Strengthening the Vertical Continuum of Care
While the USAID Mikolo Project primarily worked to strengthen health care at the community level, the project also worked across all levels of the health system to strengthen the overall vertical continuum of care (community–basic health center– district–regional–national) in order to facilitate seamless transitions between providers and maximize usability of the health system.
As community health volunteers (CHVs) are unable to provide all services, a strong referral system between CHVs and health centers is important to ensure that clients have access to care. Among those referred to the nearest health facility were 118,664 antenatal care (ANC) clients and 96,465 children under five with severe illness episodes. CHVs referred a total of 34,449 family planning (FP) clients for long-acting methods.
There was an increase from 4% to 20% of clients referred to health facilities who were counter-referred back to CHVs for follow-up. The percentage of communities with an established emergency transport system increased from 70% in 2017 to 90% in 2018. Facility-level deliveries increased from 50,192 in 2015 to 115,148 in 2018.