Supporting measurement &
improvement of primary health
care (PHC) at the facility and
community levels
Dr. Jennifer Adams,
Deputy Assistant Administrator,
Bureau for Global Health, USAID
Global and bilateral mechanisms are improving
primary health care through:
• Financial protection: Reducing financial barriers to
access essential life-saving services for the poor
• Essential services: Improving quality of care and scaling
up coordinated delivery of essential, evidenced-based
services;
• Population coverage: Ensuring that poor, underserved,
marginalized and vulnerable populations have equitable
access to essential health services
• Responsiveness: Assuring the dignity, confidentiality,
autonomy, quality and timeliness of services for poor and
marginalized populations
Facility teams independently monitor indicators
Acting on the Call: Ending Preventable
Child and Maternal Deaths (EPCMD)
• 24 priority countries
• 2.5 million more children surviving
• 200,000 maternal deaths averted
Ending Preventable Child and Maternal Deaths (EPCMD)
Roadmap to 2020
Annual
Reporting
Annualized Cycle of
Planning and Field
Support
Reporting Progress
Through
Acting On the Call
Leadership
Planning
Target
Setting
Single Roadmap Now Guiding USAID Efforts
EPCMD management
dashboards and
reviews
Strengthening prioritization and
transparency of goals and targetsetting for aligned action
Operationalizing field support through
mission visits to strengthen design efforts
and HIP/ OP development
Dashboa
rd
PPR &
HIP
Nov:
Dashboards
completed by
24 priority
Missions
Jan: PPR
Reviews &
HIP
Guidance
Released
Q
1
Acting
on the
Call
Report
HIP
June, July &
Aug:
EPCMD
Review of
24 Priority
HIPs
April 30:
Draft of AoTC
report,
Dashboard
Check in;
May: Finalize
Report
Q
2
PPR &
HIP
Mission
Visits
Oct: PPR
Guidance
Released and
Draft technical
considerations
for HIP; Dec:
PPR Due
Jan & Feb:
Mission
Visits to
support
writing the
HIP
Q
3
Q
4
Acting
on the
Call
Ministeri
al
Meeting
Dashbo
ard
Updated
Dashboard
for FY16
June: Annual
Meeting
Institutionalizing a culture of transparency /
visibility through annual performance
reporting
Setting activity targets and improving
tools to track progress and technical /
leadership capabilities
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USAID Missions’ Investments in
Newborn Health in EPCMD countries
Improving and advancing measurement
of health systems to improve PHC
Tools under development:
• Developing rapid assessment tool for checking
quality of medicines to reduce use of poor quality
medicine
• Promoting global benchmarking of health system
functions and performance through a health system
benckmarking tool to monitor performance
• Developing tool for better analysis of DHIS data for
measuring health system performance and
its correlates
The Community Health Framework
WHY should we care about community health?
Community health is foundational to attaining many of the SDGs.
WHAT is needed to create a strong community
health ecosystem?
An ecosystem of heath specific and health enabling actors and
structures, both formal and informal, working together and supported
by the agency, access, and resources needed to ensure the health of
community members:
• Agency, e.g., awareness of needs, empowerment, and incentives to
act;
• Access, e.g., access to care, access to referral systems; and,
• Resources, e.g., financial resources, medical suppliers.
DISTRICT /
NATIONAL
LOCAL
COMMUNITY
HOME
HEALTH
SPECIFIC
COMPONENTS
DISTRICT &
NATIONAL
CARE
COMMUNITY
LEVEL CARE
HOME LEVEL
PROVIDERS
COMMUNITY
MEMBERS
FAMILY
MEMBERS
LOCAL
COMMUNITY
DISTRICT &
NATIONAL
COMMUNITY
HEALTH
ENABLING
COMPONENTS
AGENCY
ACCESS
RESOURCES
HOW can we take action to strengthen community
health ecosystems?
A five step process can help leaders bring the right data to bear for
decision making, and set up sustainable community health programs
with clear accountability.
WHERE can we find examples of effective models
and innovations for community health?
This framework includes a library of existing models across each
component of community health as well as detailed case studies.
SET TARGET
OUTCOMES
UNDERSTAND
EXISTING
COMPONENTS
ANALYZE
BOTTLENECKS
DEVELOP OR
STRENGTHEN
PROGRAMS
IMPLEMENT,
MONITOR &
EVALUATE
TOOLKIT
8
This framework has been developed to support decision
makers in answering key questions about community health
The community health framework is intended to support Ministries of Health in developing and
strengthening programs for improved community health outcomes. The intention is for USAID
missions and other advisors to use the framework to structure a dialogue, develop
recommendations, and foster continuous learning with Ministries of Health.

The community health
framework does…
•
Bring together a wealth of existing
knowledge and models that articulate
components of community health
•
Provide a flexible framework for national level
diagnosis of needs and planning of actions
•
•

The community health
framework does not…
•
Serve as a strategy or action plan with
specific programs, targets, or budgets
•
Seek to provide a one size fits all view on
community health structures, programs, or
interventions
Enable a long-term view to planning and
developing strong community health outcomes
•
Represent an exhaustive list of actors, needs,
or opportunities
Allow for a “common language” with a
classification of interventions and tools
and the creation of a living and growing toolbox
•
Prescribe an impact measurement or
continuous learning agenda for countries
and programs
In the process of developing this framework, over 60 community health experts were interviewed and over 70 academic
articles, reports, and evaluations were reviewed.
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Measurement for
health summit
June 2015
Consensus
• Agree on priority actions
required to build robust
systems for monitoring
SDGs and national
priorities
• Address challenges
facing countries
(fragmentation, disjointed
efforts etc.)
Deliverables
• Common Roadmap and 5-Point
Call to Action:
• Increase level and efficiency of
investments
• Strengthen country statistical capacity
• Ensure well functioning population
health data
• Improve open facility and community
systems and disease surveillance and
admin data
• Enhance use and accountability
A way forward
• Greater partner
collaboration and joint
action
• Align and meet country
health priorities
Thank you
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