The Clinton Health Access Initiative (CHAI), with the guidance of the Federal Ministry of Health (FMOH) and the Pharmaceutical Fund & Supply Agency (PFSA), supported through funding from Bill and Melinda Gates Foundation (BMGF), are implementing Child Survival Program (CSP) to contribute to the national goal of reducing child morbidity and mortality in Ethiopia. This project, beginning in October 2015, focuses on addressing gaps in childhood pneumonia and diarrhea which is a priority for FMOH, by accelerating access to life saving child health commodities (CHC). The program is operational in four agrarian regions of Ethiopia, namely Amhara, Oromia, SNNPRs and Tigray. A total of 1194 health institutions (394 health centers, 52 hospitals, 356 health posts and 392 woreda health offices) visited for SS between January 09, 2017 and March 30, 2017. Overall performance from the planned institutions to visit was 94% achievement. In addition to on-site technical support provided to facility staff, the following major findings were identified by the SS teams. 77% and 54% of pharmacy heads and health facility heads were trained on Drug and Therapeutic Committee (DTC), respectively. The baseline for the same training of pharmacy heads and health facility heads were 13% and 7% respectively. DTC establishment and functionality improved 53% from 19% (baseline). There was low adherence to the new IMNCI guidelines in terms of diarrhea and pneumonia treatment. About 14% of diarrhea cases were not treated with ORS, and 24% of cases were not treated with zinc. Similarly among children seen with pneumonia, 72% were treated with Amoxicillin, while 14% were treated with other antibiotics (typically cotrimoxazole). Of which Amox DT 250mg treatment was given only for 7% of children with pneumonia cases. This requires expedited rollout of the new IMNCI GL. The resalt  at second round supervision was  % of HCs with Pharmacy head/head dispenser trained on DTC 77%, % of HCs with HC head trained on DTC 54%, % of HCs with DTC established/formed 91%,  % of HCs with functional DTC 53%, % of HCs with DTC but not functional 38%.  Gaps identified was Only half the HC had functional DTC , Limitations in updating bin cards for CHCs including ORS, which is in use for several years ,Availability of the ORS/Zinc co-pack is extremely low, Although Amox DT 250 mg is available in a decent number of health centers, its utilization is very low ,The practice of prescribing both Zinc-ORS simultaneously is low for diarrhea cases, Utilization of IFRR and regular reporting is poor; some facilities are using IFRR, but many of them report for items that are needed to be refilled, There is a shortage of preprinted updated LMIS format, specially IFRR and HPMRR , Although data quality is a genuine problem at all levels, there are limited efforts to improve this at facility level.  Etc  recommendation:  DTC establishment and functionality based on the criteria ,to Bin card updating for child health commodities, Availability and proper distribution of CHCs, particularly Co-Pack and Amox DT; o Utilization of Amox DT for under five children with pneumonia cases, and providing ORS and Zinc for all diarrhea cases and  Incorporation of CHCs into RRF.

• • Availability of Child Health Commodities pneumonia and diarrhea • children under-5 • progress of LMIS and DTC status • IPLS training • Ethiopia

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   This meta data contain data of joint Supportive Supervision Reported in  April 2017 by  Clinton Health Access Initiative -Ethiopia on Child Survival Program in Collaboration with PFSA and Regional Health Bureaus    The resalt  at second round supervision was  % of HCs with Pharmacy head/head dispenser trained on DTC 77%, % of HCs with HC head trained on DTC 54%, % of HCs with DTC established/formed 91%,  % of HCs with functional DTC 53%, % of HCs with DTC but not functional 38%  after the assessment of the  second  time after base line assessment. The data was cleaned and available by excel.DTC establishment and functionality based on the criteria ,to Bin card updating for child health commodities, Availability and proper distribution of CHCs, particularly Co-Pack and Amox DT; o Utilization of Amox DT for under five children with pneumonia cases, and providing ORS and Zinc for all diarrhea cases and  Incorporation of CHCs into RRF recommended from this report.

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