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URC/CHS Projects
Health & Population Past Projects
Rapid Expansion of Nutritional Recuperation Services for Malnourished Children in Nigerien Facilities
Client: Original grant from the American Jewish World Services
Subsequently funded by USAID’s Office of Foreign Disaster Assistance with funding from UNICEF
As climate conditions in Niger created a “near famine” CHS undertook a pediatric malnutrition program building on work that had been completed by CHS’s for-profit affiliate, University Research Co., LLC. Late in fiscal year 2005, CHS received a grant from the American Jewish World Services to initiate the program which builds on and expands work funded by the U.S. Agency for International Development (USAID) under an earlier project. In the spring of 2006 the Office of U.S. Foreign Disaster Assistance (OFDA) awarded URC’s Center for Human Services (CHS) a 12-month program grant. Under this project, CHS leveraged its established countrywide Pediatric Hospital Improvement (PHI) Collaborative, run as part of the Quality Assurance Project, to rapidly expand nutritional recuperation services for acutely malnourished children in 15 district hospitals while building local capacity for improved behavior change communication, screening, referral, and recuperation at global district levels.
Partners for Health Reformplus (PHRplus)
Client: United States Agency for International Development
As USAID's flagship project in health policy and systems strengthening, PHRplus brought together the expertise of leaders in international health care development in a joint global health reform initiative. PHRplus provided technical assistance and helped maintain USAID's worldwide leadership role in health care reform, health policy, management, health financing, and systems strengthening. Awarded in 2000 as a five-year project, PHRplus was built on the foundation established by the preceding Partnerships for Health Reform Project (PHR), which ran from 1995 through 2000. PHRplus continued a focus on implementation of improvements in health policy, management, financing, and health services delivery, and placed new emphasis on developing and strengthening health information and infectious disease surveillance systems, HIV/AIDS, and expanding community participation.
As the principal sub to Abt Associates, URC provided overall leadership through its participation on the Senior Management Team and specific leadership in critical project technical areas including National Health Accounts, decentralization, infectious disease surveillance, quality assurance, hospital management and accreditation. URC staff made important contributions to health systems strengthening, costing, resource allocation, health information systems, communications, and research. URC-led research focused on health worker motivation, sector-wide effects of the Global Fund, community-based health insurance, and quality improvement. In addition, URC had primary responsibility for PHRplus projects in Malawi, Eritrea, and Jordan and URC staff provided regional leadership for both West and Central Africa and East and Southern Africa, and the Latin America region. Finally, URC was responsibe for the management of the PHRplus Resource Center.
Eritrea/TASC2 Contract
Client: United States Agency for International Development
This three-year contract awarded by USAID to URC in December 2003 was the first task order issued under the Technical Assistance Support Contract 2 (TASC2) Global Health Indefinite Quantity Contract. The Eritrea task order proposed to strengthen the capacity of the country’s public sector to provide quality primary health care services and actively engage communities in three target zones to improve health behaviors and increase demand for critical health services. The contract focused on improving practices to (1) reduce infant and under-five mortality and morbidity (the leading causes of death include respiratory illness, malaria and diarrhea); (2) improve maternal health; and (3) stop HIV at an early stage. During the term of the contract, technical assistance was provided to the Ministry of Health of Eritrea to develop its capacity for efficient allocation and management of resources. URC and partner Abt Associates worked with the Ministry of Health of the Government of Eritrea, USAID, other USAID-funded implementing organizations, and local partners to improve and expand both the use and availability of quality health care services. Project activities built on technical assistance activities that both URC and Abt Associates implemented in Eritrea through the Quality Assurance Project and Partners for Health Reformplus (PHRplus) Project.
Improving Primary Health Care in Albania
Client: U.S. Agency for International Development
This three-year contract awarded to URC in 2003 supported USAID's goal to improve the quality of integrated primary health care services and increase service access and utilization. Spearheaded by URC, a four-organization project team implemented measures to deepen and broaden primary health care reform in the country in order to ensure quality of and access to integrated primary health services. The Pro Shëndetit Project was implemented with the Albanian Ministry of Health and with the Health Insurance Institute. Project goals included development and dissemination throughout Albania of a primary health care model that delivers integrated and comprehensive services for family planning and reproductive health, HIV/AIDS and sexually transmitted infections, tuberculosis, and other infectious diseases. In addition, the project implemented improvements in other aspects of the primary health care system including financing, information systems, and regulation. URC’s partners on the project included Bearing Point, the American Academy of Family Physicians, the Joint Commission International, and the National Perinatal Information Center, as well as several Albanian organizations.
Benin Integrated Family Health Project
Promotion Intégrée de Santé Familiale dans le Borgou et l’Alibori (PROSAF)
Client: U.S. Agency for International Development
Through the Benin Integrated Family Health Program (PROSAF) (1999-2004) funded by USAID, URC supported implementation of a decentralized and integrated program of family health services in the Departments of the Borgou and Alibori. As prime contractor, URC led a contractor team of four organizations who worked in close partnership with the Ministry of Health at the central, regional, zonal, and community levels, USAID, other donors, cooperating agencies, and NGOs. The project team worked to develop and execute innovative community-based approaches to the integration of family planning, maternal and child health, and STD/HIV prevention. PROSAF provided overall technical and administrative direction to improve health planning and coordination, increase access to integrated family health services and commodities, and increase the capacity of local health workers to provide quality services. URC's partners included l'Association Béninoise pour la Promotion de la Famille (ABPF), the Cooperative League of the United States of America (CLUSA), and the Program for Appropriate Technology in Health (PATH).
Promotion Intégrée de Santé Familiale dans le Borgou et l’Alibori (PROSAF) Transition Phase
Client: United States Agency for International Development (USAID)
PROSAF Transition Phase, 2004-2006, was the two-year follow-on contract to the Benin Integrated Family Health Project (PROSAF). University Research Co., LLC, led a consortium of four organizations that worked in close partnership with the Ministry of Health at the central, regional, zone, and community levels. The program worked to achieve results under USAID/Benin’s Health Strategic Objective to increase the utilization of family health services and preventive measures in a favorable political environment by implementing health systems improvement activities in the departments of Borgou and Alibori in Northern Benin.
Maternal and Child Health Technical Support Contract
Calidad en Salud/Guatemala
Client: United States Agency for International Development (USAID), Guatemala (USAID/G-CAP)
Designed to support ongoing Guatemalan healthcare reform and promote the integration of maternal and child healthcare (MCH) and family planning (FP) services, this 46-month TASC contract was awarded to URC in December 1999. Funded by USAID/G-CAP, the program's overall goal was to achieve expanded and improved quality healthcare services for rural women and children, particularly those residing in the highlands region of the country. URC led a core team of five technical assistance organizations in partnership with USAID, the Guatemalan Ministry of Health (MOH), the Guatemalan Social Security Institute (IGSS), non-governmental organizations (NGOs), and the underserved Mayan populations of Guatemala’s highlands. Calidad en Salud made Guatemala’s pioneering decentralization model—known as the Sistema Integral de Atención en Salud (SIAS)—a reality by fostering effective collaboration between government institutions, NGOs, and community representatives in the delivery of basic healthcare services. The model placed greater emphasis on community participation and empowerment and engaging communities in the design, implementation and evaluation of MCH programs. Calidad en Salud provided the tools and skills to improve both quality and access to basic health services and to stimulate demand for these services by effecting behavior change among caregivers and clients and promoting improved health behaviors at both the community and household level.
Dominican Republic Child Survival Project
Client: United States Agency for International Development
The purpose of this two-year USAID-funded project was to strengthen the capacity of private voluntary organizations (PVOs) to implement a child survival strategy in the three poorest regions of the Dominican Republic. The services initially targeted for introduction in a phased approach were management of diarrheal diseases, promotion of oral rehydration therapy, breastfeeding, and birth spacing. Through support to develop and implement tailored management improvement plans, URC helped strengthen the training, logistic support, and supervision systems of 14 Dominican PVOs. The URC team also provided a forum for planning and coordinating the health activities all PVOs working in child survival. The project also implemented mass media campaigns for diarrheal disease control and breastfeeding through television and radio spots, street banners, and written materials. USAID/Santo Domingo awarded the project an "A" rating, citing it as one of the most successful and efficiently managed projects in the USAID portfolio. The project was completed in 1993.
Egypt Cost Recovery for Health Project
Client: United States Agency for International Development
The Cost Recovery for Health Project supported the transition of five Ministry of Health and Population (MOHP) facilities to cost recovery, to enable the Government of Egypt to determine the feasibility of converting all MOHP curative facilities into self-managed entities. The three-year project, which ended in 1998, was funded by USAID. The URC team analyzed and developed implementation plans for health financing options to improve coverage of the underserved, including continuation of a loan program to expand private practices, development of a Health Maintenance Organization model, and expansion of a national insurance plan. A major task was institutionalization of improved management and administrative systems in the five hospitals and the introduction of quality assurance initiatives and quality management techniques. URC also developed a prototype local area network management information system which was later expanded to other hospitals and the MOHP central office.
Global Programme on AIDS Senior Managers’ Training Course
Client: United States Agency for International Development
For the World Health Organization Global Programme on AIDS (WHO/GPA), URC developed the content, approach, and trainer and participant materials for WHO’s training course for managers of national HIV/AIDS programs in developing countries. URC’s team, working closely with WHO/GPA staff, defined the components of a comprehensive HIV/AIDS control program and the activities and tasks required of a national manager to effectively design, implement, and manage the program. Training modules were developed around each major skill area, including selecting control activities and target populations for prevention; establishing appropriate policies; selecting priorities and setting targets; planning program activities; and monitoring and evaluation. URC supervised the field test of the training modules and methods in Zimbabwe and a subsequent refinement of the modules. The project was completed in 1993.
Haiti Voluntary Agencies for Child Survival Project
Client: United States Agency for International Development
In the Management Assistance to Voluntary Agencies for Child Survival Project, URC was tasked with assisting nongovernmental organizations (NGOs) in Haiti to strengthen their capacity to delivery preventive and promotive health services to mothers and children. URC’s technical advisors developed capabilities in institutional development, grants and financial management, planning, fundraising, applied research, and management information systems in three large Haitian NGOs which in turn were able to provide assistance in these areas to smaller NGOs. URC personnel worked closely with staff of the three main NGOs to design and develop material support for training workshops, develop supervision tools and personnel management procedures, and design financial management and information systems that could be replicated by other NGOs, as well as to develop their consulting skills as providers of technical support. This six-year project was completed in 1995.
Indonesia Private Sector Family Planning Project
Client: United States Agency for International Development
The Indonesia Private Sector Family Planning Project addressed a critical resource issue facing national family planning programs throughout the developing world. Under the six-year project, which ended in 1996, URC mobilized and strengthened private sector family planning activities, building upon the foundation set by the National Family Planning Coordinating Board. URC assisted in development of private organizations’ capacity to provide family planning services; expansion of a social marketing campaign nationwide; improvement of the quality of clinical contraceptive services; and development and testing of fee_for_service strategies in rural areas. The URC team also worked with professional associations of physicians, nurse-midwives, and pharmacists to strengthen their capacity to support quality assurance and continuing education in family planning for their members.
Latin America and Caribbean Health and Nutrition Sustainability
Client: United States Agency for International Development
From 1990 to 1995, URC’s Latin America and Caribbean Health and Nutrition Sustainability (LAC HNS) project provided technical assistance to USAID’s Latin American and Caribbean Bureau and country Missions in the priority areas of health management and administrative strengthening, health care financing, and nutrition. URC provided a core team of long-term advisors and short-term consultants that supported the development of regional and country strategies and provided technical assistance in design, monitoring, and evaluation to USAID-supported health projects throughout the region. As a result of the project’s activities, the LAC Bureau and Missions engaged in policy dialogue with governments and other donor organizations and were able to develop, monitor, and evaluate more effective projects in health management, financing, and nutrition. Over the course of the project, LAC HNS developed 9 tools for policy analysis, prepared 21 strategies and assessments, carried out 13 project design and evaluation activities, conducted 44 special studies, and organized 25 regional and national workshops related to health management, financing, and nutrition.
The Maram Project: Healthier Palestinian Families
Client: United States Agency for International Development
On the Maram Project, awarded in 2001 and managed by IBM Global Services, URC was one of a consortium of US-based technical assistance organizations which worked to build Palestinian health service delivery capacity and provide support for the service delivery sector during emergencies. In cooperation with the consortium partners, the USAID Mission, the Ministry of Health of Palestine, local non-governmental organizations, and village health worker networks, URC spearheaded a number of research activities including an assessment of health services in the West Bank and Gaza which established uniform definitions that allowed for comparisons between public, private, and the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) services.
URC led a comprehensive immunization coverage assessment which was the first conducted in the region in approximately 10 years and contributed to establishment of a research website. Following a 2002 UN declaration of a nutrition humanitarian emergency in the West Bank and Gaza, the URC team contributed to nutrition related activities including facilitation of the development of a national nutrition strategy, design and conduct of a regional conference on state of the art approaches to data-based decision-making for nutrition programs and policies, and research of a number of maternal and child nutrition issues in the West Bank and Gaza Strip.
Peru Consultancy in Quality Assurance and Improvement
Client: World Bank
The Health and Basic Nutrition Project (PSNB), financed by the World Bank, spearheaded health sector reform in Peru by helping the Ministry of Health (MOH) to improve the quality of primary health care services and establish decentralized health service networks. Through the PSNB, URC was hired by the Ministry of Health in a two-year consultancy to support the introduction of quality management approaches and quality improvement projects in MOH facilities in Lima and the departments of Cusco and Piura. URC’s consultancy focused on strengthening leadership in four health service networks, developing a broad range of quality management tools to support supervision and monitoring, supporting quality improvement projects, and training health professionals in health services management. URC also assisted the MOH in improving its health information system and introducing key quality indicators and standards to monitor the quality of care. The consultancy was completed in 2000.
Malawi Support to AIDS and Family Health Project
Client: United States Agency for International Development
Funded through USAID, this four-year project (1994-1998) sought to reduce total fertility and transmission of HIV/AIDS and other sexually transmitted diseases (STDs) through efforts to increase the contraceptive prevalence rate and promote behavioral change in Malawi. URC, in partnership with prime contractor John Snow, Inc., the Malawi Ministry of Health, and local nongovernmental organizations, worked to expand the availability, accessibility, and utilization of quality family planning and STD/HIV education and services. We provided support for the introduction of quality assurance methods into family planning services, increasing and improving clinical facilities, broadening the range of family planning methods, and providing training to health care workers. In addition, URC led behavioral research efforts to determine reasons underlying low rates of HIV preventive behavior and contraceptive prevalence despite high levels of awareness about the disease. Findings were used to make family planning services and HIV/AIDS interventions more relevant to the Malawian population and to support community mobilization efforts.
Mozambique Primary Health Care Support Project
Client: United States Agency for International Development
Under a five-year contract from USAID/Maputo (1994-1999), URC assisted the Mozambican Ministry of Health (MOH) to decentralize health service delivery and management and increase the availability and use of essential maternal child health and family planning services. URC’s team assisted the MOH to address project objectives at the national level and in three target provinces. At the national level, URC helped to formulate, field test, and implement decentralization policies in the areas of planning, administration, human resources, and continuing education. Project advisors at the provincial level provided hands-on management training and technical support to increase provincial capacity to manage all health-related activities. Technical assistance in strategic planning focused on developing provincial capacity to create realistic, integrated work plans that accounted for all donor agencies and nongovernmental organizations working in the province. Priority districts were assisted to write brief annual reports and produce simple work plans incorporating local health data. URC also conducted a pilot cost-recovery activity in the hospital system in Maputo and assisted in developing a national strategy for cost recovery.
Niger Family Health and Demography Project
Client: United States Agency for International Development
From 1989 to 1995, URC provided extensive assistance to the Government of Niger to strengthen the delivery of family planning services nationwide. URC resident advisors provided technical assistance in management, training, and information, education, and communication (IEC) and established the foundation for well-managed, widely accessible, high quality services. One of URC's major accomplishments in the project was the creation of a national training unit in the Directorate of Family Planning. URC's training advisor developed counterparts' abilities to assess training needs, develop criteria for trainee selection, establish annual training plans and schedules, and decentralize the delivery of clinical, IEC and logistics training through training-of-trainer courses for regional training teams. Over the course of the project, URC was responsible for ensuring the delivery of clinical family planning training to public health workers nationwide, the majority of whom had virtually no prior experience or training in family planning. The project also developed job descriptions, administrative procedures, and supervisory protocols to guide the decentralized implementation of family planning services. Our Niger team expanded program coverage more rapidly than USAID and the government had thought possible by successfully integrating family planning, sexually transmitted disease, and HIV/AIDS services within maternal and child health programs. We helped to significantly improve the acceptability of family planning services by raising health worker consciousness about client rights and responsibilities and stimulated innovative demand creation and supply approaches to expand coverage.
Peru Strengthening Health Institutions Project--MaxSalud Component
From 1994 to 1999, URC provided technical and logistical support for the development of a self-sustaining primary health care system serving some 165,000 low- and middle-income people in Chiclayo, Peru. URC helped to establish the MaxSalud Institute for High Quality Health Care as a legal entity and enabled the private health organization to forge a strong institutional image based on the provision of high quality services at affordable prices. URC’s activities included convening and facilitating focus groups of providers and clients, helping to identify and recruit an effective community-based board of directors, hiring and training staff, designing services and clinic infrastructure to meet client needs and expectations, developing manuals of care, and establishing a management information system to monitor key indicators of quality, cost, and performance. Over the course of the project, six MaxSalud clinics opened to offer a wide range of services: general medicine, pediatrics, gynecology, family planning, pre-natal care and delivery, postpartum care, growth monitoring, vaccinations, emergency services, and dentistry, along with laboratory, pharmaceutical, and emergency services. With URC assistance, MaxSalud also developed a strong community outreach program, implementing community campaigns for breastfeeding, vaccinations, family planning, tuberculosis, and AIDS prevention.
Quality Assurance Project I
Client: United States Agency for International Development
The Quality Assurance Project I (QAP I) was a five-year project of USAID to provide international leadership in the area of quality assurance (QA) and continuous quality improvement in health care and institutionalize quality assurance systems in USAID-supported health programs. QAP I carried out activities in 20 countries, providing technical assistance and training in standards development, quality assessment and monitoring, problem solving, and quality improvement. The project supported the development of national or regional QA programs in Chile, Costa Rica, Ecuador, Egypt, Jordan, Niger, and Nigeria and implemented smaller scale technical assistance efforts in Guatemala, Honduras, Indonesia, Malawi, Paraguay, the Philippines, Uganda, and other developing countries. The project also sponsored several central level activities to support the development of country programs, including operations research to develop and refine QA methods for use in developing countries and the design of standardized training courses that could be easily adapted to country-specific needs. QAP I also actively disseminated project results and methods to the international health community through newsletters, brief reports, and technical monographs. Implemented from 1990 to 1995, QAP I was followed by Quality Assurance Project II.
Support for the Education Programs of the National Heart, Lung and Blood Institute
Client: National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health
Widespread concern with reducing a broad spectrum of health risks led the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health to initiate several national health education programs and initiatives aimed at reducing morbidity and mortality related to undetected and untreated acute myocardial infarction, high blood cholesterol, high blood pressure, sedentary lifestyle, obesity, and smoking and lung diseases. From 1987 to 1993, URC assisted NHLBI in implementing several risk factor reduction programs for cardiovascular and pulmonary disease, including the National Cholesterol Education Program, the National High Blood Pressure Education Program, the National Heart Attack Alert Program, the NHLBI Obesity Education Initiative, and the NHLBI Smoking Education Program. In addition, URC assisted in planning, developing, and implementing the National Blood Resource Education Program and the National Asthma Education Program. URC played a key role in helping these programs to accomplish their goals through the development and dissemination of professional, patient, and public education materials. URC also provided technical support to state and local organizations, such as health departments, through workshops and conferences. URC services included developing continuing medical education courses, educational pamphlets, fact sheets, posters, booklets, videos, brochures, and slide kits and providing computer, social marketing, and data analysis and evaluation support. URC was also responsible for marketing these educational materials through the media and professional organizations. To complement the major program areas, URC provided expertise in areas of special interest to the risk reduction efforts of NHLBI, including minority health, workplace health promotion, and community program development.
Women and Infant Health Strategy/Russia
Client: United States Agency for International Development
The Women and Infant Health Strategy (WIN) Project was a comprehensive, USAID-funded effort to reduce maternal morbidity and mortality in Russia. Implemented from 1999-2003, the project supported service restructuring and provider training to improve the quality of maternal and newborn services, increase access to high-quality reproductive health services, and increase demand for these services among the population. URC served as a subcontractor to John Snow, Inc., which managed WIN under its Maternal and Child Health Technical Assistance and Support Contract (TASC). URC provided training to health professionals and policymakers in quality improvement principles and activities and supported the development and testing of quality monitoring indicators and implementation of targeted quality improvement demonstrations in the cities of Perm, Novgorod, and Berezniki. URC staff also supported the development of evidence-based clinical guidelines to redefine women's and infant's health services and practices in Russia.
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