The Clinton Health Access Initiative (CHAI), Ethiopia has been implementing the Child Survival Program (CSP) since October 2015. It is a multiyear project that is funded by the Bill and Melinda Gates Foundation (BMGF) to support the national child survival strategy with a focus on pneumonia and diarrhea. The program is operational in four big agrarian regions of Ethiopia, namely Amhara, Oromia, SNNPR and Tigray intended to serve 1600 Health facilities in 400 Woredas. But oxygen support extends to all regions in all public hospitals across the country. Although the program was initially started in 2015 with a specific focus on diarrhea and pneumonia, the work has extended to support the broader supply chain as a whole, including the improvement of Integrated Pharmaceuticals Logistics Systems (IPLS), Drug and Therapeutic Committee (DTC), Quantification, Distribution and procurement as well as access to oxygen therapy (which is a cross-cutting service). Apart from on-site technical support provided to facility staff, the following major findings were identified by the SS teams. 86% and 65% 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. As the result DTC functionality improved from 17% (baseline) to 90% now. The SS revealed that there is significant improvement in IPLS/LMIS implementation and availability of CHCs compared with the baseline. In terms of commodity availability, 93%, 100% and 97% of HCs had Amox DT 250mg, ORS, and Zinc, respectively, on the day of visit. Although there is progressive improvement in using Amox DT for HC consumption, still there are some (4%) facilities that do not yet use Amox DT for intra facility consumption. Rather they were serving as temporary storage until it was transported to satellite HPs in their catchment areas. Application of IPLS formats for CHCs was also improved from the previous SS. About 94%, 94% and 93% of HCs included ORS, zinc and Amox DT in their last RRF sent respectively that shows progress than the previous visit.Major Gaps Identified: Limitations in updating bin cards for some CHCs including ORS, which is popular for years, Adapting and utilization of facility-specific medicine list (FSML) is limited ,Some HCs didn’t develop the current year annual action plan for DTC ,There are some HCs yet they do not use Amox DT for HC patients, There is low practice of prescribing of Amox DT for pneumonia 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 the facility level. Recommendations: Ad hoc technical support for stagnant HFs/with enforcement from government end, Advocacy at RHBs//WoHO level to assign pharmacy professionals at least one pharmacy professional per WoHO and one per HC, Strengthening WoHO/ZHD/PSA capacity in conducting regular SSs, Review Meetings and follow up of HFs using structured and standardized checklist,Strengthen non-model site visit via Woreda LOs and access data regularly CHAI Ethiopia, Child Survival Program, PFSA and RHBs Collaborative SS Report 42,Conduct data verification of non-model sites • HC-HP linkage and regular reporting of HPMRR should be strengthened, Improve availability and distribution of LMIS/IPLS formats, guidelines, SOPs and job aids at all levels,Provide focused technical support/mentoring in IMNCI implementation in all HCs and ICCM implementation in all HP through coordination with demand creation partners and RHB.

• • 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 shows  data of joint Supportive Supervision Reported in  February 2019 by  Clinton Health Access Initiative -Ethiopia on Child Survival Program in Collaboration with PFSA and Regional Health Bureaus .This report investigate the  progress of  % of HCs with Pharmacy head trained , HCs with HC head trained on DTC,  % of HCs with DTC established/formed , % of HCs with functional DTC, IPLS Implementation Status, Supply Chain Management and Availability of Storeroom and Availability of Child Health Commodities for  pneumonia and diarrhea .the data was   cleaned available by excel.

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