Between Q4 2015 and Q1 2016, in collaboration with the FMoH and PFSA, CHAI completed a baseline survey to measure the availability of key commodities necessary for accurately diagnosing or treating pneumonia and diarrhea in children under-5. The results of this survey will provide the basis for future programmatic evaluation, as well as program planning and budgeting. Methodology The study design used mixed methods to understand the landscape of child health delivery services in Ethiopia, including a health facility based cross-sectional survey and a separate survey at regional PFSA hubs and woreda health offices. Additionally, a qualitative component of the study was conducted to provide contextual information. Data collection was rigorously monitored and was subsequently analyzed using STATA. Results The qualitative study findings revealed that although the FMoH adopted the 2014 WHO recommendations on childhood diarrhea and pneumonia management, the guidelines have not yet reached all facilities. Additionally, regional respondents were unaware of the recently revised IMNCI guidelines (to include pulse oximetry) and they would expect guidance on how to implement from FMOH when the guidelines are available. Furthermore, policies/guidelines on medical oxygen use and supply systems were unavailable, and respondents felt the current system was irregular, less efficient and not costeffective. All respondents felt there was a clear resource gap for oxygen, and current reliance on partners was not sustainable. The quantitative assessment also found that essential medicines (ORS/Zinc and Amox DT) have only been recently included in the RRF, but these forms have not been distributed and are not being used at the facility level. While there are have been significant success in the implementations so far, the assessment also found significant limitations IPLS related issues, such as low training coverage on IPLS, lower availability of IPLS formats, and IPLS forms which have not been updated to include key child health commodities. There was significant variation of IPLS implementation between regions and facility types in terms of challenges and gaps, but there are best practices exist within the system that can be scaled up after further evaluation. There was also a weak supply chain management linkage between the health centers and health posts but the assessment has shown also better experience in this regard especially in Tigraye region. Few health centers and hospitals had functional DTC across the four regions, and training coverage on DTC was very low. Commodity availability widely varied between regions and facility levels. In general, oxygen available was much higher at the hospital level and lower at the health center level. However, staff members lacked training on providing oxygen therapy and facilities lacked SOPs/job aids for providing oxygen therapy. As anticipated, the Zinc/ORS co-pack availability was fairly low across all regions and facility types. ORS availability tended to be higher at the hospital level, but was relatively low at the health post and health center level. Zinc availability was highly variable between regions/facility types – i.e. lower in Oromia and SNNPR, but higher in Amhara and Tigray. Amx DT 250mg and 125mg availability varied widely between regions, and stock at the health center level may indicate there is a missing link to distribution at health posts. Furthermore, the source of the majority of these commodities was through non-PFSA channels, which makes tracking difficult for stocking and refill decision making

• • key commodities necessary for accurately diagnosing or treating pneumonia and diarrhea • Children under-5. • Ethiopia

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This data element  conation the base line survey of Implementation for Pneumonia and Diarrhea Commodities in Ethiopia and reported March 04, 2016. The study design used mixed methods to understand the landscape of child health delivery services in Ethiopia, including a health facility based cross-sectional survey and a separate survey at regional PFSA hubs and woreda health offices. Additionally, a qualitative component of the study was conducted to provide contextual information. Data collection was rigorously monitored and was subsequently analyzed using STATA.  Indicator assessed Trained on IPLS, Availability of IPLS S, IFRR Forms Updated for ORS, Zinc, and Amox DT, Availability of HPMRR Forms, DTC Established and Functional, Availability of Essential Child Commodities and Oxygen Supply System in all study area.

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