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Doris Duke Charitable Foundation African Health Initiative Population Health Implementation Training (PHIT) Planning Grant Team Project Summaries

through training as community health workers for the provision of basic health education and disease surveillance, 2) strengthening nursing education to bolster the provision of skilled community-based care, 3) improving efficiency of medication and supply chains for rural facilities, 4) improving transportation for emergency care, and 5) developing effective community support for health activities through village health committees and religious and community based organizations. We intend to develop a model that is replicable elsewhere in Malawi and other resource-poor rural settings.

Mozambique

Grantee Institution: Health Alliance International Team Leaders: Dr. Kenneth Gimbel-Sherr, Dr. Fatima Cuembelo Project Title: Strengthening Integrated Primary Health Care in Sofala Province, Mozambique

The Mozambique PHIT Partnership proposes to improve and integrate essential curative and preventive primary health care provision by strengthening district-level management and planning in the 13 districts of Sofala Province (estimated population 1.5 million). The project’s approach centers on 1) using on-the-job training and ongoing coaching to strengthen district-level management teams, 2) improve data utilization and decision-making around resource allocation through operations research approaches to model provincial and district systems in order to identify bottlenecks, gaps in service, and points in the system where further integration is needed, and 3) use innovative implementation research to develop and test new strategies to support service integration for improved service coverage and quality. Activities slated for the initial 6-month planning grant include district visits to assess the data environment and identify key management challenges and needs, mapping of resource flows from the national to health facility levels, interviews with policymakers and project stakeholders, and the development of an operations research model in one pilot district. The Mozambique Partnership is a joint effort between the Ministry of Health, Health Alliance International, the University of Washington Department of Global Health and Department of Industrial Engineering, and Eduardo Mondlane University.

Tanzania

Grantee Institution: Harvard School of Public Health Team Leaders: Dr. Wafaie Fawzi, Dr. Gernard Msamanga Project Title: Dar es Salaam Population Health Implementation and Training Partnership

Dar es Salaam is the most densely populated region in Tanzania and has significant gaps that need immediate attention in the primary healthcare delivery system. To strengthen primary care the Dar es Salaam PHIT will introduce three service delivery programs and one health systems strengthening (HSS) intervention. Hypotheses to be tested will include: (1) Mobile services delivered through a community-based health worker will reduce morbidity of pregnant women, newborns, and children; (2) A package of interventions for primary school children that include a new wellness curriculum and daily micronutrient supplementation will enhance the child’s development; (3) A non-communicable diseases (NCD) wellness intervention targeting adults will increase awareness about risk factors, methods of prevention and treatments for obesity, Type II diabetes, hypertension and stroke; and (4) Implementing best practices for high priority HSS activity areas will improve program process indicators and client outcomes. To test hypotheses, our team will use randomized controlled intervention designs for the three delivery programs and a non-randomized design with accompanying time series measures for the HSS intervention. Novel interventions will first be targeted in the Ilala district of Dar es Salaam, and lessons learnt will be shared with the two other districts in Temeke and Kinondoni.

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