CLAimHealth - pdf.usaid.gov

CLAimHealth: Collaborating, Learning, and Adapting for Improved Health Activity Quarterly Progress Report: Quarter 2, Year 3 For the period January 1, 2020 – March 31, 2020

April 30, 2020/Revised June 29, 2020 DISCLAIMER The authors’ views expressed in this document do not necessarily reflect the views of the United States Agency for International Development or of the United States government.

PANAGORA GROUP

ii | CLAIMHEALTH QUARTERLY PROGRESS REPORT – Q2 Y3

This document was produced for review by the United States Agency for International Development. It was prepared by Panagora Group for the USAID/Philippines Collaborating, Learning, and Adapting for Improved Health (CLAimHealth) Activity, IDIQ No. AID-OAA-I-15-00025, Task Order No. 72049218F00001 as a Management Report per Section F.6 (a) and therefore uses the Panagora Branding per the CLAimHealth Branding and Marking Plan. Recommended citation: USAID Collaborating Learning and Adapting for Improved Health (CLAimHealth) Activity. 2020. Quarterly Report, Quarter 2, Year 3. Silver Spring, Maryland: Panagora Group. Panagora Group Contact:

Chief of Party 23/F Tower 1, The Enterprise Center Makati City 1200, Philippines

PANAGORA GROUP

iii | CLAIMHEALTH QUARTERLY PROGRESS REPORT – Q2 Y3

CONTENTS 1. Activity Overview .................................................................................................................................. 1

1.1. Activity Information ................................................................................................................. 1

1.2 Activity Description .................................................................................................................. 1

1.3 Key Achievements for the Quarter ........................................................................................... 2

2. Performance Status ............................................................................................................................. 5

2.1 Summary of Performance for the Quarter .............................................................................. 5

2.1.1 Monitoring and Evaluation ...................................................................................................... 5

2.1.2 Building the Evidence Base ...................................................................................................... 9

2.1.3 Learning & Adapting Activities ............................................................................................... 11

2.2 Matrix of Key Activities Accomplished vs. Planned Activities for the Quarter ..................... 16

3. Key Challenges and Proposed Solutions .......................................................................................... 24

4. Cross-cutting Issues ........................................................................................................................... 26

4.1 Update on Gender .................................................................................................................. 26

4.2 Update on Family Planning Compliance ............................................................................... 26

4.3 Update on Environmental Compliance and Climate Risk Mitigation ................................... 26

5. Management, Administrative, and Financial Issues ......................................................................... 27

5.1 Management and Administrative Matters ............................................................................. 27

5.2 Financial Matters and Contract Deliverables ........................................................................ 28

5.3 Change in TOCOR and TOCO ................................................................................................. 28

6. Planned Activities for Q3 Y3 ............................................................................................................... 28

7. Annexes .............................................................................................................................................. 33

7.1. Data Quality Assessment Quick Reference Guide (January 2020) ....................................... 33

7.2. Third-Party Monitoring Report for the TB Platforms Activities in Marawi City (January 13 – 17, 2020) ................................................................................................................................. 33

7.3. Continuous Evaluation of TB Platforms Activities in Marawi City, Monthly Report (February 2020) ....................................................................................................................................... 33

7.4. CLAimHealth’s Priority Activities in Response to the COVID-19 Pandemic (April 9, 2020) .. 33

7.5. Progress on CLAimHealth’s Activity MEL Plan ...................................................................... 34

7.6. Financial Information ............................................................................................................. 42

PANAGORA GROUP

iv | CLAIMHEALTH QUARTERLY PROGRESS REPORT – Q2 Y3

ACRONYMS 3Ms Midwife Mentoring and Monitoring Program, CMSU2 AAR after-action review ACF active case finding A/COR Agreement/Contract Officer’s Representative AI artificial intelligence AMELP activity monitoring, evaluation, and learning plan AMS adaptive management session ARH adolescent and reproductive health AWP annual work plan BARMM Bangsamoro Autonomous Region in Muslim Mindanao BARMMHealth BARMM Health Capacity Building CBDR community-based drug rehabilitation CD clinically diagnosed (TB) CDCS Country Development Cooperation Strategy CE continuous evaluation CHO City Health Office CIP Costed Implementation Plan (for FP Program), DOH CLA collaborating, learning, and adapting CLAimHealth Collaborating, Learning, and Adapting for Improved Health CMSU2 Community Maternal, Neonatal, Child Health & Nutrition Scale-up Follow-on CommS Communications Specialist COP Chief of Party COVID-19 coronavirus disease in 2019 CU current user CY calendar year CYP couple-years of protection DCOP Deputy Chief of Party DMAS Data Management & Analysis Specialist DOH Department of Health DQA data quality assessment FP family planning FY fiscal year GBV gender-based violence GoP Government of the Philippines GPPI good practices and promising interventions HCW health care worker HP Health Project, USAID Office of Health HPPE health project performance evaluation HPPI health project performance indicators HRH2030 Human Resources for Health in 2030/Philippines ICV informed choice and voluntarism IHLGP Institutionalization of the Health Leadership & Governance Program IMAP Integrated Midwives Association of the Philippines IP implementing partner J2SR Journey to Self-Reliance KII key informant interview KL Knowledge Library, USAID Office of Health KM knowledge management

PANAGORA GROUP

v | CLAIMHEALTH QUARTERLY PROGRESS REPORT – Q2 Y3

LCBS Learning and Capacity Building Specialist LCE local chief executive LGU local government unit M&E monitoring & evaluation mCPR modern contraceptive prevalence rate MEL monitoring, evaluation, and learning MELC MEL coordinator MNCHN maternal, neonatal, & child health & nutrition MOP manual of procedures MTaPS Medicines, Technologies, and Pharmaceutical Services NDHS National Demographic and Health Survey NOH National Objectives for Health NTP National TB Control Program OH Office of Health, USAID P&R pause-and-reflect (session) PHO Provincial Health Office PIR program implementation review PIRS performance indicators reference sheet PITT performance indicators tracking tool PMP Performance Management Plan POPCOM Commission on Population and Development PPR Performance Plan and Report ProtectHealth Health Equity and Financial Protection Platform ReachHealth Family Planning and Maternal and Neonatal Health Innovations and Capacity

Building Platforms RenewHealth

Expanding Access to Community-based Drug Rehabilitation Program in the Philippines

RHU Rural Health Unit SBCC social and behavior change communications SELAS Senior Engagement, Learning, and Adapting Specialist SMES Senior M&E Specialist SO strategic objective SOW scope of work SRLS Senior Research & Learning Specialist SSV+ Supportive Supervision Plus, CMSU2 STTA short-term technical assistance TA technical assistance TB tuberculosis TB IHSS TB Innovations and Health Systems Strengthening TB Platforms TB Platforms for Sustainable Detection, Care, and Treatment TOCO Task Order Contracting Officer TOCOR Task Order Contracting Officer’s Representative TPM third party monitoring TPT TB preventive treatment TWG technical working group UHC Universal Health Care USAID U.S. Agency for International Development WRA women of reproductive age

PANAGORA GROUP

3 | CLAIMHEALTH QUARTERLY PROGRESS REPORT – Q2 Y3

● Initiated using Zoom as the main virtual learning and coordination platform for CLA activities to continue in the setting of the enhanced community quarantine (ECQ) due to corona virus disease in 2019 (COVID-19).

● Supported IHLGP to identify potential GPPIs and to design their turnover events. Assisted TB Innovations and Health Systems Strengthening (TB IHSS) to design and conduct a Zoom webinar on the key findings and recommendations from the TB IHSS TB & Gender Analysis on March 31, 2020.

● Supported the OH in designing and conducting seven P&R sessions on various topics.

● Conducted four learning events to strengthen capacity. ● Supported the OH in organizing seven (7) adaptive management activities: FP

Portfolio Meeting (1), TB Portfolio Meeting (3), 6th CLA Technical Working Group (TWG) meeting, Chief of Party (COP) Meeting (1), Adaptive Management Session (AMS) for HSS (1).

We submitted one management report and five technical deliverables to the OH during Q2 Y3:

● DQA Quick Reference Guide – submitted on January 10, 2020 ● Final Revision of the FY2020 Annual Work Plan (AWP) and Budget (including AMELP) –

submitted on January 17, 2020 ● Q1Y3 Progress Report – submitted on January 31, 2020 ● Final TPM report for January 2020 - submitted on February 14, 2020 ● Updated HP MEL Plan, Learning Plan, Capacity Building Plan, and Dissemination Plan –

submitted on March 4, 2020 The following activities planned for Q2 Y3 were delayed or deferred due to factors described below:

● Addition of Health Project Performance Indicators (HPPIs) into the HP results framework for the following areas: community engagement, health-related indicators for the new CDCS and PMP, and community-based drug rehabilitation (CBDR) because the new CDCS-related indicators were still under discussion and RenewHealth had not yet shared its revised AMELP.

● Final research outputs from participants of the 2017 NDHS secondary data analysis workshop because of competing priorities within POPCOM.

● Conduct of implementation research due to needing further discussions with OH and IPs on the implementation of the Universal Health Care (UHC) Law and subsequently implications of SARS-COV-2 pandemic on all IP efforts.

● Initial work on the proposed CLA Awards due to giving way to other more pressing CLA activities, such as providing guidance to the IPs on identifying and documenting GPPIs, redesigning the OH Knowledge Library (KL), and producing the next issue of the CLA Bulletin.

● Launch of an online seminar based on IHLGP’s experience in engaging LCEs due to the need to redesign the contents and structure of the learning material to more effectively capture the attention of the target audience and achieve the learning objectives.

● Submission of HPPE due to challenges arising from the change in reference period (from FY to CY), reported performance data of the FP portfolio, and adjustments prompted by the COVID-19 response.

● Submission of a video slide presentation on engaging LCEs based on IHLGP’s experience due to awaiting feedback/inputs of IHLGP on the video slide presentation.

● Updating the FP Baseline Report will be carried over to Q3 due to the delay in our access to the BARMMHealth Baseline Report, which was shared with us in mid-March.

PANAGORA GROUP


● Resubmission of two GPPI briefers because these are under revision according to recent comments from OH.

● Conduct of a webinar on Digital health financing with CommonHealth was moved by OH to May 2020 submission of papers from the Secondary Data Analysis of the 2017 NDHS because the participants were preoccupied with other responsibilities at POPCOM.

We describe these activities in Section 2.2, Table 3.

PANAGORA GROUP


● Conducted validation of data on FP users and commodities in Laguna, specifically at the Laguna provincial health office (PHO) and two (2) selected rural health units (RHUs). The data validation report has been submitted to and acknowledged by OH.

● Consolidated and verified IPs’ progress data (FY 2019 Annual Reports and the Q1 Y3 Quarterly Progress Reports) as input to the CY 2019 Health Project Performance Evaluation (HPPE), to be submitted in mid-April 2020.

● Coordinated with TB Platforms for the TPM and CE of their activities in Marawi City; held an after-action review (AAR) with OH and TB Platforms.

We detail our main accomplishments related to M&E below: Updated HPPIs (AWP Y3 Activity 1.1). We updated the HP MEL Plan with HPPIs based on agreements from the 6th CLA TWG Meeting conducted in January 2020. We also supported the OH in streamlining and operationalizing OH-assigned shortlisted PMP indicators for the new CDCS. For the 13 CDCS indicators, we drafted the corresponding PIRS and conducted a learning session on two (2) indicators on civil society engagement (CSE) with the OH and IPs representatives. Updated Baseline Report and Target-setting for FP/ARH indicators (AWP Y3 Activity 1.3). Upon the request of OH, we developed a method of estimating targets for FP Portfolio activities based on the DOH CIP in January 2020. We computed ReachHealth and BARMMHealth targets for CYP and FP new acceptors based on the DOH-CIP 2020-22 targets and FP method mix to reach National Objectives for Health (NOH) target of 30% modern Contraceptive Prevalence (mCPR) among women of reproductive age (WRA). Thus, we were able to provide Current FP User, New Acceptor, and CYP targets for FY 2020 – FY2022 based on the CIP to ReachHealth and BARMMHealth through OH. On March 26, 2020, OH noted that the CYP targets based on the CIP were not consistent with the FY 2020 target submitted by OH for the Performance Plan and Report (PPR) in FY 2019 that was based on ReachHealth’s baseline data. In March 2020, OH also directed CLAimHealth to update the Phase 2 Baseline Report using final ReachHealth baseline data and the updated baseline data from BARMMHealth. Work on updating the FP Baseline Report this quarter has been delayed and will be carried over to Q3. This is due to the delay in our access to the BARMMHealth Baseline Report, which was shared with us in mid-March. For target-setting, upon the request of OH, the CYP targets we computed in Q1 were revisited with the availability of the DOH CIP for the FP Program. We computed ReachHealth and BARMMHealth targets for CYP and FP new acceptors based on the DOH-CIP 2020-22 targets and FP method mix to reach NOH target of 30 percent mCPR among WRA. Updated HP MEL Plan (AWP Y3 Activity 1.4). In Q2 Y3, we revised the HP MEL Plan for Y3 that we submitted to OH on August 2, 2019. Revisions to the HP MEL Plan included updates on the HPPIs, Learning Plan, Capacity Building Plan, and Dissemination Plan. We submitted the updated HP MEL Plan to OH on February 20, 2020 but received feedback from the TOCOR that we needed to expand all four plans to adopt the OH and whole-of-project perspective and further update these plans. These expanded and revised plans will be submitted in April 2020.

PANAGORA GROUP


DQA Plan and Tools (AWP Y3 Activity 1.5). We submitted the DQA Quick Reference Guide to OH on January 10, 2020 (see Annex 7.1). We also supported OH in planning and initiating the conduct of DQA through the presentation of the DQA Quick Reference Guide during the OH P&R session on DQA and during OH’s initial DQA meeting with ReachHealth. During the OH P&R session on March 9, 2020, OH discussed the following: (1) DQA schedule for the HP standard indicators; and (2) data quality issues arising from the change of data collection methodology for Average Stockout Rate and Percent of Service Delivery Sites Providing FP Services to random sampling. During this OH P&R session, the OH tasked CLAimHealth to assist in the selection of BARMMHealth sites for DQA and Informed Choice and Voluntarism (ICV) compliance monitoring. On March 16, 2020, we had an online DQA learning session with the AORs where we reviewed USAID guidance on DQA and then conducted a short DQA simulation. Materials of the learning session on DQA were again presented during the DQA session with ReachHealth on March 26, 2020. The OH and ReachHealth levelled off on the objectives for stockout and service delivery site indicators such that ReachHealth agreed to revert to the data collection method used previously by the LuzonHealth project. That is, 25 percent of facilities shall be visited, and the remaining 75 percent of facilities shall be monitored through phone each quarter, such that all facilities would have been visited by the end of the fiscal year. CLAimHealth is currently working with BARMMHealth and OH in selecting sites to undergo DQA and ICV monitoring. Data Validation. We validated FP user data in Laguna where we visited the provincial health office (PHO) and two rural health units (RHUs) on January 9 – 10, 2020. Key findings from the data validation activity in Nueva Ecija and Laguna included issues on logistics, commodities management, and knowledge and training of health providers in FP data reporting and recording. Logistics issues included: (1) mismatch of commodities delivered to the PHO to actual needs of the province; (2) lack of transportation services; and (3) delays in submitting reports to the PHO. Training and knowledge gaps of health providers in FP data recording and reporting included: (1) lack of training of health providers in recording and reporting FP data through Field Health Service Information System (FHSIS) 2018 Manual of Procedures (MOP); and (2) gaps in determining and classifying new acceptors for some methods. Key findings in commodities management included: (1) lack of training of some staff in stock management; and (2) inconsistencies in the order point for commodities in some facilities. We have drafted the Activity Report for the data validation in Nueva Ecija and Laguna and will submit the full report in early April 2020. Consolidation of Year-end HP Performance Data (AWP Y3 Activity 1.6). In a meeting with CLAimHealth’s Task Order Contract Officer’s Representative (TOCOR) held on December 12, 2019, the TOCOR recommended the merging of the year-end HP performance data consolidation report (Deliverable 1.6) with the year-end HPPE, Deliverable 2.1. The TOCOR also recommended that, henceforth, the HPPE would cover CY periods (i.e., CY 2019: January – December 2019) instead of the US government’s fiscal year (FY) (i.e., FY 2019: October 2018 – September 2019). This would allow for a

PANAGORA GROUP


better alignment with the PIRs conducted by the Government of the Philippines (GoP) agencies, which are based on CY periods.

In Q2, we consolidated and triangulated data from IPs’ FY2019 Annual Reports and Q1 FY2020 progress reports for the 2019 HPPE, which we will submit to OH in mid-April 2020. We consolidated HPPIs for TB and FP indicators for all the quarters in FY 2019 and Q1 of 2020. For the FP Portfolio, we liaised with the FP Portfolio Activities through email and face-to-face consultations to clarify and verify data extracted from their progress reports. We were able to verify the data with ReachHealth, but we have yet to receive validated data from BARMMHealth.

We will submit the HP consolidated data for FY 2019 and Q1 FY 2020 as part of the HPPE in mid-April 2020.

TPM visit in Marawi City for TB Platforms activities (AWP Y3 Activity 1.7). We conducted the TPM activity in Marawi City from January 13 – 17, 2020, which included visits to the Marawi City Health Office (CHO) and the Amai Pakpak Medical Center. We observed the Marawi City data quality check (DQC) activity and joint PIR with TB Platforms. Key findings of the TPM included: (1) gaps in knowledge of staff on National TB Control Program (NTP) protocols resulting in decisions inconsistent with the NTP MOP; (2) improper and incomplete documentation in patient registers; (3) high percentage of clinically diagnosed (CD) cases; and (4) low yield of active case finding (ACF) activities, with only one bacteriologically confirmed (BC) patient and 19 CD patients identified out of 1,200 individuals screened during the ACF.

We submitted the final TPM report to OH on February 14, 2020 (see Annex 7.2). On March 3, 2020, OH, TB Platforms, and CLAimHealth held an AAR, resulting in agreements and action points based on the key findings from the TPM. We will continue to coordinate with OH and TB Platforms to monitor implementation of the actions/interventions agreed upon during the AAR. We will validate the progress of implementation of these agreements with OH and TB Platforms during the third TPM visit, which is scheduled in June 2020.

CE of Marawi-based activities for TB Platforms (AWP Y3 Activity 1.7). Our two short-term technical assistance (STTA) consultants, , visited Marawi City on February 10 – 12, 2020 to conduct CE in coordination with the TB Platforms Activity. They observed two TB Platforms activities: (1) orientation of health care workers (HCW) of Marawi CHO for the community-based mass screening activity for TB; and (2) house-to-house case finding for TB. They submitted an initial feedback report and a final report that we shared with OH and TB Platforms (see Annex 7.3).

Together with OH, TB Platforms, and , we conducted an AAR on March 3, 2020 where the CE findings were discussed, and agreement was reached for TB Platforms to identify and document potential GPPIs arising from the CE activities. Specifically, TB Platforms shall ensure full documentation of the three interventions (ACF, Intensive Case Finding (ICF), and House to House visits) to support potential GPPI Case documentation and to facilitate replication in other sites. The documentation shall contain a detailed description of the protocol (how-to) of the packaged learning materials, tools, and templates, the results across the cascade of care and an analysis of (cost) effectiveness. As approved in our Y3 Work Plan, this CE activity conducted in February 2020 is the last

PANAGORA GROUP


CE of the TB Platforms activities in Marawi. However, there will be one last TPM visit in June 2020 unless COVID-19 community quarantine and/or security issues arise.

2.1.2 Building the Evidence Base In Q2 Y3, we carried out the following activities in line with SO-2 (strong technical evidence base):

● Consolidated, analyzed, and triangulated IPs’ progress data for the CY 2019 HPPE. Conducted key informant interviews (KIIs) and focus group discussions (FGDs) and identified qualitative themes.

● Revised two GPPI briefers on FP in Hospitals and IMAP’s J2SR. ● Developed draft concept notes for two new GPPIs from IHLGP and CMSU2. ● Continued discussions with OH and IPs on the changing focus of CLAimHealth’s potential

implementation research. ● Identified an additional topic for secondary data analysis on unmet need among postpartum

women. ● Supported POPCOM staff in checking data runs and completing their secondary data analysis

of the 2017 NDHS. We further discuss these activities below. HPPE (AWP Y3 Activity 2.1). In Q2 Y3, we completed a first draft of the final HPPE, with the submission to OH expected in mid-April 2020. As discussed in Section 2.1.1, this year’s HPPE evaluation period covers CY 2019. This means the report this year covers five quarters: October 2018 – December 2018 (which was not reported in the HPPE FY2018) and January – December 2019. To report performance with respect to stated targets, we analyzed the OH PPR, performance indicator tracking table (PITT), and special surveys described in IPs’ quarterly and annual reports. To provide context and offer additional points of comparability, we also analyzed available data from the Philippine Statistics Authority, DOH, other government administrative data sources, and the Philippine TB project supported by the Global Fund to Fight AIDS, TB and Malaria. To obtain qualitative information, we conducted a desk review of relevant documents, KIIs, and FGDs among selected government officials, service providers, and clients. Identified themes from the qualitative data and information were particularly valuable in measuring the relevance of the HP to partners, clients, and patients, and the impact of HP Activities on local health systems, governance, and sustainability. GPPI Documentation (AWP Y3 Activity 2.2). This quarter we finalized two GPPI briefers (FP in Hospitals and IMAP’s J2SR), incorporating substantial comments from AORs, ReachHealth, BARMMHealth, and CMSU2 to create collaborative and usable products. Over the course of the revision process, we were able to incorporate the most recent information and strategies while honing down text for a concise, visual, and reader-friendly product for use by IPs and stakeholders at the local level. Through this collaborative process, we also learned and adapted with OH to create a system of consolidating major points of feedback from OH, in order to incorporate all comments and streamline the overall revision process. In Q2 we also began drafting a third GPPI briefer, the Program for Young

PANAGORA GROUP


Parents, and we are using feedback from previous briefers to create a similarly styled product, which will be submitted for OH review in Q3. The remaining two briefers for this fiscal year will cover our new GPPIs from IHLGP and CMSU2 and will be finalized and submitted in Q4. This quarter, we also drafted two GPPI concept notes: CMSU2’s combination intervention of the Midwives Mentoring and Monitoring (3Ms) Program and Supportive Supervision Plus (SSV+), and IHLGP’s strategies of engagement of LCEs to effect health system change. These concept notes will be submitted by May 2020 for OH review. After OH approval, we will engage STTA consultants to conduct the GPPI documentation. In Q3 we will also be working with OH and IPs to use our GPPI criteria to systematically identify any additional potential GPPIs on ensuring continuity of FP, TB, HSS, and/or CBDR efforts in the context of the COVID-19 epidemic. Lastly, we continued the process of working with IPs to establish real-time monitoring of GPPIs, including discussions with ReachHealth regarding FP in Hospitals, Usapan, and FP in the Workplace. An in-depth meeting on the interventions, including discussions on plans for answering OH learning questions, measurement of effectiveness, and sharing results over time, was postponed to later in Q3, due to the COVID-19 epidemic. Real-time documentation of IPs’ GPPIs may also partly shift in focus to responsiveness of interventions to the COVID-19 epidemic and IP efforts to ensure continuity of FP and TB services. CLAimHealth will continue to work with IPs to share with OH and other IPs relevant challenges, progress, and lessons learned from potential GPPIs. Guidance, feedback, and sharing of ideas may happen through learning forums (e.g., the CLA TWG, smaller roundtable discussions, or specific learning sessions on this topic). As in Q1, consultations in Q2 regarding real-time monitoring of GPPIs have proceeded more slowly than originally expected due to budget constraints, work plan approvals, and now the COVID-19 epidemic. Implementation/Strategic Research (AWP Y3 Activity 2.3). As of the end of Q1 Y3, we were awaiting guidance from OH on which direction CLAimHealth should pursue in its UHC implementation research for Y3. In February 2020, after conversations with OH and IPs at the ProtectHealth roundtable discussion on Universal Health Care (UHC) implementation, we received general support for the idea that CLAimHealth could potentially conduct IR that supports a "community of practice" among all IPs, systematically documenting process and producing the kinds of iterative, qualitative lessons learned that would be relevant to share – in real-time – across all IPs, as they are working in their respective areas. We were in the process of following up on the progress of UHC implementation research of the other IPs and developing this concept note when the COVID-19 pandemic escalated. We must now consider UHC support in the context of the COVID-19 crisis, and the fact that our support to health systems pre-COVID and post-COVID will no longer be the same. As of March 2020, we are now considering alternative implementation research activities regarding IP efforts in the context of the COVID-19 pandemic. How will IPs work with government at the national and local levels, CSOs, and the private sector to: (1) ensure continuity of FP, TB, CBDR, and HSS efforts and services; and (2) support the GoP in its mitigation efforts against COVID-19? With the support of OH, we may choose to track IP efforts and extract lessons learned from this adaptive process. What are the iterative, qualitative lessons learned that will be relevant and valuable to share across all stakeholders, as they are working in their respective fields and locations? How will these shared lessons contribute to achieving the goals of FP and TB service provision and supporting the health system in the time of COVID-19? Lessons and experiences systematically captured and shared (in the

PANAGORA GROUP


form of technical advisories or presentations at virtual stakeholder meetings, for example) may serve as the basis for further discussion, guidance, and action by the GoP and its stakeholders. With further conversations and guidance from OH, we can collaborate with other IPs, finalize a scope of work, and subsequently launch the search for an institutional partner that is best prepared to conduct implementation research in collaboration with CLAimHealth and other participating IPs. Secondary Data Analysis (AWP Y3 Activity 2.4). As we worked on the FP in Hospitals briefer in Q2, we noted that the number being used as an estimate of unmet need among postpartum women is quite dated, circa 2001, and quite high, citing 66 percent of postpartum women. A more recent global estimate of 61 percent is not specific to the Philippines. We posed the question: What is a more accurate and more recent estimate of unmet need of postpartum women in the Philippines, and why is this important? An up-to-date, accurate estimate is a fundamental component of justifying the need for interventions for postpartum women and for estimating the percent unmet need that OH FP interventions (e.g. FP in Hospitals) may be addressing. With submission of a formal concept note and official approval from OH in Q3, we plan to use a revised definition of unmet need to create new estimates of the percent of postpartum women with unmet need for contraception based on data from the 2013 and 2017 NDHS. We will also analyze pregnancy spacing, unmet need for spacing and limiting, factors influencing return to fertility, method mix, and uptake of FP by place of delivery. In addition, we will analyze reasons for nonuse among postpartum women. We plan to circulate results of this analysis via a concise briefer and a learning and dissemination forum planned for Q4. Currently no other secondary data analyses are planned, but additional learning on FP, TB, and/or HSS may be done within the FY as datasets become available (e.g. 2019 National Drug Resistance Survey on Tuberculosis). DHS Further Analysis Workshop (AWP Y3 Activity 2.4). We received the revised outputs of the DHS Further Analysis workshop participants from POPCOM in February 2020, two months after the original deadline for submission of December 2019. Competing priorities from their main tasks at POPCOM caused delays in their data analyses and write-ups after the workshop. We reviewed and returned the papers to POPCOM with our comments and further suggestions in March 2020. Noting their delayed progress in developing their papers and considering that the papers returned to them still require substantial work, OH indicated during the TOCOR meeting on March 9, 2020 that CLAimHealth will no longer be required to submit the compendium of full papers. Instead, the TOCOR suggested that CLAimHealth develop a policy brief using key findings from the papers generated during the 2017 NDHS secondary data analysis workshops (to be submitted in Q3).

2.1.3 Learning & Adapting Activities In Q2 Y3, we organized and/or supported the conduct of the following key learning and adaptive management activities:

● AAR with TB Platforms on key recommendations from TPM and CE of TB activities in BARMM.

PANAGORA GROUP


January 7, 2020

FP Portfolio Meeting

The meeting agenda included: (1) updates on the revisions of the DOH Administrative Order on ICV compliance and the upcoming national FP conference; (2) private sector engagement opportunities focused on improving access to FP commodities; and (3) program implications of UHC.

January 8, 2020

COP Meeting The meeting agenda included: (1) the HP learning agenda; (2) feedback on PPR Indicators: FY 2019 performance and life-of-project targets; (3) USAID priority activities for the next 9 months to improve performance with respect to the TB and FP programs; and (4) key FY 2020 OH events and schedules for the HP calendar.

February 4–5, 2020

TB Portfolio Meeting CLAimHealth supported TB Portfolio in reviewing and enhancing the proposed TB Inventory Study protocol.

February 6, 2020

TB Portfolio Meeting CLAimHealth provided technical inputs in the harmonization workshop for USAID’s technical support to the NTP.

Communications and Dissemination Activities CLA Bulletin. The Q2 Y3 issue of the CLA Bulletin focused on work adaptations to the COVID-19 pandemic. The edition described key recommendations for work-from-home arrangements, including a comparison of popular web-based meeting tools

OH Knowledge Library. The relaunch of the enhanced OH KL in December 2019 sustained interest in accessing the site, with several IPs verifying their access credentials. Since the relaunch, the OH KL has tracked 73 active users, approximately at par with the users of the previous OH KL, with 421 visits and an average session time of 5 minutes. These usage statistics are high, given the small internal target audience of the OH KL. Overall, however, OH KL usage has declined significantly since the imposition of the EQC in March, presumably due to priority given to the COVID-19 response. On the other hand, the number of users outside of traditional working hours has climbed over the same period. Analytics also show that despite the OH KL’s added functionality even over mobile devices, 100 percent of KL users access the site via a desktop or laptop computer.

1 The CLA Bulletin issue is found in the OH Knowledge Library. Readers may contact CLAimHealth if they do not have authorized access to the OH Knowledge Library.

PANAGORA GROUP


4. CROSS-CUTTING ISSUES

4.1 Update on Gender Presentation of HP performance indicators related to gender. We continue to support OH and IP discussions on gender indicators. In the 6th CLA TWG in January 2020, OH updated IPs on the new set of mandatory gender indicators: (1) Number of people reached by a USG-funded intervention providing gender-based violence (GBV) services (e.g., health, legal, psychosocial counseling, shelters, hotlines); and (2) Number of persons trained with USG assistance to advance outcomes consistent with gender equality or female empowerment through their roles in public or private sector institutions or organizations. In subsequent OH P&R sessions for gender, the final set of gender indicators for the HP was agreed on:

● TB portfolio: (1) TB case notification rate, all forms (by sex) in USG-assisted sites; and (2) Percent of gender-friendly USG-assisted service delivery points.

● FP/ARH portfolio: (1) Number of people reached by a USG funded intervention providing GBV services (e.g. health, legal, psychosocial counseling, shelters, hotlines, other); and (2) Number of persons trained with USG assistance to advance outcomes consistent with gender equality or female empowerment through their roles in public or private sector institutions or organizations. The previous HP indicator on percent of men who support the use of modern contraception for themselves or for their partners in USG-assisted sites, was demoted to an Activity-level indicator, to be collected and reported by ReachHealth and BARMMHealth.

Facilitation of webinar on TB and Gender Analysis. As discussed in Section 2.1.3 on Learning and Adapting Activities, CLAimHealth facilitated the TB IHSS interactive learning session on March 31, 2020. TB IHSS presented the final results of its desk review and field-based study, which aimed to identify gender norms among a variety of stakeholders and decision-makers and to determine the gender dynamics among men, women, boys, and girls related to TB health-seeking behavior. Facilitation involved organizing and synthesizing results of break-out group discussions to identify next action steps. 4.2 Update on Family Planning Compliance Staff have begun completing the two required 2020 USAID Global Health online courses: US Abortion & FP Requirements 2020 (Revision 6) and Protecting Life in Global Health Assistance & Statutory Abortion Restrictions 2020 (Revision 4). All staff are expected to complete the 2020 training by the end of April 2020.

4.3 Update on Environmental Compliance and Climate Risk Mitigation The approved Initial Environmental Examination (IEE) under our contract is “Negative Determination with Conditions.” In Q2 Y3, we implemented all IEE conditions pertaining to activities funded under our Task Order. We also instituted and continue to follow environment-friendly measures in office operations as part of the Environmental Mitigation Plan.

PANAGORA GROUP


5. MANAGEMENT, ADMINISTRATIVE, AND FINANCIAL

ISSUES 5.1 Management and Administrative Matters STTA consultants. The CLAimHealth Office executed the following contracts: contract term extensions for to cover the extended period for CE work, given the delays in the TB Platforms activities in Marawi (security issues and extension of the DOH’s mass polio immunization); for the design and conduct of secondary data analysis workshops, training, and supervision of research outputs from workshop participants; and

for data validation of baseline data on FP. AO staffing. In our Year 3 workplan, we requested for one additional staff position for the LCBS. CLAimHealth’s achievements in fostering CLA practices has created a growing demand for TA in coordinating and facilitating inter-IP activities and supporting AOR-led learning sessions and Cluster meetings. The LCBS will work with the Senior Engagement, Learning and Adapting Specialist (SELAS) and the Monitoring, Evaluation and Learning Coordinator (MELC) to ensure that the activities related to SO-3, specifically the skills building sessions and other learning opportunities, are carried out in a timely manner. The LCBS is a full-time position that is planned until the end of the Panagora LLC contract with USAID in March 2022. The LCBS will have a yearly contract that will be renewable, depending on the USAID funding situation and performance. The LCBS is not a key position. This vacancy was posted in the Panagora website in December 2019 where it remained until mid-January 2020. There were 65 applicants who were screened based on competency and experience requirements. Following the recruitment and competitive selection process, we were able to select

as the LCBS. We agreed to defer his start date with CLAimHealth to May 4, 2020 to ensure a smooth leadership and management transition in the current Global Fund TB grant, which he has managed since 2014. CLAimHealth notified OH of recruitment on March 17, 2020. As part of USAID’s commitment to the Philippine Country Coordinating Mechanism (for Global Fund grants), OH requested the services of as a part-time USAID consultant to support the development of The Global Fund funding request for TB. During the quarter, from Panagora HQ were scheduled to visit Manila in March 2020 for the semi-annual supervisory review focused on management – work plan updates, contractual requirements, contract structure, staffing and administrative concerns, client check-in, and financial audit. This visit was cancelled due to COVID-19 and a virtual mid-year review will take place on May 14 – 15, 2020. As part of the national response to the COVID-19 epidemic, President Rodrigo Duterte declared the enforcement of ECQ for the main island group of Luzon (where Metro Manila is located). Thus, CLAimHealth staff have been working from home since March 16, 2020 and will do so until the ECQ is lifted.

7. ANNEXES

7.1. Data Quality Assessment Quick Reference Guide (January 2020)

7 .2. Third-Party Monitoring Report for the TB Platforms Activities in

Marawi City (January 13 -17, 2020)

CLAimHealth_Jan 2020TPM Marawi Re�

7 .3. Continuous Evaluation of TB Platforms Activities in Marawi City,

Monthly Report (February 2020)

CE_MONTHLY REPORT_26Feb2020 1

7.4. CLAimHealth's Priority Activities in Response to the COVID-19

Pandemic (April 9, 2020)

Revised CLAimHealth priority actions_COVII

33 I CLAIM HEAL TH QUARTERLY PROGRESS REPORT - Q2 Y3

Documents

CLAimHealth - pdf.usaid.gov