CSA Toolkit – What is it and how to use it?

What is the toolkit and who is the toolkit for?

The CSA Toolkit is a curated set of practical tools and resources to support county stakeholders, including policymakers, national and sub-national program managers, academics, professional associations, non-governmental organizations, and international agencies working towards improving child mortality outcomes in their national settings.

The toolkit includes a repository of existing tools and resources as well as relevant country examples and experiences to support stakeholders in greatly accelerating reductions in child mortality – iterative processes for assessing the country context, identifying game-changing priorities, advocating for these changes, developing/sharpening and implementing action plans to achieve them, operationalizing existing strategies, monitoring implementation, and ensuring accountability.

The resources collated within the toolkit are based on engagement with countries around the CSA process and identified needs to support planning and operationalization. The toolkit is not intended to be prescriptive. It is designed to be adaptable so that it can be used across a range of different country contexts and at various stages of CSA implementation. The CSA process should be country led and countries should own the process for selecting and adapting any resources or strategies within the toolkit to meet country specific needs.

How is the toolkit organized?

The CSA Toolkit offers a broad range of tools and resources to help support countries with efforts to plan, prioritize and implement activities to accelerate reductions in child mortality. In addition to an overarching CSA process guide, the tools are organized by the following five elements:

Each of these sections are further divided into the following sub-components:

Overview text summaries describing what each element entails
Tools and resources that can be used to support the development/sharpening and/or implementation and monitoring of CSA plans and processes
Examples and learnings from implementation across difference countries

Types of Resources

CSA Element

Advocacy/Stakeholder Engagement

Resources that support strengthening and maintaining partnerships, building political will, and social action

CSA Element

Review and Analysis

Resources that help analyze and assess the strengths and challenges of delivering child health services

CSA Element

Planning and Costing

Resources that help to make informed decisions and support the development of medium-term action plans, and tools that aid in assessing resource needs and quantifying cost estimates

CSA Element

Implementation

Resources that support implementation and delivery of child health services at national and subnational level

CSA Element

Measure Results and Impact

Resources that aid in measuring, monitoring, and evaluating child health programming and implementation

The following categories of resources are included within the toolkit:

Tool: a document designed to assist in the completion of a task or achieve a goal more efficiently and effectively
Template: a pre-formatted, but adaptable guide for developing key documents
Guide: a document from which additional information, knowledge, and advice can be drawn upon
Toolkit: a collection of tools and resources around a particular topic
Data source: a location where data can be obtained.
Presentation: slides used to present and explain information on a particular topic
Journal Article: a piece of research, usually scientific or scholarly, published in a peer-reviewed academic journal

Users can also search the toolkit for keywords and resources, using the built-in search function

The toolkit is available in both English and French. Tools/templates in other languages may also be made available on an ad hoc basis.

How to use the toolkit

The CSA toolkit offers a systematic, but flexible approach to implementation, recognizing that there is no ‘one fits all’ methodology to implementing child survival initiatives and that countries may be at different stages or have different contexts that require distinct approaches and tools. The CSA elements are non-linear. Countries can begin an approach with any element or even multiple elements concurrently, based on the country’s current phase with planning and implementation.

The toolkit provides the following:

Easily accessible information stored in one place
Tools and resources for implementation across different elements that can also be adapted to different contexts
Opportunities to learn from others

Some examples of tools include:

Templates for developing and revising a CSA Plan
A guide for conducting national child health situational analyses
Advocacy materials for engaging stakeholders across all levels
Example terms of reference for a country-level Child Health Technical Working Group or Child Survival Focal Point
Suggested indicators to use to periodically assess the status of CSA implementation and ensure continued adherence to standards that support effective delivery of CSA and impact on child survival

The content has been organized for users to apply it in a variety of ways, for example:

Specific tools: users can search for a specific tool or resource relevant to the work being undertaken around child survival
Systematic planning: Users can work through the planning and implementation cycle based on the relevant stage the country is at.
Continuous learning: The toolkit shares ongoing learnings from country implementation to enable cross-country learning and knowledge sharing

Guidance on preparing and adapting tools

The tools in this toolkit vary widely in scope and focus and may not be immediately ready for practical application in all settings. Some of the tools require preparation or adaptation before they can be effectively applied in each context, which will vary according to the type of tool, users, and respective contexts in which they are applied. Tool application is an iterative process and will likely require more than one round of refinement and improvement in practice. This will require a level of monitoring and review to assess the tool’s effect and impact, which in turn informs any necessary adjustments in practice. Below is a summary of some key points and questions that may be useful for users to consider when planning to use any of the tools.

Adapting to context

The adaptation of tools to local contexts requires consideration of many factors, such as the acceptability of the methods and approach in the context of local customs and culture; the language in which the tool must be made available; alignment with structures, systems, and terminology in use; resources required for tool application; and the feasible scope and scale of its use in the face of competing local needs. It is important to consider the utility of a specific tool within a specific country context, which may require changes in the scope of the tool, engagement of stakeholders, and even processes for applying the tool. Tools chosen for implementation may also require some modification or adaptation for the specific improvement needs one may encounter, including modification of the scope or technical content to reflect the local context and existing process or policy guidelines.

Questions to consider when preparing to adapt the tools:

+ Does the setting for application of the tool match the intention of the tool?

Tools may have shown promise and success in one setting, however their success in differing settings may vary. It is important to assess and document adaptations necessary to meet the needs in a specific context.

+ Is there support available from local leadership and partners to apply the tool?

This may require engagement of key leaders at the specific level where the tool is to be applied. Gaining buy-in will generally facilitate engagement and the availability of sufficient resources for successful tool application.

+ Does the technical content of the tool need to be modified to align with other national guidelines or tools?

This may require detailed review of guidelines already in use or liaison with local sub-national teams to understand where the tool will fit within broader processes or strategies and alignment with related efforts, such as Every Newborn Action Plan (ENAP)/Ending Preventable Maternal Mortality (EPMM) Acceleration Plans, where applicable.

+ Is the tool available in the local language, or does it require translation?

Consider translation of materials to meet local needs.

Preparing for tool application

Ahead of applying the tool, there will also be a need to consider both the practical requirements for successful use of the tool (e.g. human, financial, or other resources) as well as external factors that may influence its application. These include stakeholder engagement, political will, and advocacy, which often helps set the environment which will either catalyse or impede efforts when implementing a specific approach, method, or tool.

Questions to consider when preparing for application of the tools:

+ Who should be involved/engaged?

Consider relevant stakeholders who may influence or be influenced by the tool. This could include Ministry of Health (Child Health Department, but also other departments focused on family health, community health or specific technical areas such as malaria, nutrition, water and sanitation, or primary health care), Ministries of Finance, Health Promotion, Education or Policy and Planning, civil society organization, professional associations, academic/research institutions, advocacy organizations, private sector organizations, donors, or service users.

+ When should involvement/engagement occur?

It is important to consider proper timing for engaging various stakeholders. Not everyone may need to be engaged at the same time, and the manner of engagement may be different for various stakeholders. For example, if a country chooses to develop a Child Survival Action Plan, it would be important to consider the timing of other key planning processes – e.g. revision or mid-term review of a broader Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) strategy, development of an investment case for child health or alignment with an annual sub-national work planning cycle.

+ Do those involved have the knowledge and skills to complete the action or task associated with the tool?

Those involved should be knowledgeable about the elements needed to apply the tool, or external capacity-building support may need to be arranged.

+ Are those needed to apply the tool available to do this or is it necessary to out-source or seek additional support?

If there are staff who have the knowledge and competency to apply the tool, consider if they have the time and ability to do it. It may be necessary to bring in external experts to help support application of a given tool.

+ What resources exist, and what are the resource gaps that need to be addressed to complete the action or task?

It is important to understand what would be required to apply the tool, including personnel and capacity. Review what is needed, what already exists, and what additional resources may be required.

How was the toolkit developed and who was involved?

The toolkit was developed by the Child Health Task Force’s CSA Working Group action teams for Country Engagement, Advocacy, and Results and Accountability.

The CSA Working Group is coordinated by the Secretariat of the Child Health Task Force and includes representatives from the Global Financing Facility (GFF), John Snow Inc. (JSI), Market Access Africa, Save the Children, United Nations Children’s Fund (UNICEF), United States Agency for International Development (USAID), and World Health Organization (WHO).

Guidance and input were provided throughout the process by a CSA Toolkit Advisory Group, composed of the CSA Working Group action team co-chairs, as well as key stakeholders working at global, regional, and country level.

The development of the CSA toolkit was informed by a desk review to identify existing tools, resources, guidelines, and frameworks around child health programming, as well as to highlight any gaps in resources or tools. Consultations with members of the Country Engagement action team, co-chairs for the Advocacy and Results and Accountability action teams, and purposefully selected regional and country stakeholders were conducted to receive additional feedback and insight on existing tools and country experience in CSA plan development and implementation.

While several resources within the toolkit are from existing tools and resources, additional tools have been developed and/or adapted as part of a co-creation process with countries currently going through the process of sharpening and prioritizing actions for child survival.

Process for ongoing toolkit development and adaptation

The toolkit currently includes a curated collection of tools and resources based on identified needs from countries currently in the process of refining strategies for child survival.

The toolkit is a living repository. New tools and resources will be considered for inclusion in the CSA toolkit based on ongoing consultations and feedback from countries. Best practices and lessons learned from country experiences will also be documented and included as resources within the toolkit and used for consideration in tool adaptations and additions.

Criteria that guide the selection of resources for the CSA Toolkit are as follows:
The resource…

Includes child survival as a main focus. This includes broader systems tools that may also address maternal health, newborn health, adolescent health,nutrition, primary health care, community health, etc.
Directly supports one of the five CSA elements (Advocacy/Stakeholder Engagement; Review and Analysis; Planning and Costing; Implementation; Measure Results and Impact)
Is consistent with evidence-based practice recommendations, including state-of-the-art policy guidelines from international organizations, development partners, etc.
Is broadly applicable and adaptable – can inform the work of multiple countries and applied to diverse settings
Is freely available online with identified points-of-contact for follow-up.

To provide feedback on the toolkit and the current available resources please click here.