Technical Review Meeting:Preparatory Meeting in Advance of Joint Annual Health Sector Review 2008

摘要

This report like the previous technical review reports provides a brief record of the proceedings of the Technical Preparatory Meeting that took place at Belinda Hotel, 3rd - 5th September 2008. The report does not provide an exhaustive record of all discussions in the plenary or work groups. Rather, it highlights the issues that are to be carried forward to the Main Review. Apart of the general issues related to the management of health services, the review discussed in more in-depth the following areas; Performance assessment report, Public Expenditure review report, progress on milestones, the proposed Health Sector Strategic Plan and indicators to monitor its performance. The purpose of the meeting was to: Review progress in implementation of the 2nd HSSP (a) Assess progress against 2007/8 milestones (b) Report upon service delivery performance since the September 2007 JAHSR (using the health sector performance profile, MKUKUTA Monitoring Report, HMIS/routine data system, and reports from health programs) (c) Budget execution (PER, Income and Expenditure Statement). Review the draft Health Sector Strategic Plan III (2009-15) that has been developed jointly between stakeholders since the September 2007 JASHR. Share important policy developments (The 2008/2009 budget of the MOHSW, Payment for Performance strategy, draft strategy for Non-communicable Diseases, RHMT strengthening). Agree upon specific priorities for the fiscal year 2009/2010. The presentation of health sector performance during FY 2007/8 was hampered by the fact that not all data is collected so early after the end of the year. Financial indicators show an increasing trend in recent years. While malaria indicators demonstrate positive trends compared to 2004/5 data, some maternal, reproductive and child health indicators seems to be stagnating. The discussion revealed concern with the stagnating performance of some indicators and methodological issues were raised. It was questioned if the timing of the JAHSR was optimal for presenting complete, validated data. Not all of the 15 milestones set for FY 2007/8 were fully achieved. The group works on milestones undertook the valuable task to updating and commenting on the milestones (attached as Annex 1). It was agreed to try to define future milestones as specific, measurable, realistic and time bound. The Public Expenditure Report presentation highlighted the substantial increase in health sector budgets during the past 3 years. The budget item increase has moved from personal emoluments (2005/6) to development budget (2007/8). However, budget execution has decreased significantly with a low of 84% in FY 2007/8. Though the PER has room for improvement, the annual undertaking was considered important. The meeting suggested certain improvements of the PER including change of timing to March-June every year. The Comprehensive Council Health Plans have improved substantially this year. A number of specific recommendations for improvement of the planning tool and its implementation were suggested. It was underscored that delay of funding was detrimental to execution of CCHPs. The draft Health Sector Strategic Plan III (2009-2015) was presented and discussed in groups as well as in plenary. The plan has been developed over the past year through a very inclusive and thorough process where a large number of stakeholders have participated. The meeting was not expected to reiterate the process of reconciling a balanced strategic plan; but some suggestion regarding focus and presentation of the plan were expressed in the discussions and agreed to be taken into consideration while finalizing the document. Three work groups provided in-depth analysis of financing, monitoring and evaluation, and the human resource issues related to HSSP III. The Payment for Performance reform plan was presented and the discussion focused at the complexity of the reform and the risks of creating inappropriate incentives. Also the draft strategy for non-communicable diseases and the status of the Regional Health Management Team strengthening were presented and discussed. It was decided to refer planning of FY 2008/9 Milestones to a small work group, and to request the M&E group to suggest HSSP III indicators ahead of the JAHSR main meeting 24th-26th September.ud