Nov 13, 2019

Integrate Health Q1 Impact Report (July - Sept 2019)

Funding Snapshot
Funding Snapshot

Integrate Health Launches in Third District

Integrate Health’s Integrated Primary Care Program launched in four clinics and their surrounding communities in the Dankpen district on July 8th. With this expansion, Integrate Health’s Integrate Primary Care Program, implemented in partnership with the Ministry of Health, now serves a total population of over 142,000 in 13 clinics with 95 Community Health Workers across three districts. Within the last two months, all 33 new Community Health Workers in the Dankpen district successfully completed four weeks of intensive supervision from Integrate Health staff and have been providing high-quality, proactive care to their communities. Integrate Health is pleased to have received extremely positive feedback on program deployment and quality of services in the first few months in this new district. The launch of services in the Dankpen district marks the halfway point of Integrate Health’s planned four-year expansion to serve a population of 240,000 over five districts in northern Togo by 2021.

The following report describes additional progress made over the past three months, including successes and challenges, as well as outputs, outcomes, and funding metrics. Please let us know if you have any questions. Thank you for your support.

Program Highlights

Successes

1. Community Health Workers in the Kozah district have gone paperless! We are excited to announce that our Community Health Workers in all pilot sites have stopped using paper backup and use only the smart phone application co-designed with Medic Mobile. Our team will assess all data from October to December and will use this experience to inform a scale-up of mobile tools to other districts planned for 2020.

2. The Integrate Health program team held bi-annual community town hall meetings in the Bassar district in September. During the meetings, Integrate Health staff discussed program results from the last six months, addressed community feedback, and celebrated recent successes. Over 100 community members and stakeholders were present at each meeting, including clinic staff, Ministry of Health representatives, and village chiefs. During the meetings, chiefs expressed their gratitude for the Integrated Primary Care Program, and the District Health Director reiterated the Ministry of Health’s commitment to this program and partnership.


Challenges

1. In August, the Community Health Worker Supervisor in the Kozah district and the Clinical Mentor in the Dankpen district were recruited to join the public sector through an annual recruitment process. Both decided to leave Integrate Health to work within the government system. While sad to lose talented staff, Integrate Health is pleased to contribute to training strong public sector employees. Although new candidates were hired in September, some activities were postponed to afford new staff adequate time to be properly trained.

Expansion Highlights
Successes

1. Integrate Health was proud to join Togo’s Minister of Health, Dr. Moustafa Mijiyawa, and the Director-General of the Ministry of Health, Dr. Bertrand Beweli, in NYC for events around the UN General Assembly in September. Both Minister Mijiyawa and Dr. Beweli had the opportunity to meet with Integrate Health partners and learn from their experiences scaling professional Community Health Worker programs in other West African countries. The Minister and Dr. Beweli have pledged to continue these action-oriented conversations in Togo.

2. In September, Integrate Health embedded a new position, Quality Assurance Officer, in the Regional Health Management team to oversee ongoing implementation of the Integrated Primary Care Program. Reporting directly to the Regional Health Director, this position is designed to accelerate integration and facilitate local ownership of program implementation.

 

Challenges

1. In the first few months of launching services in the Dankpen district, Integrate Health staff have noticed that the new district has higher levels of under-five malnutrition compared to other districts. Furthermore, due to the rainy season and rough terrain in the Dankpen district, there have been transportation problems in getting severe malnutrition cases to the hospital. The Integrate Health program team is analyzing the possibility of expanding the rural ambulance program, while the Community Health Workers will be attentive to follow up on all malnutrition cases.

Organizational Highlights

Successes

  1. The Integrate Health operations and HR staff rolled out two new exciting organizational tools this quarter. First, all staff have completed the new performance management system adapted from our friends at Last Mile Health, which includes annual goal setting, updated performance plans, and professional development. Second, the Integrate Health finance team has created an internal finance manual with updated policies and procedures. Both tools will be guides and resources for Integrate Health operations.

Challenges

  1. Analysis of the data collected through Integrate Health’s repeated cross-sectional study is behind schedule. To address this challenge, Integrate Health has contracted a researcher to conduct the analysis and has opened recruitment for a new full-time position: Deputy Director of the Community Health Systems Lab . Integrate Health hopes that the analysis will be complete by the end of the calendar year.


Financial Highlights

Successes

1. Integrate Health received renewal funding from two existing partners and has submitted applications to two new funding partners this quarter.

Challenges

1. An application to USAID Health Systems Prize for $25,000 was not accepted.

Quarter 1 metrics
Quarter 1 metrics

Links:

Aug 16, 2019

Quarterly Progress Report Q4 FY 2019

Summary

Integrate Health works alongside governments and the local community to implement and study an integrated approach to strengthening primary healthcare delivery in order to achieve universal health coverage. This report describes progress made over the past three months, including successes and challenges, as well as outputs, outcomes, and funding metrics. Please let us know if you have any questions. Thank you for your support.

 

Program Highlights

Successes

1. The male peer educator program was launched in the Bassar district. Ten male peer educators were selected, trained, and completed 37 educational talks. These men (two per site) promote family planning in their communities by dispelling common myths and misconceptions and educating men on the benefits of family planning.

2. In April, IH staff and representatives from the Ministry of Health (MOH) conducted joint supervision visits to all sites in the Kara, Kozah, and Bassar districts to observe, discuss and provide recommendations on the work of Community Health Workers (CHWs) and health center providers.

Challenges

1. Due to a slight drop in home visits in the second quarter, the IH program team organized community meetings in the Bassar and Kozah districts. The meetings were designed as an opportunity for IH to listen to the feedback of the community and address any concerns. During this time, IH discovered additional coverage was needed in multiple CHW zones in both districts. In June, IH hired and trained three backup CHWs in response to coverage needs.

Expansion Highlights

Successes

1. The IH program team successfully recruited 41 CHWs for the July expansion to the Dankpen district. Over 20 days in June, all Dankpen CHW candidates were trained in integrated maternal, child and reproductive healthcare delivery. The top 33 CHWs were selected to serve their communities in the Dankpen district following a period of intensive supervision.

2. To prepare for service launch in the Dankpen district, the IH program team organized an initial training for clinical staff from each of the four participating health centers on integrated maternal and child healthcare, assisted delivery, essential care for newborns and mothers, and the use of IH reporting and quality improvement tools. Following the training, each clinic received three-days of additional onsite training and supervision conducted by IH with the MOH.

Challenges

1. The redesigned Medic Mobile application was evaluated in April, however the level of accuracy between data collected on the application and via paper forms was not high enough to enable IH to drop the use of paper backup. The application was revised in June to improve speed and backend access, which IH is hoping will address the ongoing accuracy issues. Further evaluation is ongoing.

Organizational Highlights

Successes

1. In June, IH published, “Implementing an integrated community-based health systems strengthening approach to improve HIV survival in Northern Togo” in partnership with AED-Lidaw and the MOH. The manuscript documented a survival probability of 75% five years after starting antiretroviral therapy among patients enrolled in community-based HIV care.

Challenges

1. IH’s audit of fiscal year 2018 identified areas for improvement in financial systems and processes to keep pace with organizational growth. IH’s newly hired Finance Manager and COO have led these improvements with 9 of 15 recommendations implemented. The remaining six areas are being addressed this month as IH’s Finance Manager visits Togo to update all manuals and train Togo-based staff.

Financial Highlights

Successes

1. IH secured one new funding partnership and received renewal funding from five existing partners this quarter. As a result, we have secured approximately 47% of FY20 projected expenses.

Challenges

1. An application to Johnson & Johnson Africa Innovations was not accepted.

Links:

May 22, 2019

Quarterly Progress Report: Q3 FY 2019 (January 1 -

Outcomes
Outcomes

Summary

Integrate Health (IH) exists to end preventable deaths in forgotten communities. By integrating professional Community Health Workers (CHWs) with improved care in public clinics, we are achieving lifesaving results. This report describes progress made over the past three months, including successes and challenges, as well as outputs, outcomes, and funding metrics. Please let us know if you have any questions. Integrate Health is deeply grateful for your support.

Program Highlights

Successes

 1. In March, IH trained 230(!) traditional healers in our new Bassar sites on identification of danger signs. The team

was overwhelmed by the large participation and is organizing refresher trainings for traditional healers in pilot sites.

2. Community town hall meetings were held in each of the nine sites, attended by community leaders and members,

clinic staff, IH staff and for the first time, the MOH District Health Director or their representative. Discussion topics

included family planning misconceptions, low ANC completion rates and how to improve clinic staff treatment of patients. This was a unique opportunity for patients to speak directly to their government officials for their health.

Challenges

1. The redesigned Medic Mobile application launched on January 24th, while CHWs and clinic staff continue to paper data collection as backup. In May, IH will assess data consistency between data collected via paper and mobile in the hope of fully transitioning to mobile data collection in our pilot sites.

 

Expansion Highlights

Successes

1. The IH program team has begun holding community meetings in preparation for expansion into four new clinics

in the Dankpen district in July 2019. IH has successfully recruited two new Community Health Worker (CHW)

Supervisors and one new Clinical Mentor (two women and one man). The community-led recruitment process for

CHWs has begun and 252 candidates, 80% were women, applied for 34 CHW positions.

2. IH program staff presented at two District Annual Review meetings and conducted a “State of the Partnership”

meeting to review three-year program outcomes with the Regional Health Direction. IH staff are now working with

the Regional Health Director on practical recommendations to further integrate IH’s approach with the public

sector, such as embedding supervisory staff, streamlining accounting practices and further integrating supply chain.

Challenges

 1. Our team is thrilled to be receiving multiple requests for technical assistance from the government of Togo. We

are working to best position IH to respond to and prioritize among these requests. We will begin a strategic

planning process with workshops across the US and Togo, culminating in an updated three-year strategic plan.

2. IH continues to make progress in our partnership with national pharmaceutical distributor, CAMEG. CAMEG has

committed to fulfilling 80% of IH’s monthly procurement orders moving forward, up from less than 50% in Q2. IH

and CAMEG staff will meet monthly to assess progress on an ongoing basis.

 

Organizational Highlights

Successes

 1. After almost a year recruitment phase, IH has officially hired a Kara-based Data and Analytics Manager! We are

also happy to welcome to our team a Chief Operating Officer, Finance Manager, Managing Director of Research

and Analytics, Development and Communications Manager and Data Entry Assistant.

Challenges

 1. Through the annual audit process it became clear that the outsourced financial firm IH had engaged for the past

18 months was not providing a sufficient service. We quickly made the decision to hire a full time Finance Manager

and have since ended our contract with the outsourced firm. We are very pleased to welcome a new francophone

Finance Manager who brings significant experience, including management of large USAID contracts.

 

Financial Highlights

Successes

 1. IH secured one new funding partnership and received renewal funding from two existing partners this quarter. As

a result, the current fiscal year is fully funded, and we have secured approximately 50% of FY20 budget.

Challenges

 1. An application to the AllPeopleBeHappy Challenge Grant was not accepted, and IH’s application to the Innovations in Healthcare 2019 cohort was not selected.

 

Outputs
Outputs
Funding Snapshot
Funding Snapshot

Links:

 
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