Abstract
Background: In 2018, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project started a new partnership with four Eastern and Southern Caribbean countries impacted by the Zika virus: Antigua and Barbuda, Dominica, St. Kitts and Nevis, and St. Vincent and the Grenadines. The goal of the project was to provide short-term technical assistance (STTA) to strengthen the health systems’ capacity to detect newborns and young children potentially affected by Zika and to address their health needs. To meet these objectives, ASSIST developed an innovative approach based on its existing model for service delivery improvement. This novel approach is known as Rapid, Multi-country, Parallel Process, Multi-tasking Approach for a Project Startup (RMPP-MAPS). An evaluation was conducted to document the STTA startup activities, to identify enabling and constraining factors, and to capture lessons learned. Methods: An external consultant conducted remote in-depth interviews with individuals involved in the startup using semi-structured interview guides and retrieved data from the review of project documents. Results: Using RMPP-MAPS, the ASSIST Project successfully implemented the startup for complex STTA in four countries within less than four months, spanning mid-May to early September 2018. Project milestones included achieving buy-in from stakeholders, co-developing the technical scope and materials, and rapidly executing critical operational functions. Dedicated project teams, country leaderships, and local champions were essential to overcoming the main challenges, which included a condensed timeframe, lack of in-country offices, and country-level factors such as a shortage of health care workers and a weak health infrastructure. Conclusions: The RMPP-MAPS is a feasible and resource-efficient mechanism of interest to implementers, donors, and low and middle-income countries facing temporal and financial limitations to rapidly addressing public health priorities.
Highlights
The rapid spread of the Zika virus (ZIKV) infection to countries in the Latin American and Caribbean (LAC) region in 2015 and 2016 and its association with serious health consequences such as microcephaly prompted the World Health Organization (WHO) to declare the ZIKV infection a public health emergency of international concern (PHEIC) on February 1, 20161
The decision was made to design the effort as a one-year short-term technical assistance (STTA) activity aimed at improving detection and addressing the unique health needs of children potentially affected by Zika in the four countries
Documents reviewed included: (1) startup documents obtained from the ASSIST Project, (2) online public resources (e.g., United States Agency for International Development (USAID) Zika program overviews, press-releases, Eastern and Southern Caribbean (ESC) country-specific information, literature related to Zika outbreak in the region, summary of relevant work by implementing partners, etc.), and (3) documents obtained from program managers (e.g., Maternal and Child Survival Program reports and documents)
Summary
Background The rapid spread of the Zika virus (ZIKV) infection to countries in the Latin American and Caribbean (LAC) region in 2015 and 2016 and its association with serious health consequences such as microcephaly prompted the World Health Organization (WHO) to declare the ZIKV infection a public health emergency of international concern (PHEIC) on February 1, 20161. The STTA planned to achieve these objectives by strengthening newborn and well-baby care systems and early childhood development (ECD) programs in all functional health facilities providing childbirth services and well-baby care. These efforts were in line with national and USAID goals to improve public health emergency response and to strengthen the resilience of health systems to address future emergencies. The goal of the project was to provide shortterm technical assistance (STTA) to strengthen the health systems’ capacity to detect newborns and young children potentially affected by Zika and to address their health needs To meet these objectives, ASSIST developed an innovative approach based on its existing model for service delivery improvement. Results: Using RMPP-MAPS, the ASSIST Project successfully implemented the startup for complex STTA in four countries within
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