John Snow, Inc. - Region

Africa - Current Projects

Projects are listed by award date. Alternatively, list projects by title.

Rwanda Injection Safety Project
JSI Research & Training Institute, Inc. (JSI) has been awarded a five-year cooperative agreement from the Centers for Disease Control and Prevention (CDC) to implement the Rwanda Injection Safety Project. Over the past five years, JSI has implemented the Making Medical Injections Safer (MMIS) project, a PEPFAR-funded initiative, to prevent the medical transmission of HIV and other bloodborne infections through injection safety and healthcare waste management interventions. These interventions assure that every injection given is safe, necessary and does not pose a risk to the patient, provider, or community. JSI has implemented the MMIS project in close partnership with the Government of Rwanda (GOR) and local stakeholders. The follow-on Injection Safety project will build upon the success of the MMIS project by providing technical assistance to the Ministry of Health (MOH) to further institutionalize systems for safe injection, waste management, and phlebotomy.
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ETHIOPIA UNICEF Integrated Community Case Management of Common Childhood Illnesses
In order to reduce mortality of children under five years of age, the Ethiopia Federal Ministry of Health has developed a strategy and an implementation plan for Integrated Community-Case Management (ICCM) of Common Childhood Illnesses. Since 2007, JSI Research & Training Institute, Inc., with support from the Bill & Melinda Gates Foundation, has been implementing The Last Ten Kilometers: What it Takes to Improve Health Outcomes in Rural Ethiopia Project (L10K).

With the strong support of L10K, the ICCM Project, funded by UNICEF, will be implemented in 112 woredas of 12 zones in four regions of Ethiopia: Amhara, Tigray, Oromia, and SNNP. This work will contribute to accelerating the reduction of under-five mortality and assist Ethiopia to achieve the MDG 4 by 2015.
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TANZANIA Most Vulnerable Children Coordinated Care
In Tanzania more than half the population--roughly 21 million--is the age of 18. Approximately two million are classified as most vulnerable children (MVC), and 40% are estimated to be AIDS orphans. MVC in Tanzania are typically cared for by a surviving parent, extended family members, or older children in child-headed households. In many cases, these caregivers are themselves vulnerable. Nationally, more than a third of MVC live below the basic needs poverty line.

More than 220,000 MVC have been identified in the northern regions of Tanzania, the majority of which are adolescents, ages 15-17 years old. Through the Most Vulnerable Children (MVC) Coordinated Care project, JSI will work at the community level to build the skills, networks, linkages, and referrals necessary to create an integrated network of essential service provision for vulnerable children and families in northern Tanzania.

The MVC project will improve the coordination and functioning of local government authorities (LGAs), reinvigorate or establish village level Most Vulnerable Children Committees (MVCCs), and promote greater vertical and horizontal integration of key ministries charged with support for OVC. All efforts will be linked and coordinated with MVCC and LGA activities at the village and district levels.

Most Vulnerable Children (MVC) Coordinated Care project, managed through the World Education/John Snow, Inc. Bantwana Initiative, is a five-year project funded by USAID.
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Cancer Anti-Stigma Initiative in South Africa (LIVESTRONG-JSI )
In 2010, cancer became the leading cause of death worldwide. Nearly 50% of new cancer incidence and 2/3 of cancer deaths now occur in low and middle-income countries. In many of these countries, the stigma associated with cancer is a barrier to treatment and contributes to the high rates of mortality.

JSI recently was selected as the implementing partner for a cancer anti-stigma project in South Africa. Funded by LIVESTRONG, the goal of the project is to reduce stigma associated with cancer through culturally-relevant and targeted messaging while raising awareness of the global cancer burden.

In 2009 LIVESTRONG launched its Global Cancer Campaign, seeking to address the pervasive problem of stigma around cancer in communities worldwide, working in one country at a time. LIVESTRONG identified South Africa as the initial site for its international work in stigma due to the high level of stigma in country, significant cancer prevalence, and the presence of potential partners and collaborators.
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Development of a Procedures Manual for Routine Malaria Information Systems in Benin
After two years of implementing the Benin Malaria Control Monitoring and Evaluation Plan (2007 - 2010), the National Malaria Control Program (NMCP) continues to encounter difficulties accessing the necessary information to make decisions and to meet the reporting needs of the various partners who finance malaria control in Benin.

To coordinate the implementation of these recommendations, the NMCP developed an action plan for the period of January - December 2010. This system will require a manual that contains all of the necessary tools and procedures at the central, intermediary and operational levels to put in place these recommendations. It is in this context that the Minister of Health proposed this scope of work for the development of a strategic document through USAID support.
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HIVQUAL International Evaluation
HIVQUAL International (HIVQUAL-I) focuses on quality improvement of HIV and AIDS care. Working with NY State Department of Health, JSI is performing quality evaluations for this project in three countries: Namibia, Nigeria and Uganda.

The goals of this program are to assess short-term, intermediate and long-term impact of TA services; monitor and take rapid action based on key performance indicators; enhance the quality of HIVQUAL services; and respond to HRSA and other agencies.

A structured QI methodology is being applied to routinely evaluate effectiveness and continuously improve internal processes, utilizing the same QI approach and methods used by the HIVQUAL team when working with providers.
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Project HEART Tanzania Monitoring and Evaluation Support
In response to the CDC-led data quality assessments in Mozambique, Tanzania, and Cote d'Ivoire, the Elizabeth Glaser Pediatric AIDS Foundation has identified M&E systems strengthening as a key priority for all Foundation programs in the coming year. Toward this end, the Foundation has defined a set of minimum standards activities that need to be undertaken and/or evaluated over the short term (Nov 2009 to April 2010). Adequate human and financial resources, including technical assistance, should be planned and budgeted to cover these activities.

There are six core activities, which must be implemented immediately:
1. Indicator Mapping
2. Development of Standard Operating Procedures (SOPs)
3. Site Level Data Use Plans
4. Data Quality Assurance Activities
5. Comprehensive M&E Baseline Assessments, including assessment of patient level databases
6. Training and Career Development for M&E Staff Retention

JSI will be available to EGPAF country directors and other technical staff for targeted technical assistance to help address some of the core systems strengthening activities. The technical assistance JSI technical assistance will include - but is not limited to - data quality assurance and M&E human resource planning.
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Data Quality Audit | South Africa
Globally, there is increasing interest in the measurement of indicators to capture key information about disease treatment and prevention programs. This reliance on indicators necessitates quality assurance mechanisms that promote reliable data collection, storage and management.

JSI, as a partner on the MEASURE Evaluation Project, was contracted by The Global Fund to assist in the development and pilot testing of the DQA methodology and tools. JSI has also been instrumental in the development of the Routine Data Quality Assessment Tool (RDQA), the capacity building and self-assessment version of the DQA tools. JSI is an industry leader in ensuring data quality of routinely reported data for monitoring and evaluation and is continually bidding on audits with the Global Fund.
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Strengthening the Health Information System in the Republic of Djibouti
Despite of overall progress in national systems for health information, the countries in greatest need still lack such systems. Even in the countries where a health information system (HIS) is available, it is often wasted due to lack of knowledge on how to use it effectively in order to make informed public health decisions and policies.

In the Republic of Djibouti, the national HIS was not being used to consolidate information in the decision-making process of any level in public health planning. In collaboration with UNICEF and the Ministry of Health, JSI is providing technical support in updating the national system for health information to generate usable information in the public health sector. The project will help update or create specific indicators, strengthen the communication/transfer of data between the periphery and center, and develop a structure where the public health policy is based on the information and evidence collected from the national system for health information.
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Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood (SC4CCM)
The Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood (SC4CCM) project aims to demonstrate that supply chain constraints at the community level can be overcome, and that doing so may yield significant improvements in the effectiveness, scale, and impact of CCM.

SC4CCM will identify, demonstrate, and institutionalize supply chain management (SCM) practices that improve the availability and use of selected essential health products for treating children under five in community-based programs.

The Improving Supply Chains for Community Case Management of Pneumonia and Other Common Diseases of Childhood project is a five-year initiative funded by the Bill & Melinda Gates Foundation.
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ETHIOPIA Maternal and Neonatal Health in Ethiopia Partnership (MaNHEP)
Ethiopia is a country of 80 million people, 85% of whom live in rural areas. With the ninth highest birthrate in the world, the lifetime risk of dying in childbirth is 1 in 27. Ethiopia also has high infant mortality rate (77 deaths per 1,000 live births), with half of the deaths occurring in the first month of life. 94% of births occur in the home, making a community-based approach to care essential.

The Maternal and Neonatal Health in Ethiopia Partnership (MaNHEP) is a Bill & Melinda Gates Foundation-funded initiative designed to demonstrate a community-oriented model to improve maternal and newborn health (MNH) care in rural Ethiopia. Working collaboratively with the Ministry of Health (MOH) and Regional Health Bureaus (RHB), this learning project will use a "lead woreda approach" to improve maternal and newborn health in two regions of the country and to demonstrate its broader scalability. In keeping with the Gates' model of change (more, better, more equitable), this community-oriented approach will strengthen provider capacity at local and regional levels, increase local demand from women and families for enhanced MNH care, and, using locally designed solutions, overcome key challenges to in-home provision of a package of evidence-based MNH care practices during the critical birth-to-48 hours window.

Emory University is prime implementing agency on this project, and JSI Research & Training Institute is a sub-partner.
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Botswana Injection Safety Project
JSI Research & Training Institute, Inc. (JSI) has been awarded a five-year cooperative agreement from the Centers for Disease Control and Prevention (CDC) to implement the Botswana Injection Safety Project. Over the past five years, JSI has implemented the Making Medical Injections Safer (MMIS) project, a PEPFAR-funded initiative, to prevent the medical transmission of HIV and other bloodborne infections through injection safety and health care waste management interventions. These interventions assure that every injection given is safe, necessary and does not pose a risk to the patient, provider, or community. JSI has implemented the MMIS project in close partnership with the Government of Botswana (GOB) and local stakeholders. The MMIS project made significant progress in expanding injection safety interventions in 10 of the 24 districts in Botswana. The follow-on Injection Safety project will build upon the success of the MMIS project and further expand injection safety and healthcare waste management interventions to additional districts. To achieve these goals, JSI will provide technical assistance to the GOB and leverage resources from existing partnerships with local stakeholders.
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Ethiopia Urban Health Extension Program (UHEP)
The Ethiopia Urban Health Extension Program (UHEP) is a three year program funded by USAID which aims to support at scale, implementation and monitoring of the Government of Ethiopia's UHEP and improve access to and demand for health services. More specifically, the program aims to strengthen the capacity of UHEWs to identify Most At Risk Populations (MARPs) in their catchment areas and provide public health services to improve their overall health outcomes including HIV prevention, care and support services. To meet these expected results, the UHEP Program will implement a strategic approach that will reach MARPs. All strategies and activities put forward under the UHEP Program will focus on establishing and strengthening the bridge between MARPs and the UHEP mainly through the UHEW but also through engaging Civil Society Organizations and Community Based Organizations working with these populations.
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NIGERIA Urban Reproductive Health Initiative (URHI)
This project will work in six urban areas, focusing on the urban poor. The project objectives are:

1. Develop cost-effective interventions for integrating quality family planning into other MNCH and RH programs
2. Improve quality of family planning services for the urban poor
3. Test public-private partnerships and innovative private sector approaches
4. Develop interventions for creating demand
5. Increase funding and supportive policy environment for ensuring access to family planning

JSI is leading the service delivery and contraceptive supply components of this project, and includes quality improvement, systems strengthening, supply chain, and performance based grants.

NURHI is a project funded by the Bill & Melinda Gates Foundation, with JHU/CCP as the prime recipient.
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GHANA Focus Region Health Project
While Ghana's health status has improved in recent years, many challenges remain. The USAID-funded Ghana Focus Region Health Project (FRHP) is a four-year (2009-2013) integrated maternal, newborn, and child health, and family planning (MNCH/FP) project that aims to improve the health status of communities in three focus regions of Ghana (Greater Accra, Central, and Western Regions). FRHP will increase access to and use of key, high-quality MNCH/FP services, as well as improve the management and health systems performance in these regions and districts. Working closely with the Ghana Health Service (GHS), FRHP will support decentralization and service delivery of priority health services and will assist the GHS to implement key policies and programs included in the GHS Five-Year Strategic Framework for Service Delivery 2007-2011. FRHP will work with the GHS in sub-districts, districts and regions to form deep connections to civil society, NGOs, communities, and the private sector to improve health for all members of the community.

FRHP is implemented by JSI Research & Training Institute, Inc., in partnership with World Education, Inc.
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NIGERIA Targeted States High Impact Project (TSHIP)
Nigeria represents less than 1% of the world's population, but accounts for 10% of global infant, child and maternal mortality. The worst situations are consistently found in the northeastern and northwestern regions of the country. Under-5 mortality in Bauchi (NE) is 260/1000, and in Sokoto (NW) it is 269/1000. Maternal mortality in Bauchi is 1549/100,000 live births and in Sokoto 1500/100,000.

The Targeted States High Impact Project (TSHIP) is a five-year, USAID-supported project which aims to strengthen healthcare delivery in Bauchi and Sokoto states. TSHIP is working to establish strong and durable bonds between community institutions and the healthcare delivery system to improve household health practices and increase people's use of health services. Through TSHIP, all wards in Bauchi and Sokoto will benefit from improved health systems and management, as well as higher quality service delivery for family planning, antenatal care, complicated pregnancy, emergency obstetric and neonatal care, routine immunization, vitamin A distribution, and child health.

To manage TSHIP, JSI Research & Training Institute, Inc. has partnered with Jhpiego, Futures Group International, LLC, The Center for Development and Population Activities (CEDPA), as well as one Nigerian organization, Management Strategies for Africa (MSA).
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Global Fund Voluntary Pooled Procurement (VPP)
The Global Fund to Fight AIDS, Tuberculosis and Malaria is a major financing institution in the fight against these diseases in 140 countries. The Global Fund established a Procurement Support Service for its Principal Recipients, with Voluntary Pooled Procurement and Capacity Building Services aimed at ensuring a cost-effective and efficient procurement process. These services provide support to countries to resolve procurement bottlenecks and supply chain management challenges and facilitate timely access to pharmaceuticals and health products.

In March 2009, the Global Fund selected the Partnership for Supply Chain management (PFSCM) as its Voluntary Pooled Procurement Service Agent. JSI is a managing partner of PFSCM.
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MTCT-Plus Data Management Center
JSI's clinical data management and quality assurance experience is internationally recognized. For five years, JSI has been contracted as the Data Management Center for the Mother to Child Transmission Plus (MTCT-Plus) Initiative, developed in response to the UN Secretary General's Call to Action. Managed by the Mailman School of Public Health at Columbia University (the Secretariat), the center serves demonstration sites in 8 countries in Africa and Asia and as such handles data related to the care of over 9300 patients in 18 clinical facilities in Cameroon, Cote d'Ivoire, Kenya, Mozambique, Rwanda, South Africa, Uganda, Zambia and Thailand.

The clinical care paradigm for this initiative is family-centered and holistic, addressing the stigma and physical and mental health needs of HIV+ women and their family members, in addition to the distribution of anti-retroviral medications.

JSI has operated the programs Data Management Center for the Secretariat, helping sites manage and automate their medical record system for MTCT-Plus patients. Seven sites began record keeping on paper forms (in a variety of languages), which were processed at JSI into electronic format; now all 14 sites use an Access database developed by JSI. The database also has an appointment tracking system built into it. Each month, JSI's DMC staff work with sites to resolve discrepancies in their data - providing collaborative training/technical assistance in data entry, records management, and the clinical protocol in the process. Each month, the DMC returns clean data files to each site and to the Secretariat and also produces quality/performance indicators to help staff ensure all patients are being adequately managed. Some of the key performance indicators are: (a) the number and percent of patients who have not been to clinic or have missed appointments for over 3 (6) months; (b) the number and percent of patients who have had ARV regimen changes; (c) the number and percent of patients who are eligible for opportunistic infection prophylaxis but not currently receiving it.
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Supply Chain Management System (SCMS)
The Supply Chain Management System (SCMS) provides global procurement and distribution for essential HIV/AIDS medicines and supplies needed to provide care and treatment of people living with and affected by HIV and AIDS. Funded by the President's Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development, SCMS is implemented by 13 organizations, lead by the Partnership for Supply Chain Management (PSCM), a partnership established by JSI and MSH.
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UGANDA STAR-EC Project
Uganda has a population of 28 million people, with 85% living in rural areas. The country has had considerable success in reducing HIV prevalence over the past 15 years; however, despite successes in the late 1980s and early 1990s, the decline in prevalence has stagnated over the past five years and no longer shows a downward tendency. In partnership with the Government of Uganda and the Ministry of Health, USAID and PEPFAR are supporting access to HIV/AIDS prevention, care and treatment services.

The Strengthening TB and HIV & AIDS Responses in East-Central Uganda (STAR-EC) project is aimed to increase access to, coverage of and utilization of quality comprehensive HIV/TB prevention, care and treatment services within district health facilities and their respective communities. JSI will work over 5 years in demand creation for access to TB/HIV preventative and care and support services, increasing access to these services, conducting the Lot Quality Assurance Sampling (LQAS) surveys at the district level, and capacity building of civil society and indigenous organizations. The project is based in Jinja, Uganda.
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LIBERIA Rebuilding Basic Health Services in Liberia (RBHS)
Rebuilding Basic Health Services (RBHS) is a five-year program to support Liberia's goal, outlined in its National Health Policy and Plan, of increasing access to basic health services and strengthening the decentralized management of the health system.

Although Liberia's long civil war left its health care service delivery system fragmented, severely damaged, and heavily dependent on international donors and NGOs, in only a few short years, Liberia has taken bold steps to transition from an emergency relief model of health service delivery to a functioning, decentralized health system. While there is still a long way to go, Liberia's 15 counties have begun operational management of health services with direction and support from the central Ministry of Health and Social Welfare (MOHSW). The cornerstone of this decentralized primary care approach is the basic package of health services (BPHS). RBHS will collaborate entirely with the efforts of the MOHSW to support service delivery outcomes with a focus on the following elements: Family planning, reproductive health, and gender based violence; maternal, neonatal and child health (MNCH); malaria (PMI); HIV prevention; and water and sanitation.

RBHS is supported by USAID and implemented by JSI Research & Training Institute, Inc., with our partners Jhpiego, the Johns Hopkins University Center for Communication Programs, and Management Sciences for Health.
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Maternal & Child Health Integrated Program (MCHIP)
The Maternal and Child Health Integrated program (MCHIP) is USAID's flagship maternal, neonatal and child health program, which focuses on reducing maternal, neonatal and child mortality. MCHIP is designed to accelerate progress toward achieving the Millennium Development Goals (MDGs) in USAID's 30 maternal and child health priority countries over five years.

Using data driven priority setting approaches, MCHIP will help countries determine which innovations will yield the most impact in reaching the MDGs and support capacity building and health systems development to take those interventions to scale. Parallel to strengthening central and district level health teams, MCHIP considers communities, households and individuals not only as recipients of health services, but as an integral part of health services implementation.

JSI leads MCHIP's work in the areas of child health, immunization and pediatric HIV/AIDS. Other MCHIP partners include Jhpiego, Save the Children, PATH, PSI, Broadbranch and JHU IIP. MCHIP is the follow-on project to BASICS and IMMUNIZATIONbasics, other USAID global technical assistance projects which were also implemented by JSI.
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PATHS2 - Nigeria
Phase Two of the Partnership for Transforming Health Systems (PATHS 2) has been launched in Nigeria by the UK Department for International Development (DFID). JSI is a partner in a consortium led by Abt Associates. PATHS 2 operates in six states in Nigeria and focuses on improving the capacity of state and local health systems to finance, manage and deliver sustainable and replicable pro-poor health services for common health problems in Nigeria. Under the DFID PATHS 2 Project, JSI will contribute to the Procurement and Logistics of health commodities (including commodities for Infectious diseases HIV/AIDS/ TB/ Malaria). Outputd include: 1) addressing the Development of Stewardship at the Federal Level; 2) ensuring that Phase III drugs and medical equipment are supplied to the appropriate hospitals and clinics in a planned and timely fashion under the Health Commodities Project (HCP) Transition Plan; 3) focusing on the development and implementation of a minimum package of essential services and the further development of a drug revolving fund at the facility level; 4) providing the lead states with support to put in place social accountability mechanisms for health services, a complaint system, an Ombudsman, etc.; and 5) constitute a working group to review existing BCC strategies and materials, propose acceptance and adaptation, and identify gaps.
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Enhancing Strategic Information Project for South Africa, Lesotho, and Swaziland
The countries of South Africa, Lesotho, and Swaziland all have particularly high rates of HIV and AIDS; South Africa currently reports nearly one in five adults infected. The Enhancing Strategic Information Project focuses primarily on South Africa, but will devote significant time to work in Lesotho and Swaziland.

This five-year USAID-funded task order will build on existing initiatives and developments in the three countries and further concentrate efforts to strengthen the capacity of individuals and institutions to collect, analyze, and use information to inform the rapid PEPFAR scale-up of sustainable and quality HIV and AIDS programs.

The project aims to build capacity for strategic information in communities, to achieve comprehensive information system development for OVC and other program areas, to design and implement action plans for enhanced use of data, to provide technical assistance for maximizing data quality in results reporting, to develop and maintain a USG results reporting database, and to create high-quality multivariate GIS mapping applications.
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Integrated Family Health Program
With a population of 77.9 million, Ethiopia is the second most populous country in Africa. Without significant improvement in the use of family planning (FP), the population will double to 150 million by 2035.

The average woman bears 5.4 children, which places an unsupportable burden on families, communities, and a nation facing chronic food shortages and environmental degradation.

The Integrated Family Health Program (IFHP) is a bilateral component of USAIDs Family Health Program in Ethiopia implemented jointly by John Snow, Inc. and Pathfinder International in partnership with Academy for Educational Development and Consortium of Reproductive Health Association. It is a follow on from the former Essential Services for Health in Ethiopia by JSI and Family Planning/Reproductive Health Project by Pathfinder.

Working across 4 regions in Ethiopia, the Integrated Family Health Program (IFHP) aims to provide an integrated package of services to improve the health of mothers, newborns, and children. Through health sector partnerships, community mobilization, and BCC models, the project works to improve family planning practices; increase the availability and quality of services, products, and information; and strengthen key elements of the national health system to support local health needs. IFHP also works closely with the Ethiopian Ministry of Health to strengthen the national Health Extension Program and provide supportive supervision as well as logistics support to Health Extension Workers.

The IFHP supports USAID-Ethiopias Strategic Objective of Investing in People having a life of program goal of improved family health. Program components constitute family planning, reproductive health, maternal, newborn and child health, malaria prevention and health systems strengthening.
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Technical Assistance to the New Partners Initiative (TA-NPI)
John Snow, Inc with its sub-partner Initiatives Inc, has been contracted by CDC/Atlanta to support the organizations awarded funds by the Department of Health and Human Sciences (HHS) for Round 2 and Round 3 of the New Partners Initiative. The support is provided through TA-NPI which is based in Kampala, Uganda and works closely with JSI Boston headquarters and JSI staff at projects throughout Africa and worldwide.

The assistance spans the three year life of the NPI award to the grantees with additional time for closing out the grant. The support includes three broad areas: organizational development of the grantee organizations and its key implementing partners; support in the technical HIV implementation of the award including best practice and sharing lessons and experience; improved networking and strengthened partnerships at the community, NGO, public-private and donor levels in each case supporting the national HIV/AIDS strategy.
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New Partners Initiative Technical Assistance Project (NuPITA)
The New Partners Initiative Technical Assistance (NuPITA) project increases the quality of program implementation and strengthens the institutional capacity of 15 nongovernmental organizations that provide HIV prevention and care services in sub-Saharan Africa. These 15 organizations are New Partners Initiative (NPI) Round 2 and Round 3 grantees. Under NuPITA, JSI provides technical assistance to the NPI grantees in HIV prevention and care services, financial management and compliance with USG regulations, and organizational development (OD).

The New Partners Initiative (NPI) under the US President's Emergency Plan for AIDS Relief (PEPFAR) aims to increase the number, involvement and capacity of new partners, including community- and faith-based organizations.

With a regional headquarters in Kampala, Uganda, NuPITA supports NPI grantees who are implementing programs in Uganda, Kenya, Tanzania, South Africa, Rwanda, Zambia, and Nigeria. The JSI NuPITA consortium also includes Initiatives Inc.
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Children First
Children First is a five-year program funded by USAID that will strengthen proven programs and develop new models for care and support of orphans and vulnerable children (OVC) in Zimbabwe. Children First is committed to the use of child-focused, community-driven comprehensive programming that addresses children's needs and incorporates cutting edge technical innovations while valuing the unique contributions of resourceful, creative community responses. Children First's core services include a comprehensive approach to nutrition, health, education, legal support, child protection, psychosocial support, livelihoods, advocacy, and program sustainability, and interventions are based on a strong child rights and gender equity framework.

Through this project, managed through the World Education/John Snow, Inc. Bantwana Initiative, JSI works directly with local health organizations to access, expand, and integrate HIV care and support to children and families living with HIV & AIDS. Interventions lead by JSI include linking OVC and children at-risk to HIV clinical care, training clinical providers to service OVC and children at-risk, and expanding and establishing community based referral networks to ensure OVC and caregivers have access to essential health, HIV and AIDS services.
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AIDSTAR-One (AIDS Support & Technical Assistance Resources)
AIDSTAR Sector I Task Order 1 ("AIDSTAR-One") is USAID's global HIV & AIDS project that provides technical assistance services to the Office of HIV/AIDS and USG country teams in knowledge management, technical leadership, program sustainability, strategic planning and program implementation support.
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Uganda HIV/AIDS Services Project (UHSP)
The Uganda HIV/AIDS Services Project (UHSP) was a USAID-funded project which built on the successes of the Uganda Program for Human and Holistic Development (UPHOLD) in the areas of HIV counseling, testing, and palliative care. UHSP provided financial and technical support to civil society organizations (CSOs) as implementing partners who deliver services to Ugandans in 30 districts. In the first year UHSP worked with 12 CSOs and in the second year the number was reduced to five CSOs. Though an independent project, UHSP was initially nested within the auspices of UPHOLD and leveraged the already existing infrastructure and relationships through its other projects in Uganda and experience in working in the HIV and AIDS sector in the country.
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Supply Chain Support to VITA
Venture Investment Technical Assistance (VITA) is a partnership between Commons Capital and RTI International with technical assistance from John Snow, Inc. VITA is funded by the Bill&Melinda Gates Foundation. VITA combines the strengths of venture capital with the know-how of non-profit technical assistance, in an effort to support companies that are developing technologies or services with potential global health impact. Under VITA, JSI was engaged to offer operational field expertise and supply chain expertise to inform Claros Diagnostics' development of an innovative point-of-care diagnostic device.

Point-of-care diagnostics are receiving increased attention worldwide, and are becoming a popular method of testing for infectious diseases in developing countries due to the faster turnaround time, decreased lab and equipment costs, and increasingly reliable results. The new Claros technology would allow healthcare workers to rapidly and cost-effectively test for a panel of up to 10 diseases simultaneously and get an accurate response in less than 15 minutes.

VITA aims to provide a foundation for successful product launch in low- and middle-income settings. The VITA team helped Claros develop a business plan based on market research, public health analysis, and the supply chain characteristics of selected target countries. JSI helped VITA and Claros identify which priority global health needs the Claros technology would be best suited to address. In particular, JSI conducted country-level analyses in Rwanda and Tanzania, exploring user requirements and client characteristics (including informal willingness and ability to pay inquiries), as well as supply chain considerations related to regulatory policies, pricing, procurement, packaging, distribution, and storage.
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ETHIOPIA Gates The Last Ten Kilometers: What it Takes to Improve Health Outcomes in Rural Ethiopia
The goal of The Last Ten Kilometers: What it Takes to Improve Health Outcomes in Rural Ethiopia Project (L10K) is to strengthen the bridge between Ethiopian families, kebeles (communities) and the Health Extension Worker program (HEP) to achieve sustainable reproductive, maternal, newborn and child health (RMNCH) improvements, at scale, in order to advance Ethiopia toward meeting Millennium Development Goals (MDG) 4 and 5.

Households and communities, at large, represent potential human resources for health that are under-utilized. In Ethiopia, the bridge between households and the Health Extension Worker Program will be strengthened to achieve sustainable RMNCH improvements at scale.
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ETHIOPIA Saving Newborn Lives Project / Community Based Interventions for Newborns in Ethiopia (COMBINE) Project
Nearly 120,000 newborns die of preventable causes annually in Ethiopia. The high neonatal mortality rate is attributable to various factors: A majority of the population is at least 10 kilometers away from a health center and coverage of maternal and child health services in the country is extremely low. Nearly half (44%) of neonatal deaths in the country are due to infections, most of which are easily treatable. Unfortunately, treatment is not readily accessible to communities and few caretakers seek care at health centers when their child is ill.

Under the Saving the Newborn Lives Project, Save the Children USA and John Snow, Inc. in collaboration with the Federal Ministry of Health (FMoH), Ethiopian Paediatrics Society, WHO and UNICEF will conduct a randomized control trial for community-based treatment of neonatal infections and pneumonia using these health extension workers with support of Community Health Promoters for the promotion of essential newborn care practices, recognition of danger signs, and prompt care seeking in households. This study aims to assess the effectiveness, feasibility, acceptability and cost of integrating community-based management of neonatal infections and pneumonia by HEWs into the current Ministry of Health's training and implementation of IMNCI as well as building the capacity of HEWs and CHPs to improve newborn care practices, home management of illness, and care seeking practices for sick neonates.
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USAID | DELIVER PROJECT: Supply Chain Management for Outbreak Response (SCM-OR)
The USAID | DELIVER PROJECT improves essential health commodity supply chains by strengthening logistics management information systems, streamlining distribution systems, identifying financial resources for procurement and supply chain operation, and enhancing forecasting and procurement planning. Health programs cannot operate successfully without a full supply of essential commodities. The project encourages policymakers and donors to support logistics as a critical factor in the overall success of their health care mandates.

Task Order 2 (TO2) supports USAID's Avian and Pandemic Influenza Preparedness and Response Unit. Objectives include procuring commodities; and establishing and operating a secure and reliable global distribution system to store, transport, rapidly deliver, and track in-country distribution of current and future USAID Avian Influenza International Stockpile (USAID AI Stockpile) assets.

Implemented by John Snow Inc., the project designs, develops, strengthens, and, upon request, operates safe, sustainable, and reliable supply systems that provide a range of affordable, quality essential health commodities, including drugs, diagnostics, and supplies, to clients in country programs. Under this task order, JSI will establish a comprehensive management information system to provide current information about all aspects of the AI global distribution mechanism.
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Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative
The RAISE Initiative seeks to ensure that displaced populations receive quality reproductive health (RH) services. Despite the great need, the provision of high quality RH services for displaced persons is often neglected in emergency response. There are approximately 70 million displaced persons in the world today, and roughly half of them are women who are especially vulnerable to RH risks both in crisis and conflict settings. When RH care is limited or absent, the toll - in terms of life-threatening medical emergencies and the violation of human rights - is profound.

Developed by Columbia University's Heilbrunn Mailman School of Public Health/Department of Population and Family Health and Marie Stopes International (MSI), the RAISE Initiative is committed to the provision of fully integrated and comprehensive RH services for refugees and internally displaced persons (IDPs). Through partnerships with humanitarian and development agencies, United Nations (UN) bodies, advocacy agencies and academic institutions, RAISE strives to have RH recognized as an absolute necessity for populations displaced by emergencies - and, in a broader sense, as an integral part of basic health care for all, just as food, water, sanitation and shelter are commonly accepted as primary needs. The RAISE Initiative emphasizes positive change in six priority areas within RH care, which were identified by staff, partners, and leading researchers as key factors in achieving overall RH improvement, including: technical support, clinical training, emergency funding, advocacy, research, and documentation and dissemination. RAISE is working in Colombia, N. Uganda, S. Sudan, Darfur, Sudan and Chad.

JSI Research & Training Institute is a RAISE Initiative advocacy partner. In collaboration with RAISE staff and partners, JSI provides assistance to the initiative's advocacy efforts, working to positively influence the policy and funding environment to facilitate widespread support for comprehensive RH care in emergency situations. JSI's work with the RAISE Initiative falls under JSI's Reproductive Health for Refugees Project which encompasses multiple initiatives that seek to increase quality RH services in crisis-affected areas.
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Sudan HEAR Project
JSI has been awarded a subcontract to integrate health services and messages into basic education in the three transitional counties of Sudan (Blue Nile, South Kordofan, and West Kordofan). The Health, Education and Reconciliation Program (HEAR) is a three-year project funded by USAID that will run from 2006-2009. The goal of HEAR is to improve the quality of primary education and link education to community mobilization and essential health services. JSI's role is build the capacity of teachers, parents and the community in an effort to:

improve immunization coverage and nutritional standards;
create and strengthen linkages between health clinics and the primary school system; and
raise awareness regarding best practices for improved hygiene and basic sanitation for primary school children.

Specific activities will include the recruitment and training of health workers, integrating health education training into pre-service and in-service teacher training and conduct an assessment to determine whether to recommend a supplemental food program for the schools.

Read the following success story about the project: Strengthening Learning through Vitamin A Supplementation
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USAID | DELIVER PROJECT: Supporting Malaria Initiatives
The USAID | DELIVER PROJECT improves essential health commodity supply chains by strengthening logistics management information systems, streamlining distribution systems, identifying financial resources for procurement and supply chain operation, and enhancing forecasting and procurement planning. Health programs cannot operate successfully without a full supply of essential commodities. The project encourages policymakers and donors to support logistics as a critical factor in the overall success of their health care mandates.

Task Order 3 (TO3) supports the President's Malaria Initiative (PMI) and USAID's malaria procurement and supply chain requirements. This task order provides USAID with a worldwide mechanism to support the President's Malaria Initiative and USAID's goal of reducing the burden of malaria, especially in Africa.

To help assist USAID in its implementation of malaria prevention and treatment programs, John Snow, Inc. is procuring, managing, and delivering high-quality, safe, and effective malaria commodities. JSI is also strengthening in-country supply chains by improving logistics management information systems, enhancing forecasting and procurement planning, developing efficient distribution systems, and identifying resources for procurement and supply chain operations.

Task Order 3 manages procurement of malaria commodities for all 15 PMI focus countries, as well as for Nigeria. In addition, the project provides both short-term and long-term technical assistance for supply chain strengthening in more than half the PMI focus and non-focus countries.

In Liberia, for example, in order to develop an action plan for the PMI launch and the Insecticide Treated Net (ITN) campaign, JSI recently sent a team to assess the current ITN distribution system and the requirements for an ITN campaign. The project also reviewed the current supply chain(s) for malaria commodities including the National Drug Services, to identify any capacity gaps, including the quantification, procurement, and distributions mechanisms for ITNs and medicines, and to identify areas where the project can intervene to build upon and strengthen existing capacity. The assessment was conducted in collaboration with National Drug Services, the pharmaceutical department of the MOHSW, and the National Malaria Control Program.
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USAID | DELIVER PROJECT
The USAID | DELIVER PROJECT, a U.S. Agency for International Development (USAID)-funded project, improves essential health commodity supply chains by strengthening logistics management information systems, streamlining distribution systems, identifying financial resources for procurement and supply chain operation, and enhancing forecasting and procurement planning. Health programs cannot operate successfully without a full supply of essential commodities. The project encourages policymakers and donors to support logistics as a critical factor in the overall success of their health care mandates.

Implemented by John Snow Inc., the project designs, develops, strengthens, and, upon request, operates safe, sustainable, and reliable supply systems that provide a range of affordable, quality essential health commodities, including drugs, diagnostics, and supplies, to clients in country programs. The project's technical support strengthens all aspects of in-country supply chains, including forecasting, procurement, distribution, management information systems, quality assurance, storage and infrastructure, and medical waste disposal.

The USAID | DELIVER PROJECT works on a range of health commodities, including contraceptives and condoms, essential drugs, as well as select commodities for HIV/AIDS, malaria, maternal and child health, infectious diseases, and avian influenza (AI). The project currently supports USAID's efforts to improve product availability through task orders in strengthening integrated in-country supply chains, avian and pandemic influenza preparedness, and the President's Malaria Initiative (PMI).

To support the three task orders, the USAID | DELIVER PROJECT partners with many organizations including: 3i Infotech, Abt Associates, Center for International Health and Development at Boston University School of Public Health, Crown Agents Consultancy, Inc., Family Health International, Fuel Logistics Group (Pty) Ltd., The Manoff Group, MAP International, PATH , UPS Supply Chain Solutions, and U.S. Pharmacopeia.

Read the following success story about the project: Logistics Plays Key Role in Zambia's Effort to Reduce Maternal Mortality
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Ethiopia Health Management Information System Strengthening Project
Strengthening the national Health Management Information System (HMIS) and Monitoring and Evaluation (M&E) system has long been a priority for Federal Ministry of Health (FMOH) of Ethiopia. JSI, in an agreement with UNDP and the FMOH is working in a technical partnership with FMOH/PPD HMIS team to carry out the project activities based on a performance-based approach.

The objective of the project is to review, design, and implement a cascaded National HMIS and M&E strategy and system. This will be complemented by rationalizing the use of information and communication technology (ICT) with a view to successfully implement, monitor, and evaluate the HSDP III, SDPRP II and the Health MDGs.

The Performance of Routine Information System Management (PRISM) framework is being used to define HMIS performance as the production of quality data as well as the continuous use of information. It proposes the analysis of a set of technical, organizational, and behavioral factors which influence the HMIS processes, with the objective of improving HMIS performance.

Read a success story about the project: Managing Health Information Effectively
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UGANDA NUMAT (Northern Uganda Malaria AIDS & Tuberculosis) Program
Northern Uganda has a history of armed conflict, now more than two decades old, which has resulted in the deaths of thousands of children, women and men and has led to displacement of huge numbers of people who now live in camps of internally displaced persons. Although there has been some recent improvement in the security situation in most parts of Northern Uganda, the armed struggle in the region has resulted in a situation whereby districts have not fully benefited from the overall impressive national progress made by HIV, tuberculosis (TB), and malaria programs in other parts of Uganda. HIV prevalence in the North remains high at 9.1% according to a recent survey, and although HIV and AIDS services are available in all districts of the North, they are of varied quality and typically restricted to towns and municipalities.

The Northern Uganda Malaria AIDS & Tuberculosis Program (NUMAT) is a five-year USAID-funded program that was designed in consultation with the Ministry of Health, Uganda AIDS Commission, international agencies, non-governmental organizations, community-based organizations, and people living with HIV and AIDS (PLA) networks. The program began in August 2006 with the goal of expanding access to and utilization of HIV, tuberculosis, and malaria prevention, treatment, care and support activities in Northern Uganda. NUMAT will expand the geographic coverage and populations served through strengthening local government responses, expanding the role of communities in planning implementation and monitoring activities, and building upon existing networks.

NUMAT is implemented by JSI Research & Training Institute, Inc. in partnership with AIDS Information Centre (AIC), World Vision, local governments, and civil society partners.

Read the following success stories about the project:
An HIV-Positive Mother Protects Her Family
Good Information for Good Health
Living Positively Together
Reinforcing a Cadre of Health Workers
Taking a Stand Against HIV
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Egypt Takamol Project
The Integrated Reproductive Health Services Project, Takamol, builds on a thirty year partnership between USAID and Egypt, assisting the government to improve health outcomes for newborns, mothers and families.

The Takamol approach strengthens community mobilization and involvement in local Ministry of Health and Population (MOHP) health units and hospitals as driving forces for change, in addition to strengthening the capacity of health facility managers and ministry officials to sustain improvements in the quality of care.

Improving the quality of care in 200 primary health care units and 25 district and general hospitals in 12 different Upper and Lower Egypt governorates begins with the renovation and equipping of the units, and is complemented by the training of health care service providers and community outreach workers. The inclusion of community residents on reactivated clinic and hospital management boards puts decisionmaking in the hands of the community.

With the active participation of community development associations, religious leaders, youth, women, schools and universities, agricultural and irrigation extension workers, literacy facilitators, the local media, and the local private sector, the Takamol Project establishes a foundation for sustainable change.

The Takamol Project is implemented by Pathfinder International through the funding support of USAID. Collaborating partners include: JSI; Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health; Meridian Group International, Inc; and American Manufacturers Export Group.
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Ethiopia Essential Services for Health (ESHE) Project
In Ethiopia, most of the population have inadequate access to basic services, including health, education, clean water, and sanitation. JSI's Essential Services for Health in Ethiopia (ESHE) project was designed to improve health sector reform, integrated child survival interventions, and health sector reform. Funded by the U.S. Agency for International Development (USAID), the ESHE project worked in collaboration with health offices at all levels to reduce child deaths and strengthen the health system. The Project took a three pillar approach that addressed health provider skills, strengthened the health system, and engaged families and communities to improve family health.

ESHE worked in three regions and assisted health offices in improving the quality and utilization of high-impact child survival interventions in the form of the Extended Program of Immunization (EPI), Essential Nutrition Actions (ENA), and Integrated Management of Childhood Illnesses (IMCI). Key approaches included capacity building, community mobilization, and behavior change communication. Other selected activities included: development of the special pharmacies program, policy reform to allow retention of user fees at health facilities and revision of exemption/waiver practices, and creating a more enabling environment for increased private sector development. Abt Associates, AED, and Initiatives Inc., were sub-contractors to JSI in implementing the project, which ended in September 2008.

Read the following success stories about the project:
Along the Road to Health Extension
Health Extension Workers Ready to Train
Modeling Healthy Behavior for the Community
Promoting Breastfeeding

Read the ESHE Final Report
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Basic Support for Institutionalizing Child Survival (BASICS)
Less than half of the world's newborns and children receive the basic nutrition and health care that they need to ensure healthy growth and development. As a result, 10 million children under the age of five die each year, most from preventable causes and almost all in developing countries.

BASICS - Basic Support for Institutionalizing Child Survival - was an innovative project funded by the United States Agency for International Development (USAID) for three project cycles between 1994 and 2009. BASICS helped scale-up the use of proven effective nutrition and health interventions for newborns and children in developing countries. To achieve population-level coverage of life-saving interventions, BASICS partnered with ministries of health, other USAID projects, UN organizations, donor agencies, and nongovernmental organizations (NGOs).

The Partnership for Child Health Care, Inc., implemented BASICS. The Partnership was comprised of John Snow, Inc., the Academy for Educational Development, and Management Sciences for Health and supported by the Manoff Group, Inc., PATH, and Save the Children USA.

The website, www.basics.org, not only houses 15 years of BASICS publications, but also features an innovative close-out report design that links readers to expanded documentation on the themes and results being discussed. Be sure to check out this and other "Knowledge Sharing Quick Links" you can find directly on the homepage.
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ZAMBIA: Support to the HIV/AIDS Response in Zambia (SHARe) Program
The Support to the HIV/AIDS Response in Zambia (SHARe) Project serves as a catalyst to reduce the impact of HIV and AIDS and improve the quality of life for persons affected by HIV and AIDS in Zambia. By strengthening leadership, building local capacity, and improving the policy environment, the Project supports the institutional response to HIV and AIDS. SHARe is working with the public and private sectors to establish workplace programs that strengthen HIV prevention, treatment, care and support services for employees, families and the community at large.

In addition to supporting workplace initiatives, SHARe supports the Zambia government and nongovernmental organizations to improve the management and coordination of HIV activities, including improved data collection and decision making. The program also works closely with policymakers to strengthen the legal and regulatory environment as it relates to HIV and the national HIV/AIDS performance monitoring and evaluation system. SHARe is implemented by JSI in partnership with Abt Associates, Inc., Initiatives, Inc., the Zambian Health, Education and Communication Trust (ZECHT) and CHAMP, along with other local partners.
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Djibouti: Expanded Coverage of Essential Health Services (Projet PECSE)
In 2004, the Expanded Coverage of Essential Health Services in Djibouti Project (Projet PECSE) was awarded by USAID to provide the population, in particular those in rural districts, with a package of quality health services to improve access, reduce morbidity and mortality rates among women and children, and promote full community participation in health services delivery.

The Republic of Djibouti was confronted with enormous health problems, evidenced by extremely high infant and maternal morbidity and mortality, as well as poor accessibility to basic health services, especially for rural populations. Much of the health infrastructure, damaged in a recent civil war, consists of auxiliary health posts with limited capacity to offer quality services or to engage community participation.

The Project, which closed in 2008, collaborated with other local technical and financial partners to support the Government of Djibouti's Ministry of Health in it's efforts to improve the availability of basic care, to improve infrastructure in rural districts, to improve the training of health professionals in the country, and to improve basic support systems especially HMIS.

Read the following success story about the project: New Breed of Community Organizer: Saida of Daley Af Obock District, Republic of Djibouti

Read the 2006 annual report
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Making Medical Injections Safer (MMIS)
Poor injection and sharp waste disposal practices for preventive and curative services pose an avoidable risk of transmission of deadly diseases such as HIV, hepatitis B, and hepatitis C to consumers, health care providers, and communities. In 2004, as part of the President's Emergency Plan for AIDS Relief (PEPFAR) focusing on countries with high HIV prevalence, JSI Research & Training Institute, Inc., and its subcontractors, Program for Appropriate Technology in Health (PATH), Academy for Educational Development (AED), and the Manoff Group, were awarded funds through the Centers for Disease Control and Prevention (CDC) and the US Agency for International Development (USAID) to implement "Rapid Interventions to Decrease Unsafe Injections" in 11 countries. The project is commonly known as Making Medical Injections Safer (MMIS). By the end of the project and with national counterparts, MMIS will establish an environment where patients, health care workers, and the community are better protected from the medical transmission of HIV and other bloodborne pathogens.

Read the following success story about the project: Integrating Injection Safety into the National Nursing School Curriculum
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MEASURE Evaluation Project
MEASURE Evaluation develops and applies methods for monitoring and evaluation for population, health, and nutrition projects. MEASURE works with developing country programs, USAID, and other international donor agencies to: improve performance monitoring systems, identify indicators and test their measurement, develop and apply methods for evaluating interventions, and increase capacity for monitoring and evaluation through technical assistance and training.

MEASURE Evaluation is a USAID-funded Leader with Associates award implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill, in partnership with The Futures Group International, ICF Macro, John Snow, Inc., Management Sciences for Health, and Tulane University.
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UGANDA Program for Human and Holistic Development (UPHOLD)
UPHOLD was an integrated social services program designed by the Government of Uganda and the United States Agency for International Development (USAID) that ran from 2002-2008. UPHOLD supported the Government of Uganda's social sector policies and priorities as well as USAID's Strategic Objective 8 results framework for improved human capacity. The program was strategically designed to increase the utilization, quality, and sustainability of education, health, and HIV and AIDS services in 28 districts covering approximately 42% of the country's population. Working in partnership with local governments and over 110 civil society organizations (CSOs), the program brought together innovations in each of these sectors in Uganda's decentralized context to achieve broad improvements in human capacity. It built on good practices, scaling up interventions, and strategies in order to achieve sufficient outreach and substantive impact.

To learn more, read the 2007 Annual Report. You can find all UPHOLD's annual reports as well as other materials and technical reports at the UPHOLD website.

Read the following success stories about the project:
Mobilizing Communities to Use Services through Art in IDP Camps
Providing Combined Services at the Kajjansi Youth Center
Talking about Sex in Primary Schools
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Kenya: Support to the National Leprosy and TB Program (NLTP)
The Canadian International Development Agency (CIDA) and the Royal Netherlands Tuberculosis Association (KNCV) signed an agreement in March 2002 to facilitate DOTS expansion initiatives in six countries, including Kenya. JSI's office in Nairobi, Kenya was contracted to co-operate in the support of Kenya's National Leprosy and Tuberculosis Program (NLTP) for: organization of customs clearance for all goods arriving in Kenya that had been procured by KNCV for the NLTP, including cars and laboratory equipment; transportation of goods that had been procured by KNCV from port of entrée in Kenya to safe temporary storage; assistance in the registration and insurance of surrendered cars; distribution of cars, laboratory equipment, and supplies to provinces and districts according the distribution list provided by the Central Unit of the NLTP; and providing funds to the NLTP, including administering the expenditure of a portion of the budget.
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