This document summarizes a panel discussion on cross-cutting themes in community health from USAID's Child Survival and Health Grants Program (CSHGP) 2014 cohort. It discusses USAID's commitment to ending preventable child and maternal deaths through community-based programming. Two grantee presentations showcase integrated quality improvement collaboratives in Benin and a people's institutions model in Bangladesh. A cross-cutting analysis identifies key themes of community engagement and service delivery. MCSP aims to accelerate institutionalization of community health and proposes a "Looking Glass" model of viable integrated community health platforms centered around interventions, workforce, governance, learning and support.

1. Cross-cutting Themes in Community Health:
Engagement from the CSHGP
FY2014 Cohort
Concurrent Panel Session; CORE Group April 14, 2015
Moderators from MCSP: Emma Sacks and Melanie Morrow

2. USAID is Committed to Ending Preventable
Child and Maternal Deaths (EPCMD)
A Call to Action: A Promise
Renewed (June/2012)
Acting on the Call to End Maternal
& Child Deaths (June/2014)

3. Integrated RMNCH
• “We are entering (or are in the midst of) a
paradigm shift in which:
• Community-based programming is being seen as the
most cost-effective approach for improving
RMNCH
• Movements toward integration will increasingly be
seen as essential for long-term sustainability and
effective programming”
CBPHC Conclusion (from H. Perry)

4. USAID’s Child Survival and Health Grants Program
(CSHGP)
• Partnership model engages and builds the
capacity of civil society with host country
governments
• Cooperative agreements - international
NGOs and their local partners.
• Programs generate new knowledge to
improve the health of women, children, and
communities.

5. CSGHP 2014 Cohort
• 10 of 11projects completed final evaluations
• Liberia granted extension
• 7 in Africa, 3 in Asia, 1 in South America
• Largely MNCH-focused; 1 TB
• Various strategies:
• Maternity waiting homes,
• integration of child survival and ECD,
• community QI initiatives,
• training/equipping/pairing CHWs,
• etc.

6. Panel
2 presentations from FY2014 grantees:
• World Renew Bangaldesh – Peoples Institutions
Model (Alan Talens)
• Center for Health Services Benin – Quality
Improvement Collaboratives (Sara Riese)
Cross Cutting Analysis of FY2014 Cohort
• Themes: Community Engagement & Service
Delivery (Lynne Franco, EnCompass)
Community Health in MCSP –
• Viable Integrated Community Health Platforms

7. MCSP and Community Health:
Viable Integrated
Community Health Platforms
CORE Group Spring Conference 2015
Melanie Morrow & Emma Sacks, MCSP

8. What’s New
• Greater emphasis on community
health and civil society engagement
• 20% of funding to be spent through
local institutions and organizations
USAID’s flagship
Maternal and Child
Survival Program

9. Goal: Ending Preventable Child and Maternal
Deaths (EPCMD)
• Scaling up community based approaches among success factors associated
with progress on MDGs 4&5
• Need to accelerate institutionalization of community health in country health
strategies.
• Challenges:
• Inconsistent language
• Multiple country contexts
• Zero sum games
• Response:A visual model (the “Looking Glass”) that can be used across
country contexts to highlight essential elements of community health
strategies as part of a broader platform intending to achieve comprehensive
services and sustainability at scale.

10. TowardViable Integrated Community Health Platforms
CHWWorkforce
↕ ↕
Community
Organizing
[Social Infrastructure]
Local Learning &
Adaptation,
Using Information for
Equity
Institutionalization,
Governance
& Partnerships
Interventions &
Outcomes:
Health Promotion,
Preventive, & Curative
Services
Support Services
and Functions
(commodities, supervision,
information systems…)
National
Policy and
Support
The “Looking Glass”- a visual model

11. Lens 1: Interventions & Outcomes
• Package of RMNH interventions aimed at
improving outcomes for mothers, newborns
and children.
• Balance of health promotion with preventive
and curative services
• Clearly identified outcomes at the
community level

12. Lens 2: Community health workforce (CHWs)
& Community organizing structures
• Re-emergence of large scale CHW
programs
• CHW roles, profile, capacity, fit to tasks and
coverage in the population.
• CHW relationship to community groups
(formal and informal) as a subsystem related
to the outcomes and interventions defined
in Lens 1. i.e.Women’s PLA groups; Care
Groups

13. Lens 3: Institutionalization,
governance & partnerships
• Sound governance and support from
subnational (i.e. district) and national MOH
• Effective partnerships with civil society,
community groups, NGOs in the health
sector and CHW professional associations.
• Steps to support those partnerships,
facilitate government to non-government
partnership for health, and build capacity and
shared ownership.

14. Lens 4: Local learning, adaptation
and Information Use for Equity
• A viable CHP requires capacity to learn and adapt by
all actors
• Not static: communities, health systems nor the
health threats they face.
• To sustain community health at scale, a CHP must
focus on how information is used horizontally (close
to communities and beneficiaries) and vertically, to
foster cycles of learning, improvement and
adaptation.
• Examples: PDQ, social accountability strategies, use
of C-HIS, Community Action Cycles

15. Lens 5: Support Services & Functions
• Health systems’ supportive functions to
community health
• Supervision
• Procurement
• Training
• Information systems

16. CSHGP and MCSP
• Using learnings from CSHGP
• CSHGP participated in MCSP workshops
• MCSP holding brownbags for CSHGP projects to
present findings
• Concern Sierra Leone’s Ebola experience
• WorldVision South Sudan’s newborn health experience
• MCSP country offices to attend CSGHP final
evaluation presentations
• MCSP producing briefs related to CSHGP
evaluations and operations research for
distribution in country

17. CSHGP and MCSP
• Cross country and cross-project learning
• Joint learning activities between CSHGP projects
and USAID Missions in Pakistan being planned
• Analysis in progress of iCCM experience across
two countries
• With EnCompass, analysis conducted of learning
themes across countries

18. In Summary
• Viable community health platforms are about
sustaining effective community health at scale
in changing environments
• NGOs and CSOs have been working at
community level for many years and have
proven strategies that can be adopted by
government programs at larger scale and in
sustainable manners

19. For more information, please visit
www.mcsprogram.org
This presentation was made possible by the generous support of the American people through the
United States Agency for International Development (USAID), under the terms of the Cooperative
Agreement AID-OAA-A-14-00028. The contents are the responsibility of the authors and do not
necessarily reflect the views of USAID or the United States Government.
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