The SANRU Program of ECC & IMA World Health

SANRU is currently assisting115 health zones in DRC with support from various agencies and partners.

Origins of the SANRU Program were the well known

USAID funded SANRU Projects

SANRU I 1980-86 50 health zones 10 MillionSANRU II 1986-1991 100 health zones 40 MillionSANRU III 2000-2006 56 health zones 28 Million

SANRU III Project was built on partnerships with U.S. faith-based partners (Catholic and Protestant) during a time of conflict and division in the DRC

SANRU III Assistance to 56 HZs (2000-

2006)

5 year28 Million USD56 Health Zones

In 2006 following the release of the ‘Fragile States Policy’ Project AXxes replaced the SANRU III project

5 year28 Million USD56 Health Zones

3 year42 Million USD57 Health zones

Three Components of Project AXxes for HZ Development:

A: Increase access to… integrated PHC

B: Increase capacity of Health Zones & referral system 

C: Reinforce national programs & provincial/district offices

AXxes Progress for Key IndicatorsIndicators Year 2

TargetYear 2

Achieved %

Rate of use of health services 2,550,144 2,235,492 88%Couple years of protection (CYP) 40,000 48,461 121%Births attended by skilled personnel 174,868 204,216 117%Antenatal care (ANC) visits 233,156 273,826 117%VAT2 (or 5 doses VAT) 186,524 203,219 87%Children with measles vaccination 228,856 216,673 95%DPT3 Coverage 228,856 241,671 106%Pregnant women received IPT 186,524 149,554 80%TB Detection Rate 8,744 11,099 127%Child with ARI/pneumonia treated correctly 291,448 283,046 97%Children with diarrhea treated correctly 291,448 147,187 51%

Family Planning

Reproductive Health & Newborn

Immunizations

Malaria & TB

Challenges forProject AXxes

andthe SANRU Program

1. Povertyand

(in)access to care

Photo: Lodja.June 2008/Mulongo

2. Infrastructure (or lack of)

Photo: ECC/AXxes 2008

Photo: Equateur Province.Mar 08/ Mulongo

Photo: National Highway #1 BDD/Mar 07/Clemmer

3. Decreasing means of

commercial transport

Photo Goma Apr 08/cnn.com

4. Constraints of importing goods

Photo: Route de Matadi Apr.08/Clemmer

5. Weak Government Support to Health Zones

Photo: General Hospital, South Kivu 2004/Clemmer

Photo: Yakusu Health Zone. February 2002/ Clemmer

6. Chronic Insecurity

Photo Mission Hospital Occupied by armed elements:. South Kivu. Apr 02/Cemmer

7. Uncoordinated donor coordination

Photo: Moanza Health Zone: Apr 06/Clemmer

8. Resurging Epidemics

Photo: Ebola.Outbreak.Ground Zero. Mweka.Oct 07/Clemmer

9. Retention of trained personnel

Photo: ITM Sona Bata. 2004/Clemmer

Vision for Future

Health Zone Development

Trends Observed

1) Geographic shift of USAID assistance (from 8 provinces to 4 with focus on south + eastern DRC)

2) Decrease in support to co-managed HZ partnerships (33% in AXxes vs. 70% for SANRU II)

3) Decreased leveraging with US-based partners historically linked to some health zones.

4) Possible fragmentation of Appui Global with vertical projects and multiple funding streams.

Suggested Strategies

1) Continue Appui Global to 57 AXxes-assisted Health Zones

2) Re-establish assistance to 30 former SANRU III HZs currently without a development partner

3) Expand to 20 (or more) additional HZs with US-based partners to leverage and coordinate additional aid.

4) Support Geographic Equity in Appui Global & Integrated Projects