Program Data Sheet
598-003

USAID MISSION: LAC Regional
PROGRAM TITLE: Health (Pillar: Global Health)
STRATEGIC OBJECTIVE AND NUMBER: More Effective Delivery of Selected Health Services and Policy Interventions, 598-003
STATUS: Continuing
PLANNED FY 2002 OBLIGATION AND FUNDING SOURCE: $ 9,029,000 CSH
PRIOR YEAR UNOBLIGATED AND FUNDING SOURCE: $600,000 CSD; $117,000 DA
PROPOSED FY 2003 OBLIGATION AND FUNDING SOURCE: $ 7,166,000 DA
INITIAL OBLIGATION: FY 1996     ESTIMATED COMPLETION DATE: FY 2004

Summary: The Latin America and the Caribbean (LAC) Regional Health program includes initiatives in: a) child survival, including vaccination, integrated management of childhood illnesses (IMCI), and nutrition; b) maternal mortality, c) HIV/AIDS; d) family planning; and e) anti-microbial resistance (AMR), malaria, and health sector reform.

Inputs, Outputs and Activities: FY 2002 Program: This program is being renotified because it is being extended to continue activities aimed at improving the delivery of health services and policy interventions in the Latin America and Caribbean (LAC) region. Although no funds were planned to be obligated beyond FY 2001, USAID will use Child Survival and Health (CSH) funds to implement the health program. USAID plans to provide technical assistance to Ministries of Health (MOHs) and non-governmental organizations (NGOs) to increase multi-sectoral approaches to child health; strengthen surveillance systems; and assess needs to reduce persistent Central America nutrition problems. A fifteen-year Regional Plan will be prepared which makes maternal mortality reduction a public health priority, and technical assistance will be provided to incorporate essential obstetric care into national health strategies. Case studies of successful maternal mortality reduction will be developed.

The HIV/AIDS initiative will work towards establishing harmonious surveillance systems in the region; supporting regional dialogue among countries on the most effective AIDS prevention programs; electronically disseminating epidemiological and program information; and adapting global tools for HIV/AIDS prevention programs. Technical assistance will be provided to countries to strengthen surveillance for drug-resistant pathogens, adapt regional treatment guidelines for local use, improve national strategies for disease control, and strengthen the role of pharmacy and therapeutics committees to manage antimicrobial drugs.

The Amazon Malaria Initiative (AMI) will assist countries to analyze drug resistance, study findings, and implement new treatment guidelines; train program managers; begin adaptation of vector control interventions to the Amazon; and continue to carry out malaria surveillance activities. Methods and approaches will be adapted to strengthen health reform outcomes; collect, synthesize, and disseminate country experiences and best practices; monitor the outcomes and processes of health sector reform; and conduct South-South (intra-regional) exchanges. Population and family planning activities will use CSH funds to acquire a technical advisor and support program implementation.

Planned FY 2003 Program: Using Development Assistance (DA), child survival programs plan to improve the delivery of child health services in response to diarrheal disease, acute respiratory infection and malnutrition; support measles eradication; strengthen surveillance systems for vaccine preventable diseases; provide technical assistance to MOHs to assess program problems; and develop responses to mitigate persistent malnutrition problems in Central America.

Technical assistance under the maternal mortality initiative will link advances in policy reform to clinical and community practices, disseminate best practices from demonstration projects, promote cross-country learning, and keep essential obstetric care on national health agendas. Under the HIV/AIDS initiative, USAID plans to conduct workshops to disseminate best practices and develop program plans on care and support; share country experiences among MOHs; and develop LAC-specific training packages, guidelines and other tools. USAID plans to adapt and disseminate best practices for hospital infection control; analyze and disseminate data on anti-microbial resistance (AMR); and advocate for and support programs that address AMR at the country level. In addition, USAID plans to continue Amazon Malaria surveillance and vector-control activities, treatment policy reform, and carry out applied research to improve program performance. Finally, USAID plans to continue monitoring outcomes and processes of health reform; collect, synthesize, and disseminate country experiences and best practices; conduct South-South (intra-regional) exchanges; and adapt methods and approaches. Population activities will use funds for a technical advisor and support for program implementation. Agreements using funds for population activities will incorporate clauses that implement the President's recent directive reinstating the Mexico City Policy.

Performance and Results: Child survival activities have resulted in the coordination of integrated management of childhood illnesses (IMCI) plans of action with other international agencies and the NGO community. In seven of eight target countries, the IMCI clinical course materials were adapted to national norms, and a new IMCI costing tool and short program review were field-tested and are now available for use in all target countries. The vaccine program provided strategies for self-financing basic vaccination services, resulting in eight of 11 target countries financing at least 77% of vaccine and syringe budgets with national resources. Maternal mortality activities have resulted in demonstration projects that contributed to reduced maternal mortality. The AMR initiative trained laboratory personnel from seven countries in bacteria identification and testing. Six of these countries were fully integrated into the regional surveillance network and a supranational quality control system. Efforts begun late in FY 2001, under the Amazon Malaria initiative will strengthen surveillance capacity to monitor drug resistance; support the adoption and implementation of evidence-based treatment regimens; and increase the use of better malaria control practices, thereby contributing to reducing malaria in the six target countries.

Also started late in FY 2001, the HIV/AIDS initiative will lead to improved skills for policymakers and program managers and increased prevention among at-risk groups through capacity building of regional organizations for vulnerable people. HIV/AIDS surveillance systems will be more consistent across countries in the region. Methodologies and tools (including a provider payment policy primer, comparative analysis of social insurance mechanisms in LAC, institutionalization of national health accounting and hospital reform) were disseminated to over 500 professionals included in the health sector reform network. Through policy dialogue, South-South exchanges, and synthesis/adaptation/training/dissemination of tools and approaches, the health sector reform initiative will improve the capacity of health professionals in LAC to design, implement and evaluate reform efforts. As a result of the LAC Regional health program, delivery of selected health services will be improved and access to services will be more equitable throughout the LAC region.

Contractors, Grantees, or Agencies: Pan American Health Organization (prime); The Partnership for Child Health Care, Inc. (prime); JHPIEGO (prime); Jorge Scientific Corporation (prime); Academy for Educational Development (prime); Management Sciences for Health (prime); Centers for Disease Control and Prevention (prime); TvT Incorporated (prime); Alliance for HIV/AIDS (prime); Abt Associates Incorporated (prime); Harvard University School of Public Health (sub).

US Financing in Thousands of Dollars