This presentation covers the USAID Office of Maternal, Child Health and Nutrition; the Office of Health Systems; Office of Population and Reproductive Health; and the Center for Innovation and Impact.

1. CCIH Conference
June 6, 2019

2. 1. Office of Maternal and Child Health and Nutrition
2. Office of Health Systems
3. Office of Population and Reproductive Health
4. Center for Innovation and Impact
Overview
2

3. 1. Global Leadership and Policy Support
– Global guidelines
– Liaison with multilateral organizations, other donors, private sector, NGOs
– Facilitating the scale-up of proven, high-impact innovations
2. Implementation Research, Evaluation, and Innovation
– Establishing proof of principle for new interventions and new approaches to interventions
with potential country-level impact
– Health Research Program, focused on research-to-use
– Collaboration with CII (innovation), P3 (metrics), OHS, GH research team
3. Support to USAID Field Missions
– TDY support, e.g. activity designs, evaluations
– Collaboration on global initiatives, including co-funded activities (e.g. Saving Mothers,
Giving Life)
– Technical assistance activities through central projects
MCHN Overarching Functions
3

4. From 2012 to 2016, USAID helped 5.9 million women
deliver in a health facility.
220,000
ANNUAL MATERNAL DEATHS
IN 25 PRIORITY COUNTRIES
MATERNAL HEALTH
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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5. • Enabling and mobilizing
individuals and communities
• Advancing quality, respectful
care
• Strengthening health systems
and continuous learning
MATERNAL HEALTH
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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6. 1,870,000
ANNUAL NEWBORN DEATHS
IN 25 PRIORITY COUNTRIES
Between 2008 and 2015, the percentage of women
giving birth in a health facility in priority countries rose
from 42% to 54%, and, partially as a result, the
neonatal mortality rate decreased 18.5% in the same
window.
NEWBORN HEALTH
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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7. • Increasing access to quality care
and services during labor,
delivery, and the first day and
week of life to reach every woman
and every newborn
• Harnessing the power of parents,
families, and communities to
promote optimal health behaviors
and care seeking
• Monitoring progress and
outcomes for enhanced
accountability
NEWBORN HEALTH
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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8. CHILD HEALTH
885,000
ANNUAL DIARRHEA & PNEUMONIA DEATHS
IN 25 PRIORITY COUNTRIES
USAID’s efforts have helped increase use of oral
rehydration solution to treat diarrhea in priority
countries from zero to as high as 54%.
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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9. • Increasing access to new
vaccines
- Pneumococcal conjugate vaccines
- Rotavirus vaccines
• Improving case management
- ORS + zinc
- Oral amoxicillin for severe
pneumonia
• Applying cross cutting prevention
- Handwashing
- Reduction of indoor air pollution
CHILD HEALTH
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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10. CHILD HEALTH
ADDRESSING THE MAJOR CAUSES OF MORTALITY
Policy environment in flux:
• MCHN supporting examination of
gaps in global and country-level
leadership in child health
• MCHN participating in global
update of Integrated
Management of Newborn and
Childhood Illness
• Child Health team working on a
new vision for child health for
GH, to be completed in early
2018 10

11. 75%
OF THE WORLD’S UNVACCINATED CHILDREN RESIDE IN
25 PRIORITY COUNTRIES
In priority countries, DPT3 coverage, a common indicator
in the strength of a routine immunization system,
increased from 71% in 2008 to 81% in 2015.
IMMUNIZATION
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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12. • Partnering with Gavi
• Sustaining routine immunization
coverage
• Eradicating Polio
IMMUNIZATION
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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• Strengthening systems
– Cold chain and logistics, information
systems, training health workers and
managers
• Improving service delivery
– Innovative approaches and tools to
reach the unreached
• Working with national immunization
programs
– Planning, review, and coordination
meetings, evaluations and
assessments, policy and guideline
development
Credit:AllanGichigi,MCSP
IMMUNIZATION
SUSTAINING COVERAGE

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Credit:AllanGichigi,MCSP
1.7 M
ANNUAL CHILD DEATHS ATTRIBUTED TO
MALNUTRITION IN PRIORITY COUNTRIES
In USAID’s focus countries for nutrition, the prevalence of
stunting, indicative of inadequate nutrition, declined from
56 percent in 1990 to 34 percent in 2016.
NUTRITION
ADDRESSING THE MAJOR CAUSES OF MORTALITY
Credit: Alda Kauffeld/USAID Ghana
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Focusing on nutrition–specific interventions (1,000 days)
• Maternal nutrition: iron folic acid, calcium, multiple
micronutrients, energy/protein supplementation.
• Infant and young child nutrition: immediate
breastfeeding, exclusive breastfeeding up to 6
months, complementary feeding with continued
breastfeeding to 2 years and beyond.
• Micronutrient supplementation: vitamin A, zinc,
iron, calcium.
• Management of acute malnutrition
Collaborating on nutrition–sensitive interventions including
agriculture; family planning; water, sanitation and hygiene; &
education.
Credit:AllanGichigi,MCSP
NUTRITION
ADDRESSING THE MAJOR CAUSES OF MORTALITY
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16. Office of Health Systems
“In partnership with the public and private
sectors, we seek to ensure affordability,
quality and delivery of health services in an
equitable and sustainable manner,
ultimately protecting people against
unforeseen shocks.”
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• “A health system is a local system
made up of all people, institutions,
resources, and activities whose primary
purpose is to promote, restore, and
maintain health.”
• USAID provides technical assistance to
help countries identify and take
ownership for investments in their
health systems.
• We invest in HSS because it is
foundational for achieving our priority
health goals.
USAID VISION FOR HEALTH SYSTEMS
STRENGTHENING

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FROM CORE FUNCTION TO OUTCOMES
USAID’s Vision for
HSS Outcomes
OHS Mechanisms HSS Impacts
Resource
Optimization
Equity
Quality
Medicines, Technologies, and
Pharmaceutical Services
(MTaPS)
Integrated Health Systems
IDIQ and TO1
Promoting the Quality of
Medicines
HSS Accelerator
Human Resources for Health
2030
Improvements in
Health for PCMD,
CHAE, and CIDT
Sustained
improvements in
health system
performance and
country self-
reliance
Scaling up what works in HSS
Ensuring Essential Health System
Inputs
HSS Functions
Leadership and
Governance
Finance
Human Resources
for Health
Medical Products,
Vaccines, &
Technologies
Service Delivery
Health Information

19. USAID’s former Health Finance and Governance Project created several tools to share lessons learned
on civil society engagement and governance, and in partnership with USAID’s ASSIST project, on
quality:
• https://www.hfgproject.org/tools-civil-society-health-governance/
• https://www.hfgproject.org/governance-to-improve-the-quality-of-health-services-a-research-agenda/
Examples of OHS Program Partnerships with Faith-Based Organizations:
• In Tanzania in FY17, the ASSIST program provided technical support to MOHCDGEC (government) structures,
regional IPs, faith-based organizations, and community groups to apply quality improvement methods towards
attaining PEPFAR 3.0 and UNAIDS 90-90-90 goals on achieving HIV epidemic control.
• In Lesotho in FY16, as a part of strengthening the linkages along the PMTCT continuum of care, USAID worked with
12 facilities including four faith-based facilities to increase the percentage of mother-baby pairs that are retained in
care from 20% in February 2014 to over 90% in February 2016, and in the percentage of mother-baby pairs receiving
standard package of care, from 20% in May 2014 to almost 100% in Feb 2016.
• HRH2030, with funding from PEPFAR and USAID, is working with the Ministry of Health (MOH) of Malawi and the
Christian Health Association of Malawi (CHAM) to strengthen the health system by increasing the supply and
distribution of human resources for health (HRH) through existing systems targeting HIV/AIDS. Through this work 300
health care workers were retained and managed in 63 PEFAR priority sites in Lilongwe and Zomba districts and more
work to sustainably manage health workers continues in partnership with the Ministry of Health.
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Tools and Examples:

20. The Office of Population and
Reproductive Health (PRH)
Improving the Healthy Timing and
Spacing of Pregnancies
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Voluntary Family Planning is a Key Intervention
for Health and Development and Self-Reliance
Social & economic
benefits
▪ Improves women’s
opportunities
▪ Improves family well-
being
▪ Mitigates adverse effects
of population dynamics
on
o Natural resources,
including food & water
o Economic growth
o State stability
▪ Reduces maternal
mortality/morbidity
▪ Reduces infant
and child mortality
▪ Reduces abortion
▪ Key intervention in
HIV settings e.g.
PMTCT
Health benefits
Enable women and
couples to decide
number, timing and
spacing of births
Principles of voluntarism and
informed choice are
fundamental

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The Countries Where We Work Have Young
Populations

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PRH Results
Framework
Goal: To enable countries to meet the family planning
needs of their people
PRH Strategic Objective:
Advance and support voluntary family
planning/reproductive health programs
worldwide
Intermediate Result 1:
Global leadership demonstrated in
FP/RH policy, advocacy and
services
Intermediate Result 2:
Knowledge generated, organized
and disseminated in response to
program needs
Intermediate Result 3:
Support provided to the field to
implement effective and
sustainable FP/RH programs
High-level Outcomes:
1. Increased availability of high quality FP
services
2. Increased demand for FP information and
services
3. Increased domestic financial contribution
to FP programs

24. 1. Increased availability of high quality Family Planning services
i. Method choice
ii. Supply strengthening
iii. Family Planning workforce
iv. Total market approach
2. Increased demand for Family Planning services, especially among youth
i. Social behavior change
ii. Total market approach
iii. Family Planning workforce
3. Increased domestic financial contribution to Family Planning programs
i. Total market approach
Underpinned by policy, research, monitoring and evaluation. Gender and youth are cross-cutting.
Outcomes encompass the focus areas
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25. Center for Innovation & Impact
“Business-minded approaches to the
development, introduction and scale-up of
health interventions to accelerate impact
against the world's most important health
challenges.”
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Center for Innovation and Impact (CII) Overview: Supporting
innovation and scale-up for USAID’s global health priorities
Role
Approach
What we do
Accelerate the development, introduction and scale up of priority global
health interventions
Catalyze
Innovation
Scale for
Impact
Identify +
Apply Cutting-
Edge Practices
Promote and reinforce innovative, business-minded approaches to address
key bottlenecks in development, introduction and scale up

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How can I work with CII?
CII is part of the Global Health Bureau Front Office and supports all global health related work across the
Agency.
Our Market Access Team provides support on strategic planning, market shaping, innovating financing, digital
health, and human centered design.
This team has access to several mechanisms that can be leveraged including:
• Scale for Impact for strategic planning, market shaping
• Invest+ for innovative financing projects
• Digital Square for digital health projects
• Engage Design for human centered design projects
Our Innovation Team identifies new innovations through 3 main Grand Challenges For Development (each
issued a BAA and resulted in over 150+ awards) and provides hands-on support to these innovators to scale:
• Saving Lives at Birth
• Fighting Ebola
• Combating Zika and Future Threats
If you are interested in working with CII or have any questions, please reach out to cii@usaid.gov

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Example of CII’s work—Blended Finance for Global
Health
• CII recently developed a Blended
Finance Roadmap, to support and
strengthen the capacity of our Missions,
to leverage additional private capital for
global health
• The Roadmap is a six-step process that
the Mission can walk through to identify
blended finance opportunities to
achieve its health goals
• Blended finance is the use of public or
philanthropic resources to mobilize new
private capital for development
outcomes
Report available for download @:
www.usaid.gov/cii

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Case Study: Blended Finance for Global Health in
Tanzania
• The Government of Tanzania is increasingly moving towards supporting the public sector
as the primary health care provider
• The expansion of the public system is a long process, and other providers, including
FBOs, still form a crucial link to service delivery for low income populations
• The Government is also actively rolling out a national health insurance program, ensuring
access to services for patients at qualifying healthcare facilities, including FBO run
facilities
• However, FBO run facilities are currently unable to provide uninterrupted services due to:
– Shift of government funds towards public facilities
– Stockouts and shortages of drugs at FBO facilities
– Difficulty in paying utilities and staff salaries affecting service delivery
• CII, in partnership with USAID/Tanzania, explored the role that blended finance could
play in helping to sustainably address the financing challenges FBO run health facilities
are currently facing

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Case Study: Blended Finance for Global Health in
Tanzania

31. THANK YOU!