Child Survival & Health Grants Program: Technical Areas

Within the Foreign Assistance Framework, the Child Survival and Health Grants Program contributes to the Investing in People objective and its supporting elements, i.e. TB, MCH, Malaria, and their respective sub-elements. Technical interventions that support these elements are outlined below. All technical guidance and relevant tools for implementing these interventions (e.g. TRMs and the MAMAN framework) can be found on http://www.childsurvival.com. Applicants should familiarize themselves with these materials, which provide guidance for developing strategic high-impact intervention packages.

Applicants must select from the below list of key interventions (illustrative examples of activities are also provided).

Immunization: Strengthening routine immunization (DPT, BCG, Measles); expanding coverage and assessment; improving surveillance methods; improving quality and safety of products; strengthening the cold chain; support of polio vaccination programs.

Vitamin A/Micronutrients: Improving coverage and supplementation of vitamin A for children under 5; increasing intake of vitamin A-rich foods; promoting vitamin A fortified foods; integrating vitamin A supplementation with expanded program for immunization (EPI) activities; expanding access to iodine and iron supplementation; provision of iron supplementation for anemia (particularly for pregnant women); increasing intake of micronutrient-rich foods; promotion of micronutrient fortified products.

Infant and Young Child Feeding: Promoting exclusive breastfeeding for children 0-5 months, promoting appropriate infant and young child feeding (IYCF) for children 6-23 months comprising three components - continued breastfeeding or feeding with appropriate calcium-rich foods if not breastfed, feeding (solid/semi-solid food) minimum number of times per day according to age and breastfeeding status, and feeding minimum number of food groups per day according to breastfeeding status; and promoting optimal nutrition for women.

Control of Diarrheal Disease: Expanding access to zinc supplementation; inclusion of zinc treatment with the new low-osmolarity ORS to improve Diarrhea Case Management for children; reinvigorating ORT practices; improving family and community practices including hand washing, transport and storage of drinking water; promotion of point-of-use (POU) treatment of water; hygiene promotion and improving water and sanitation technologies; strengthening of supportive enabling environments to reduce the incidence of diarrheal disease; improve recognition and appropriate treatment of diarrheal disease at the facility level.

Pneumonia Case Management: Ensuring adequate access to pneumonia case management which includes facility- and community-based treatment; promoting prompt recognition and care seeking from appropriate providers.

Prevention and Treatment of Malaria: Promoting intermittent preventive treatment in pregnant women (IPT); expanding ownership and use of insecticide treated bed nets (ITNs), with emphasis on long-lasting nets (LLINs); improving malaria case management at the facility and community levels; promoting care-taker recognition of fever in children under five and prompt care-seeking behavior; applications should not include activities related to indoor residual spraying (IRS). In PMI countries (Angola, Benin, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Rwanda, Senegal Tanzania, Uganda and Zambia) CSHGP projects should be implemented in collaboration with PMI efforts and priorities in country, which are based on close planning with National Malaria Control Programs (NMCPs) (see PMI the Web site at www.fightingmalaria.gov for more information). In all countries, projects should be consistent with NMCP strategies and approaches.

Maternal and Newborn Care: Improving birth preparedness and complication-readiness planning; access to focused antenatal care (including education and counseling for healthy timing and spacing of pregnancy); promotion of tetanus toxoid immunization; promoting skilled attendants for birth and improving skills of providers; promotion of clean delivery and infection control; employ appropriate household- and community-based strategies where access to skilled care is difficult, including referral; promoting active management of third stage of labor; improving access to quality postnatal (mother and newborn) care and appropriate postnatal messaging (including education and counseling for healthy timing and spacing of pregnancy); promoting essential newborn care practices for all newborns including thermal care, cord care and immediate and exclusive breastfeeding; and sick newborn care including identification and treatment of neonatal infection and complications, resuscitation, and special care of premature and low birth weight infants.

HIV/AIDS: Grant activities may include the strengthening or establishment of linkages between MCH services and HIV/AIDS related services for women and children, where these linkages will serve to strengthen both types of service, i.e. strengthening the link of MCH services providing antenatal, delivery and postpartum care with PMTCT services, to produce improvement in those maternity services as well as increased uptake of PMTCT and improved follow-up, care, and treatment of HIV-exposed infants and HIV-positive mothers; strengthening routine child health services, including community-based services, to support improved detection, care, and treatment of HIV-positive infants and children. Since CSH grant funding is not HIV-specific funding, it is important that any proposed activities related to HIV detection, care, and treatment be designed in ways that also strengthen routine MCH services for the broader population of women and children in the target population.

Childhood Injury Prevention: Assessing burden and improving surveillance of injury-related morbidity and mortality; integration of injury prevention messages with IMCI key messages (i.e. messages related to drowning, road traffic injuries, falls, poisons, burns, etc.); demonstrating effectiveness of interventions to reduce the incidence of childhood injury.

Tuberculosis: Advocating for political commitment; improving detection and diagnosis using quality-assured bacteriology and standardized treatment with supervision and patient support; ensuring a reliable drug supply and management system; improving monitoring and evaluating systems through host country strategic information systems; improving management of TB/HIV co-infection; addressing multi-drug resistant TB; and providing care and support to people with TB. Care and support includes community participation in TB care and prevention, advocacy, communication and social mobilization, patient charter for TB care, enablers to help patients adhere to treatment, and engagement of civil society organizations.

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