10.6
Logical Framework
Indicators
Critical Assumptions
/ Risks
Goal
To reduce morbidity and mortality among children under 5 in OMC
Objective 1
Improved pneumonia and diarrhea prevention &
care practices amongst community members
Objective Indicators
1.01 - % children U2 months with chestrelated cough and fast and/or difficult
breathing in the last 2 weeks taken to
appropriate health provider
Weather permits
access to remote
villages, in order to
meet targets.
1.02 - % of children U2 months with
diarrhea in the past 2 weeks treated with
ORS or home fluids
No further border
conflicts that would
prevent activities.
Outputs
1.1 VHSGs leaders providing effective home
visits, health education, and referrals
Output Indicators
1.1.1 % of VHSG active in providing health
education on a monthly basis
1.2 Improved treatment and care practice for
children U5 with diarrhea
1.1.2 % VHSG conducting Health education
with at least 80% quality rate, as assessed
using QIVC.
1.3 Improved treatment and care practice for
children U5 with ARI
1.4 VHSGs provide accurate, timely community
case management of diarrhea and referral for
pneumonia*
1.5 Improved hand washing, sanitation and safe
drinking water practices
Activities
1.1 Train 312 new VHSGs in C-IMCI
1.2 Conduct VHSG Monthly Cluster meetings to
encourage mothers groups, HH visits and CCM /
referrals, collect data on VHSG activities, and
provide C-IMCI refresher training in 25 HC areas
1.3 Conduct Quarterly VHSG meetings with HC
staff at HCs, to encourage mothers groups, HH
visits, CCM/referrals, collect data on VHSG
activities, and provide C-IMCI refresher training in
25 HC areas
1.4 Use QIVC to assess quality of community
education and CCM of Diarrhea conducted by
VHSG
1.1.3 # of participants that received
education at HH visit, mothers group or a
community based event per month
1.1.4 # of sick children U5 referred by
VHSG to HC for treatment in last 6 months
1.2.1 % of children U2 with diarrhea in the
past 2 weeks treated with zinc
1.3.1 % children U2 with chest-related
cough and fast and/or difficult breathing in
the last 2 weeks treated with an appropriate
antibiotic
1.4.1 % VHSGs in remote villages providing
correct community case management of
children U5 presenting to them with a
respiratory or diarrhea problem
1.4.2 # of children U5 in remote villages
treated by VHSGs with ORS and zinc in last
6 months (191 villages)
1.5.1% of households with child U2 who
report they wash their hands with soap at
least 2 critical times
Permission to conduct
CCM activities granted
by PHD by FY14,
including provision of
ORS +Zinc and
supportive
supervision, per MoH
protocol.
Migration and lack of
commitment of VHSG
1.5 Provide capacity building of HC staff to
facilitate VHSG Quarterly meetings and SS of
VHSGs
1.6 Supply materials and support VHSG to
facilitate Community Education Drama/Video
Events (80 per year)
1.7 Cross visits by MTI staff to other CCM
projects in Cambodia
1.8 Develop plan for CCM of diarrhea with PHD,
including supply chain plan for ORS and zinc
1.9 Develop and implement supervision
mechanisms for CCM *
1.10 Train VHSGs in community case
management of diarrhea and screening/referral
for pneumonia*
1.11 Support construction of “Easy Latrines” in ID
Poor HH with a child U5
Objective 2
Improved nutritional status of children aged 0-23
months of age
Objective Indicators
2.01- % of children aged 6-23m fed
according to a minimum of appropriate
feeding practices (IYCF)
2.02- % of children aged 6-23 months who
consumed MNP in the last week
2.03 - % of children U2 who are
underweight
Outputs
2.1 VHSGs and MSG leaders providing effective
home visits, IYCF education, and referral of
malnourished children
Output Indicators
2.1.1 # of children U5 referred by VHSG to
HC for malnutrition in last 6 months
2.2 Improved IYCF practices among women with
children aged 0-23 months
2.1.2. % of villages where a mothers group
was conducted at least 5 times in the past 6
months
2.3 PD Hearth program providing treatment for
malnourished children aged 0-23 months in target
villages with >30% malnutrition
2.2.1 - % of mothers of children 0 – 6
months practicing immediate and exclusive
breastfeeding
2.4 Regular growth monitoring of children aged 023 months at BFCI villages
2.2.2 % of children aged 6-23m who receive
minimum dietary (food group) diversity
2.5 Increased micronutrient intake of Children
aged 0-23 months through intake of both Multiple
Micronutrient Powder (MNP) and improved diet
diversity
2.3.1 % of children graduating from PD
Hearth program within 3 months of
enrollment
Weather permits
access to remote
villages, in order to
meet targets.
No further border
conflicts that would
prevent activities.
No disruption to the
national supply of
MNP
Migration and lack of
commitment of VHSG
and MSG
BFCI committees
inactive
2.4.1 % of BFCI villages conducting monthly
growth monitoring
Activities
2.1 Train 312 new VHSGs in Nutrition
2.2 VHSG’s conducting monthly education
sessions at Mothers Groups
2.2 Conduct VHSG Monthly Cluster meetings to
encourage mothers groups, HH visits and referral
of malnourished children, distribution of MNP
collect data on VHSG activities, and provide
refresher training in 13 HC areas. (note: same
activity as 1.2, but different subject covered and
in subset of HCs)
2.3 Conduct Quarterly VHSG meetings to
encourage mothers groups, HH visits and referral
of malnourished children, distribution of MNP
collect data on VHSG activities, and provide
refresher training in 13 HC areas.(note: same
activity as 1.3, but different subject covered and
in subset of HCs)
2.4 Use QIVC to assess quality of community
education conducted by VHSG (note: same as
1.4, but different subject and subset of HCs)
2.5 Supply materials and support VHSG to
facilitate IYCF Cooking demonstrations
2.6 Train MTI and PHD staff on PD Inquiry and
PD Hearth program
2.7 Conduct PD Inquiry and based on results
develop PD Hearth Program
2.8 Implement PD Hearth in 6 pilot villages in
FY14 and scale up based on results of pilot
2.9 Support the PHD to establish BFCI villages
within the target area
2.10 Support BFCI villages to conduct monthly
growth monitoring for all children aged 0-23
months, IYCF cooking demonstration, and
referral of malnourished children
2.11 Advocate for growth monitoring to be
conducted for all children seeking HC services
both at HC and during Outreach sessions
2.12 Support the PHD to train and monitor HC
staff and VHSG in the distribution and uptake of
MNP for all children aged 6-23 months in 8 new
HC areas.
2.4.2 % of BFCI VHSG/MSGs conducting
appropriate nutrition counseling as per
QIVC
2.5.1 % of children aged 6-23 months who
consumed 15 packets of MNP in the last
month
Objective 3
Improved quality of MCH care in 25 health
centers through strengthened services
Objective Indicators
3.0.1 - % of health centers in which >80% of
IMCI clinical encounters included all
assessment tasks being completed
3.0.2 - % of health centers in which >80% of
IMCI clinical encounters include treatment
that is appropriate to the diagnosis

3.0.3 - % of health centers in which >80% of
clinical encounters in which the caretaker
whose child was prescribed an antibiotic,
anti malarial, or ORS, can correctly describe
how to administer all prescribed drugs
Outputs
3.1 Health center staff trained in IMCI and
Nutrition
3.2 Supportive supervision and on-the-job
mentoring of HC staff leading to improved IMCI
and Nutrition services at 25 Health facilities and
through their Outreach
3.3 Substantial Improvement in HC staff attitudes
towards clients leading to improved services and
compassionate care
Output Indicators
3.1.1 % of HC with staff who received
training in IMCI in the past 3 years
3.1.2 % of HC where at least 2 staff
members received on the job coaching by
MTI in IMCI/Nutrition in the past 6 months
3.1.3 # of joint HC SS visit with MTI and
PHD in the past 6 months
3.4 Midwife Coordination, Alliance Team
Meetings (M-CAT) conducted Quarterly
3.2.1 % of HC SS visits by MTI given
“satisfactory” or better rating (total score of
≥80%) on QIVC
Activities
3.1 Assess IMCI training needs and conduct
IMCI training for HC staff
3.2.2 % of HC providing accurate nutrition
assessment and appropriate counseling at
HC and Outreach as per QIVC
3.2 Through on the job coaching and SS, build
capacity of HC staff to assess and treat sick
children as per IMCI standards
3.3.1 - % Mothers of Children U2 who think
health facility staff provide compassionate
care
3.3 Through on the job coaching and SS, build
capacity of HC staff to accurately monitor a
child’s growth, detect malnutrition and growth
faltering and provide correct counseling,
treatment or referral at both HC and outreach.
3.4.1 % of HC Midwives who attend
quarterly M-CAT meetings
3.4 Assess quality of clinical encounters at HCs
and Outreach using QIVC and HC assessments
and provide support for counseling/IEC materials
3.5 Provide client feedback on compassionate
care to HC staff
3.6 Support the PHD to conduct Quarterly MCAT
meetings for all Midwives to provide monitoring,
reporting, capacity building and continued training
of midwives
PHD agrees to utilize
staff for supportive
supervision
Objective 4 (delayed start)
Improved pediatric TB diagnosis and treatment.
Outputs
4.1 Increase % of children screened for TB and
treated or prophylaxed.
4.2 Household investigations of SS+ clients
complete via supportive supervision and onthe-job mentoring of HC staff.
4.3 Asymptomatic children U 5 contacts of SS+
clients complete IPT.
Activities
4.1 Revise IMCI checklist to incorporate TB
screening questions.
4.2 Train 2 staff from targeted HCs on identifying
children who are candidates for IPT and on
supportive care for IPT. Also train on household
contact investigations.
Objective Indicators
4.01 - % of children U5 successfully
completed treatment for TB
Output Indicators
4.1.1 - % of target health centers in which
>80% of IMCI clinical encounters included
TB screening
4.1.2 # of children U5 treated for TB per 6
months
4.2.1 - % of SS+ clients whose household
members received contact investigation for
TB disease and identification of high-risk
individuals for preventive therapy
4.3.1 - % of children U5 contacts completing
6 months or more of IPT in the previous 6
months
4.3.2 – # of child U5 contacts placed on IPT
per 6 months
4.3 MTI staff accompanies PHD SS staff to
conduct on-the-job training for 2 staff from each
target HC in performing household contact
investigations of SS+ clients.
4.4 Conduct training of all VHSGs in IPT support
during a quarterly meeting at target HC.
Note: Ax.x.. = Activity indicator, to distinguish from output or objective indicator
* CCM will not include pneumonia treatment with antibiotics at community level.