National Indicators (BDHS 2007)

6. 1 2 3 4 5 6 7 8 9 p1 p2 p3 p4 p5 p6 D IFA Supplementation ANC1 TT ANC2 ANC4 TT ANC3 Pregnancy identification Misoprostol Clean delivery and immediate newborn care PP maternal care, Vit A and management of complications Essential newborn care/KMC Management of newborn complications Immunization Postnatal session promoting LAM, spacing, PoP, FP, transition Supply of PoP, transition to modern method, Supply of FP methods and referral for LAPM Integrated safe motherhood-newborn-family planning: MaMoni package Birth preparedness HW counseling AMTSL & referral for EmOC Exclusive breastfeeding and promotion of LAM/PPFP

8. Integration in MaMoni WHAT? Program integration Maternal Integration of Interventions Neonatal Child Family planning Nutrition Integration at Provider level Integration at Delivery level Skill Strategy Integration at Management level Planning Supervision & QA Monitoring Functional integration between structures DGHS MO Local Govt. Community GO DGFP MOH&FW Formal health systems NGO To make effective and sustainable, we need