Evaluation of the rapid, multi-country, parallel process, multi-tasking approach to startup of short-term technical assistance to improve service delivery in newborn and child health in the context of USAID’s Zika response in four Eastern and Southern Caribbean countries

Abstract

Background: In 2018, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project started a new partnership with four Eastern and Southern Caribbean countries impacted by the Zika virus: Antigua and Barbuda, Dominica, St. Kitts and Nevis, and St. Vincent and the Grenadines. The goal of the project was to provide short-term technical assistance (STTA) to strengthen the health systems’ capacity to detect newborns and young children potentially affected by Zika and to address their health needs. To meet these objectives, ASSIST developed an innovative approach based on its existing model for service delivery improvement. This novel approach is known as Rapid, Multi-country, Parallel Process, Multi-tasking Approach for a Project Startup (RMPP-MAPS). An evaluation was conducted to document the STTA startup activities, to identify enabling and constraining factors, and to capture lessons learned. Methods: An external consultant conducted remote in-depth interviews with individuals involved in the startup using semi-structured interview guides and retrieved data from the review of project documents. Results: Using RMPP-MAPS, the ASSIST Project successfully implemented the startup for complex STTA in four countries within less than four months, spanning mid-May to early September 2018. Project milestones included achieving buy-in from stakeholders, co-developing the technical scope and materials, and rapidly executing critical operational functions. Dedicated project teams, country leaderships, and local champions were essential to overcoming the main challenges, which included a condensed timeframe, lack of in-country offices, and country-level factors such as a shortage of health care workers and a weak health infrastructure. Conclusions: The RMPP-MAPS is a feasible and resource-efficient mechanism of interest to implementers, donors, and low and middle-income countries facing temporal and financial limitations to rapidly addressing public health priorities.

Adaptation of Essential Care for Every Baby Educational Program to Improve Infant Outcomes in the Context of Zika

“…(4) Full description of this technical assistance program is described elsewhere. (4) The total number of suspected cases of Zika in these countries ranged from 508 to 1154 from 2015 to January 2018, and 5-17 con rmed cases in pregnant women per country. At the start of this project (2018 data), the median neonatal mortality rates ranged from 3.4 to 28.3 per 1,000 live births in these countries and the UN SDG is a rate of under 12 deaths per 1,000 neonates by 2030.…”

Adaptation of Essential Care for Every Baby educational program to improve infant outcomes in the context of Zika

“…The outbreak and ongoing transmission of Zika virus in Latin America and the Caribbean since 2016 provided an opportunity to strengthen essential newborn care and early childhood development systems in Zika-affected countries through donor assistance. Beginning in July 2018, the US Agency for International Development Applying Science to Strengthen and Improve Systems (USAID ASSIST) Project began working with Ministries of Health (MOH) to provide short-term technical assistance in four Eastern and Southern Caribbean countries (Antigua and Barbuda, St. Vincent and the Grenadines, St. Kitts and Nevis, and Dominica) to improve early detection, care and support of children and families potentially affected by Zika [ 4 ]. Full description of this technical assistance program is described elsewhere [ 4 ].…”