Building capacity for sustainable community health systems

1. AMP Health
Building capacity for sustainable
community health systems
May 2016

2. AMP Health 2
% increase in coverage of key
interventions after management
capacity building in Kenya
67%
Multiple measures of performance of
higher functioning organizations vs
lower functioning
>2x
CHW coverage is limited in scope & effectiveness
Stronger leadership & management were key
enablers of CHW success in Rwanda & Ethiopia
SOURCES: 1M CHW Campaign, MSH, McKinsey
In addition, CHW deployment is often
fragmented due to disease-oriented funding
Lack of management skill appears to be the
single most important barrier to improving
health throughout the world
William Foege
Former Director, US CDC
Leadership and management matters
% of country population covered by CHW
No data
0-10%
11-20%
> 20%
Community health workers are limited in scope & effectiveness
in many countries

3. AMP Health
AMP Health is an innovative cross-sector approach to working
with ministries of health to strengthen community health systems
Program elements
 Placement of mid-career
professionals (Management
Partners, or MPs) into
ministries of health (MoH)
for 2 years
 Leadership & management
training and targeted
technical support
 Cross-country sharing of
lessons learned
Ministry of
Health
(and Finance)
Multi-lateral
donors
Foundations
Distinctive approach
 Real-time, sustained and
focused MoH capacity
building and support,
leveraging private sector
expertise
 Responsive to country-
specific needs, accelerating
existing priorities
 Platform for cross-sector
collaboration and
contribution
5
 Stronger health systems: Increase the effectiveness of national community health units
 Stronger leaders: Develop sustainable leadership capacity within ministries of health
Objectives

4. AMP Health
AMP Health aims to support community health worker systems
at key inflection points
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Malawi Sierra Leone KenyaExample
country
Develop national
strategy
Implement national
strategy
Adapt strategy to
changing conditions
Support transition
to sustainability
Rwanda
 Countries without
national standards
and/or strategies
for CHW
 Countries with
new strategy
being developed
or in place
 Countries facing
significant
changes
impacting CHW
program (e.g.,
devolution)
Description  Countries with
well-developed
programs
transitioning
looking to
sustainability
 Define standards
for CHW role
 Develop national
strategy
 Create investment
case
 Support
transition from
partner-led to
ministry-led
program
 Ensure
consistency in
CHW training &
deployment
 Develop
approach to
county
performance
management
 Support county-
level advocacy for
investment in
CHWs
Types of
support
 Investigate
innovative
financing models
 Identify path for
implementation
and pilot
Stage

5. AMP Health
Thomas Kisimbi, Management Partner
 Most recently Kenya Director for
Evidence Action’s Deworm the World
 Previously Malawi Director and
Global Associate Director for Malaria
at Clinton Health Access Initiative
 Graduate of University of
Pennsylvania School of Nursing and
the Wharton School
Salim Hussein
 Head of Community Health
Unit, Ministry of Health
Mark Laichena, Management Partner
 Most recently a management
consultant at McKinsey & Company’s
Africa Delivery Hub, based in Kenya
 Previously worked with McKinsey in
the US, consulting for public, private
and sector organizations
 Graduated from the University of
North Carolina at Chapel Hill
George Kasara
 Technical Assistant, Department
of Preventive & Promotive
Health
Kicked off in Kenya in February – team overview
5

6. AMP Health
 Community health extension worker (CHEW) Training –
support scale-up plans (including scaling private sector role)
 Demand generation – leverage partner communications
expertise
 HR for Health – support strengthening of recruitment scale-up
plans and county coordinator training
Strengthen data
demand and use
at all levels
Operationalize
Community
Health Strategy
 Dashboard – develop and manage action-oriented dashboard
to show MoH/county progress
 Digitization – support ongoing rollout plans
 Advocacy evidence base – conduct value-for-money analysis
and gather effectiveness evidence to strengthen the case for
community health
 Roadshow with county governments – help make the case for
investments in CHEWs
Make the case
for investments
Preliminary scope of work (to be refined and finalized in coming months)
Kicked off in Kenya in February – focus of MP support
6

7. AMP Health
Will kick off in Malawi in Q2
Precious Phiri
 National Primary Healthcare Coordinator,
Ministry of Health
Humphreys Nsona
 Program Manager for the IMCI Unit,
Ministry of Health
Standardize
services provided
by HSAs
Increase retention
of HSAs within
catchment areas
Ensure adequate
supply of HSAs
Preliminary scope of work
 Develop plan to address decreased retention within HSA catchment areas
from 68% to 95%
 Ensure HSA care offerings meet standard based on community essential
health package
 Develop investment case for increasing supply of HSAs
7
Ministry of Health participants
MoH participation
confirmed, currently in
active recruitment process
for Management Partner

8. AMP Health
 Stronger community health worker systems
o 25% additional investment in CHWs in AMP Health countries*
o 25% additional CHWs trained and/or deployed in AMP Health countries*
 Stronger leaders
o 25% improvement over baseline scores on 360 degree assessments of
leadership & management skills (for MoH participants and AMP MPs)
o 75% of AMP Health MPs continue to work in global health
AMP Health’s vision for success over the next 5 years
7
AMP Health aims to scale to 10 countries
* Compared to baseline projection based on historical trend
Work in progress, as M&E framework being refined

9. AMP Health
Priorities for AMP Health in coming months
Expand geographic scope
 Aim to launch in two additional countries later in 2016, most likely
Rwanda and Sierra Leone
Conduct first cross-country convening (‘Leadership Lab’) mid-year
 Key component of leadership and management
development program
 Opportunity to share best practices and jointly
discuss challenges
Finalize approach to monitoring and evaluation
 Initial framework includes measures for leadership & management,
community health system progress and health impact
 To be further refined with learning partner (to be selected)
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Chance for partners
to attend, share and
learn more about
AMP Health

10. AMP Health
Who we are
OrganizationPartnership Board members
Wendy Taylor
Director, Center for Accelerating Innovation & Impact
Lisa Bonadonna
Head, GSK-Save the Children Partnership
Austin Hearst
Vice-Chair, Community Health Workers
Andrew Hastings
Deputy Director, Integrated Delivery
Jeff Walker
Vice-Chair, Community Health Workers
Peggy Clark [Chair]
Vice President, Policy Programs
10
Leadership team
Peggy Clark
Executive Director,
Aspen Global Health
and Development
Katie Drasser
Deputy Director,
Aspen Global Health
and Development
Michael Park
Director of Strategy and
Operations
Serufusa Sekidde
Director of Partnerships
and Country Engagement
Scott Higgins
Director of Operations, Merck for Mothers