1100: Enabling environment: Public sector policy makers renew leadership of and commitment to more effective implementation of key Micronutrients (MN) programs. Specifically to provide iron and folic acid (IFA) supplements to pregnant women, linked to antenatal care services (ANC), zinc and ORS to children under five who suffer from diarrhea and Vitamin A supplements (VAS) to all under five children including improved policies, guidelines, product standards and increased budget allocations Standards and Guidelines: % of districts that are implementing programs with product standards consistent with international for each MN guidelines that are consistent with the WHO recommendations for each MN program Budget allocation: # of districts where there is an increase in budget allocation (supplies/training /operational cost) for the MN programs. For IFA and Vitamin A 0% For IFA 0% 80% 80% 15 of 20 districts Policy documents - Policy documents - District Development Planning documents Review of documents and policy statements District program action Once Annual MI/ DHO MI/ DHO Enabling environment – Immediate outcome
1110 Knowledge, Skills and Capacity: Policy makers have committed to revitalizing and strengthening key MN programs through changes in policy instruments, and to increase budgets to effectively plan, implement and monitor these programs. Plan and implement: # of districts with policy makers who know how to plan and budget appropriately for national procurement of key MN supplies (e-procurement) improving service delivery to increase coverage of MN programs Monitoring: # of districts that have modified HMIS to track key coverage and stock indicators. 0 0 20 districts 15 of 20 districts FGDs with policy makers Revised HMIS Analysis of FGDs Modified HMIS tools Once Once MI MI/ DHO Enabling environment – outputs
1111 Key information received: Policy makers have received information about gaps in key MN programs (including product packaging; dosage, service quality etc); and on the scope for improvement based on the results from the MI demonstration projects # of dissemination meetings organized to inform policy makers and influencers 0 1 national level advocacy workshop Advocacy meeting minutes Review of minutes of the meeting Once MI/ MoH 1112 Tools received: policy makers have received updated guidelines and approaches to monitoring to help them plan and implement these programs effectively # of districts in which key policy makers and influencers received relevant tools 0 All 20 districts Distribution records Review of distribution records Once MI/ MoH/ PHO/DHO 1113: Learning completed: Policy makers have received briefing on the above # of workshops conducted for policy makers at national level # of workshops conducted for policy makers at provincial level # of workshops conducted for policy makers at district level 0 0 0 2 (1 per year ) 2 (1 per year ) 2 (1 per year ) Minutes of the meeting Review of minutes of the meeting Annual MI/ MoH/ PHO/DHO
Provision – Intermediate outcome 1200: Provision: improvements in the extent to front-line health workers, supervisors and health service managers, prioritize the timely provision of IFA supplements to pregnant women, zinc and ORS for children under 5 suffering from diarrhoea and VAS for all under five children and are capacitated for effective planning, monitoring, management, and appropriate counselling to pregnant women and caregivers of children under five Capacity for monitoring: # of districts that actively compile HMIS data on Stock and Coverage of MN supplements 0 15 of 20 districts Revised HMIS Modified HMIS directives from DHO Once MI Adequacy of supplies: % of districts with adequate supplies of each MN available at the DHOs a. IFA supplements b. zinc and ORS c. VAS 0 100% (all 20 districts) District procurement records District procurement offices/ District Pharmacies Annual update MI Planning and monitoring: % of districts conducting annual planning and quarterly program review meetings on these micronutrient programs to identify gaps and potential solutions 0 100% (all 20 districts) Minutes of meetings Review of minutes of meetings Annual update MI Provision – Immediate outcome
1210: Knowledge, Skills and Capacity: health workers, supervisors and managers, have recognized the importance of prioritizing key MN programs through improved capacity for timely provision of adequate amounts of supplements and effective planning, monitoring, management and appropriate counselling. % of frontline workers who can correctly describe dosage, duration, benefits and side effects of each MN a. IFA supplements b. zinc and ORS c. VAS TBD from baseline survey Increase by 50% Program evaluation Baseline and end line surveys Once MI/ Independent agency Provision – Outputs 1211: Supplies ensured: bottlenecks and gaps in supply identified and streamlined in consultation with local district staff through provision of tools and checklists for planning and forecasting outs: % of districts with stock out of a. IFA supplements b. Zinc supplements c. ORS d. VAS at frontline distribution points TBD 20% 20% 20% 20% HMIS data Review of HMIS data Annual update MI and DHO
1212: Tools received: front-line health workers, supervisors and managers, have effective systems e.g. modified HMIS, training curricula for improving service delivery in provision of supplements and improved skills for appropriate counselling % of managers, supervisors frontline health workers who receive an improved package of tools 0 80% Dissemination records/ training reports Review of dissemination records estimates Annual update MI and DHOs 1213: Learning completed: health workers, supervisors and managers have completed training on modified tools for forecasting, monitoring recording and reporting use of job aids for appropriate counselling a. formal training # or % of managers and supervisors trained on improved package of tools # or % of frontline health workers trained on improved package of tools b. on the job training % of manager, supervisors frontline health workers provided on the job training during program review meetings 0 0 0 128 (80% of the 160) 512 (80% of the 640) 60% Training reports Project Monitoring reports Review of training reports Review of project MIS Annual update Quarterly MI and DHOs MI Consumption – Intermediate outcome
1300: Consumption: Pregnant women and caregivers of children under five have improved receipt and adherence of key MN supplements IFA Coverage: % of women who have been pregnant in the past year who received any iron tablets at least 90 at least 180 IFA supplements during pregnancy Utilization: % of women who have been pregnant in the past year reporting consumption of at least 90 IFA supplements 88% TBD from baseline survey TBD from baseline survey 56% Increased by 5% Increased by 25% Increased by 15% Increased by 20% Program evaluation Baseline and end line surveys Once MI/ Independent agency Zinc and ORS Coverage: % of children aged 1-59 mo presenting with diarrhoea caregivers received the recommended course of zinc and lo-ORS supplements from any sector (public-private both) Utilization:% of children aged 1-59 mo presenting with diarrhoea caregivers administered the full course of zinc and supplements as per recommendation 15% TBD from baseline survey Increased by 30% Increased by 20% Program evaluation Baseline and end line surveys Once MI/ Independent agency VAS Coverage: % of children 6-59 months of age who are fully protected with two annual doses of VAS 82% 90% Program evaluation Baseline and end line surveys Once MI/ Independent agency Consumption – Immediate outcome
1310: Knowledge, Skills and Capacity: pregnant and caregivers of children under five have improved knowledge and skills on benefits, when and where to seek key MN supplements, method of administration, including the correct frequency and duration and managing side effects to ensure adherence. % of end users who can describe one benefit to seek each MN supplement a. IFA (among pregnant women) among caregivers of children under 5 b. Zinc and ORS c. VAS % of all pregnant women who can explain how to overcome at least one typical barrier/side effect to IFA consumption TBD from baseline survey TBD from baseline survey Increased by 40% Increased by 40% Program evaluation Baseline and end line surveys Once MI/ Independent agency Consumption – Output
1312: Messages received on correct use: pregnant women and caregivers of children under five have received guidance on how to administer key MN supplements at the appropriate time, with the correct frequency and duration and how to manage side effects to ensure adherence % of pregnant women who received correct messages on benefits and mitigation of side effects for IFA supplementation % of caregivers of children under 5 who received correct messages on benefits, dosage and use of zinc in diarrhea and VAS TBD from baseline survey TBD from baseline survey Increased by 60% Increased by 60% Program evaluation Baseline and end line surveys Once MI/ Independent agency Annex Project Implementation Plan (PIP) Project Reducing Iron Deficiency Anaemia in pregnant women and reducing mortality and morbidity in children under five, in two provinces of Indonesia: East Java and East Nusa Tenggara Responsible party Preparatory phase 2 provinces [20 districts] 2 provinces [20 districts] 2 provinces [20 districts] BUDGET (AUD) Start date 1-Aug-15 End date 30 September, 2018 2015-16 2016-17 2017-18 2018-19
Provision of supportive supervision during field visits to the frontline workers to register pregnant women and children under five, provision of recommended number of IFA supplements, Zinc and ORS, VAS, and use of communication materials for counselling PHO, DHO X X X X X X X X X Ensure that the HMIS data is regularly collected and compiled at the district levels and sent to the province (PHO) for feedback and necessary action. DHO X X X X X X X X X Facilitate use of the modified MIS improved recording and reporting systems and use of the data for corrective actions and decision making MI, PHO, DHO X X X X X X X X X Facilitate DHOs and PHOs in monitoring the quality of VACs in the district/province by checking at health centres and district warehouses and providing feedback to MoH and Food and Drug Administration MI, PHO, DHO X X X X X X X X X Conduct joint review meeting between PERMATA and DFATD provinces at provincial level. X Private sector - Undertake sensitization meeting with professional organizations of medical doctors, pediatricians and midwives from districts and province to promote zinc supplementation for treatment of uncomplicated diarrhea MI X X Private sector - Conduct sensitization meeting among the pharmaceutical representatives to promote zinc supplementation at the province level MI X X 1311: Evidence-informed BCI approaches uptake and use BCI plan developed with appropriate messages and channels identified for improving knowledge and skills of pregnant mothers and caregivers of children under five on benefits and use of key MN supplements in consultation with key stakeholders Undertake review of existing BCI plan developed for the demonstration and modify on the basis of recommendations MI, MoH, PHO, DHO X Identify appropriate channels, messages and communication materials MI, MoH X