MOH 2 February 2011

Identify needs Prioritize needs Finalize list of endorsed needs Submit needs to MOPAD Consult with donor Negotiation (intra- and inter- ministry) Agreement signing…Project/pr ogram Implementation Reporting – internally and to donor Monitoring

 PRDP ◦ MOH had 6 Program Areas  414 million USD (recurrent budget)  67 million USD (development budget)  23 Donors with UN

 Governance including public private partnership, aid effectiveness, planning, policy, monitoring and evaluation, and cross sectoral cooperation. ◦ 187 million USD for recurrent budget ◦ 40 million USD for development budget  Human Resource Development including pre service and in service training for all levels of professionals and systems ◦ 125 million USD for recurrent budget ◦ 30 million USD for development budget  Healthy Lifestyle ◦ 87 million USD for recurrent budget ◦ 20 million USD for development budget  Access to Quality Health Services (PHC, secondary, tertiary care- services and infrastructure) ◦ 846 million USD for recurrent budget ◦ 120 million USD for development budget  Total budget is ◦ billion USD for  billion USD for recurrent budget  210 million USD for development budget

◦ Strengthening MOH role and capacity in coordination of development and humanitarian assistance in the health sector ; ◦ Developing systems and practices to ensure successful execution of Paris Declaration principles and commitment by all Health Sector Stakeholders; ◦ Harmonize and align aid management approaches between Ministry of Health (MOH), Ministry of Planning and Development (MOPAD), Ministry of Finance of the PNA and donors

Donor relations are managed through ICD, however each of the DGs plays a role in executing the programs. This highlights the importance of coordinating efforts among donors to ensure that there are harmonized procedures, meetings, reports, missions or the work and time needed to coordinate these efforts becomes excessive and impedes implementation.  Aid coordination …. an internal ministry wide approach.  Planning department leads in ensuring well developed plans, sequencing, and prioritizing with associated costs are shared with donors and that aid priorities are adequately reflected in the plans  Key directorates identify technical aspects of programs and needs and administer implementation of programs, there are over 10 relevant DG executing projects/programs at this time.  MOH procurement, engineering, and financial DGs have cross cutting responsibilities on most projects/programs  Monitoring and evaluation department is under development

Managing over 40 different/ separate projects that extend throughout the West Bank (including East Jerusalem) and Gaza  5 mental health/psychosocial programs ranging from 6000 USD to 4.8 million USD with 4 different donors (uncoordinated*)  15 specialized health services programs ranging from 200,000 USD to 86 million USD with 10 different donors (uncoordinated)  10 primary health care programs ranging from 260,000 USD to 8.6 million USD with 8 different donors (uncoordinated)  7 major infrastructure programs ranging from 500,000 to 8 million USD (uncoordinated)  4 emergency, policy, or research support projects ranging from 8000 USD to 400,000 USD (uncoordinated) * Uncoordinated- standalone project, not a program wide approach or joint project or pooled funding or SWAP

27.51 million Euros and million USD (these are commitments with unclear levels of disbursements to date) 154 million USD total 90% of all projects had a training, capacity building, or human resource development component that was relevant to project, but not specifically linked with MOH HR needs and demands. Many programs are now managed internally by the MOH, but inadequate support staff is still an issue. Progress reports and disbursements are lacking

 MDGs – donors not interested  NHS ◦ Governance ◦ Human Resources Development ◦ Healthy Behaviors ◦ Access to quality health services  Recommendations ◦ 2011 costed work plan ◦ Donors follow process of MOH ownership ◦ Monitoring and evaluation indicators and system should be available ◦ Strategize around the MDGs ◦ Use Health Sector Working Group to manage the process above

 MOH has completed the work plan and is awaiting final endorsement from the minister.  It will be shared at the upcoming HSWG.  It represents a key document in identifying MOH priorities and costing of programs/ projects.

 Ownership Indicator 1:National plan is available and endorsed.  The NHS strategy is available and the Annual Workplan for 2011 is available. ◦ Who has copies? ◦ What are comments on its content, quality, relevance, etc. ◦ Who uses it to guide identification of priorities ◦ Where are decisions taken to put funds – at home office, in local office, one on one with MOH, or within SWG setting?

 Alignment:  Indicator 2: Reliable country systems for procurement and public financial management  Indicator 3: Aid flows are aligned on national priorities  Indicator 4: Strengthen MOH capacity by coordinated donor support  Indicator 5a: Use of country procurement systems  Indicator 5b: Use of country public financial management systems  National and ministry level system and practices exist ◦ What issues do donors have?  MOH has 4 priority programs ◦ Where are donor priorities within these programs  Is SWG functioning? Can the meetings now be organized around programs and funds, rather than updates on who is doing what on a project basis?  Who is currently using the procurement system? What problems continue to exist?  Budget support is working, why can’t the other forms of financial management inputs work?

 Indicator 6: Strengthen capacity by avoiding parallel implementation structures  Indicator 7: Aid is more predictable  Indicator 8: Aid is untied  Indicator 9: Use of common arrangements or procedures or program- based approaches  Indicator 10: Encourage shared analysis (field missions, country analytical works) ◦ How many donors are continuing to set up PIUs and why? ◦ Can the upcoming donor conference be used as a forum to commit health funds for a 3 year period ◦ What changes have been authorized within the donor countries to untie aid? ◦ EU coordination is underway, UN coordination is underway, can we use pooled funding and SWAP approaches here? ◦ How many countries had shared missions? Can we come up with a chart of missions based on one of the four MOH health programs?

 Indicator 11: Results-oriented frameworks —transparent and monitorable performance assessment frameworks to assess progress against (a) the national development strategies and (b) sector program  Indicator 12: Number of partner countries that undertake mutual assessments of progress in implementing agreed commitments on aid effectiveness. NHS and annual work plan have indicators, measurement? Do we need to ensure that quarterly SWG meetings are held that clearly present results of coordination within health and program achievements Can this be done in cooperation with key donors?

Ministry of Health International Cooperation Department It’s all about dialogue, discussion, and agreement