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Experience on HSS proposals

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  1. Experience on HSS proposals Walaiporn Patcharanarumol International Health Policy Programme (IHPP-Thailand) Current status: PhD Candidate Health Policy Unit London School of Hygiene and Tropical Medicine

  2. Proposal application and review process My experiences Call for proposal Pre-review Team Review Committees Board Decision Proposals submitted Indicate Completeness of Proposals Committees Recommend actions Board Approval Examples of HSS proposals

  3. Pre-review experience • Incompleteness of application • Incompleteness of submission vs over load submission • Quality of the application • Consistency • Alignment with national plan • Complementary with other supports • Management • Budget plan

  4. Incomplete application form • Endorsement • Signatures [understandable, time constraints] • Required information • Focal point person: name and address • Basic national information • HSS description and justification

  5. Incompleteness of submission • No application • Lack of required document e.g. • Immunization Comprehensive Multi Year Plan (cMYP) or national immunization plan • National Health Strategic Plan • Medium Term Economic Framework (MTEF) • Health Sector Assessment Document • Poverty Reduction Strategy Plan • Too rush to meet the deadline

  6. Overload submission, huge pile of documents Not relevant Duplication

  7. Consistency • Internal consistency: tables and text in application • Consistency with supporting documents • Inconsistency of DTP3 coverage in application form: • page 11 (from HDSP: Health Development Strategic Plan) • page 13 (from cYMP: Comprehensive Multi-Year Plan for Immsunization) • Consistency with other sources • Government Expenditure on Health: • Application states 5.6% of government expenditure on health (2004/2005, without source of data) while • WHO NHA website indicates 9.4% (2004)

  8. Inclusiveness of preparing the application • Iterative process with stakeholders: All major health sector partners including civil society have been involved • Evidence • Stakeholder consultative workshop • Minute of a workshop • Signatures

  9. Alignment with national health policy • Major health system constraints  Strategies to improve performance • Alignment: The proposal adds value or complements current or planned activities to strengthen the health system • Some proposals failed to show the alignment. • Some proposals showed some strategies to synchronize with the national plan.

  10. Complementary with other partner supports • Table presenting total resource needs for the whole system and disaggregate by funding agencies • Incorrect figures within the table • Inconsistency with financial plan

  11. Management and monitoring of the implementation of HSS proposal • The proposal identifies annual progress milestones, budget plan, M&E of the proposal (by whom, which tool and when). • Management, reporting and audit arrangements for HSS funding should use existing Govt. arrangements and timing, not parallel ones

  12. Example Incomplete table, not practical at the year of application, incorrect figure, no reason explain the blank of some periods

  13. Example Don’t know where it comes from, Incomplete table

  14. Other issues • Proposal for some areas or targets (not for entire country) • Poorest districts • Vulnerable groups Information of target group must be provided.

  15. Results of HSS proposal(from review committees)

  16. Assessment of Proposals

  17. Results • Inclusive in only ½ • Strategies respond to bottleneck in only ½ • Sketchy implementation plans and budgets • Management and monitoring of implementation in only ½ • Little info on complementary with other partner supports and sustainability

  18. Results • Example: • How national/provincial/hospital support will improve access and quality at first level • Show how 25% to salary increase will contribute to HSS goals, how partners were involved and how this will be sustained • Clarify how 13% management overhead will be used

  19. Feedback from countries • In some cases: • Empowerment of MoH • A step forward on harmonization and alignment with national health policy • In some countries HSS development process was based on close collaboration within and between MOH and development partners • Some countries reported that the it helped them to demonstrate a boarder scope (EPI is not only about vaccines) • Technical support is critical EPI: Expanded Program on Immunization

  20. Remark • Learning process • Country driven (not consultant based) • Using country mechanisms (fund flows, accountability, info systems…) • HSS driven: Multi-stakeholders - Department of Planning is coordinating the process at the country level (not only immunization) • Inclusive and collaborative process with all major sector partners through national Health Sector Coordination Committee; involvement of civil society – but support goes to MOH; • Align to existing Govt. planning and budget cycles (eg. National Health Strategic Plan) and use existing procedures

  21. Thank you for your attention