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

Grantee Institution: JHPIEGO/Johns Hopkins University Team Leader: Sydney Ndeki Project Title: IMARISHA- Improving Regional Integrated Systems for Health Accessibility in Ruvuma, Tanzania

The partnership for Improving Regional Integrated Systems for Health Accessibility (IMARISHA), which means “to strengthen” in Swahili, will implement strategies to improve the delivery of primary healthcare in two of the most underserved and impoverished districts of Ruvuma region in Tanzania. IMARISHA will focus on delivering quality, integrated maternal, newborn and child health services and building the capacity of health systems at community, district, and regional levels. Furthermore, IMARISHA will test and evaluate three innovative approaches to advancing health services and systems. These include: (1) training and supporting volunteer community health workers to distribute essential drugs to villagers in their homes; (2) establishing a 24-hour referral and call center as a resource for frontline health workers; and (3) instituting a health worker recruitment and retention scholarship to increase the number of skilled providers in this remote location. Throughout the life of the program, IMARISHA will continuously evaluate and monitor the impact and cost-effectiveness of its program, sharing results and lessons learned nationally and internationally. The IMARISHA partnership is led by Jhpiego, an affiliate of Johns Hopkins University, in collaboration with the University of Dar es Salaam, the Christian Social Services Commission, and the Tanzania Ministry of Health and Social Welfare.


Grantee Institution: The University of Alabama at Birmingham

Team Leaders: Dr. Jeff Stringer, Dr. Moses Sinkala Project Title: Clinical Mentoring and Community Engagement to Improve Health Outcomes

We aim to improve MDG-related health outcomes in three largely rural districts in Zambia. Our approach centers upon the simple idea that good outcomes hinge critically on the provider-patient interaction. In recent years, vertical HIV treatment programs have shown that a focus on clinical services – strategically supported by health systems and community efforts

  • can produce measurable results. We will make a similar investment in delivery of primary care, focusing on rural areas.

Our activities will optimize the provider-patient interaction through a cycle of mentoring, measuring, and evaluating care. We will begin a long-term clinical mentoring relationship with primary care providers to improve clinical care skills. We will also develop standard clinical protocols, forms, and reporting tools to allow care to be measured and routinely evaluated.

Protocols, mentorship, and information gathering will extend to community health work. Clinical quality control and mentoring teams within the districts will lead activities, and districts will have incentives to support clinical care through performance-based financing. We will assess outcomes through community surveys and cost and quality of care through facility surveys.

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