Dr. Sarah Byakika Ministry of Health, Uganda 5 th IHP+ Country Teams Meeting 2 – 5 th December 2014

 The importance of analytical health sector performance reports and how they are done  How to include many different stakeholders in JAR, and the advantages and problems with this

 Is an institutional requirement compiled annually since 2001 and presented for discussion at the JARs  The analysis and report writing is a participatory process led by the MoH SME&R TWG.  Highlights progress, challenges, lessons learnt and recommendations for moving the health sector forward in relation to the National Development Plan, National Health Policy, the Sector Strategic Plan and annual operational workplans.

 Focus is on progress in implementation of the annual operational workplans  Overall health sector performance against the core indicator targets set for the Financial Year  Trends in performance over the years

 The AHSPR is presented and deliberated upon at the JAR and biannual National Health Assembly (NHA).  NHA is characterized by more District Leadership representation (All Local Council V Chairpersons, Representatives of Resident District Commissioners, Secretaries for Health and Chief Administrative Officers).  Findings in the AHSPR and the outcomes of the JAR/NHA deliberations guide future planning and programming as captured in the Aide Memoire

 The JAR is one of the monitoring and review processes in the health sector  JARs are conducted in Uganda since 1995 between the months of September and October  Conducted over 3 days

 Health Committee of Parliament / District Leadership  Public and non public health sector representatives (MoH, Referral Hospitals, District, PNFPs and PHPs, Professional Associations & Councils)  Health related MDAs  Development Partners  Academic institutions (Universities)  Civil Society Organizations including the Health Consumer representatives  Other eminent persons e.g. emeritus health professionals

 Opportunity for all key stakeholders to interact in an open forum  District and hospital league tables are presented and this increases Local Government ownership for achievements  Creates a spirit of competition among districts and hospitals catalyzing better performance  Districts with good performance are able to share some of the best practices  Networking

 Over the years the number of participants has increased from about 150 to 400 as a result of the increased number of districts from 56 in 2005 to 86 by 2010 and 112 by 2014  Declining quality of policy and strategic discussions over the years and this can be attributed to the large number of participants with varied experience and expectations from the JAR/NHA.  Implementation of the identified priority actions is weak in the districts due to lack of district specific action plans.

 Decentralize JAR process to Regional Level ◦ Hold annual regional stakeholders’ for a prior to the JAR (10 to 12 district representatives for 2 days) ◦ Synthesize regional aide memoires for presentation at the National JAR (200 participants)