WHO Collaborating Centre for Health System Strengthening: Financing, Governance and Service Delivery Annual Report 2015

Transcription

1 Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH WHO Collaborating Centre for Health System Strengthening: Financing, Governance and Service Delivery Annual Report 2015 Quelle: GIZ/ Jörn Leonhardt

2 Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH WHO Collaborating Centre for Health System Strengthening: Financing, Governance and Service Annual Report 2015 Reporting period May 2014 July 2015 Head of competence centre for health: Coordinator: Dr. Inge Baumgarten Martina Pellny Phone: Phone: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH German Development Cooperation A World Health Organization Collaborating Centre for Health System Strengthening Registered offices Bonn and Eschborn, Germany Friedrich-Ebert-Allee Bonn, Germany T F Dag-Hammarskjöld-Weg Eschborn, Germany T F E I info@giz.de

3 CONTENTS Preface... 1 Part I: Terms of Reference as designated in Part II: Implementation of the Workplan in relation to the terms of reference... 4 Activity A1.1: Evidence building for national health financing strategies and policies... 4 Activity A1.2: Document reform experiences... 5 Activity A1.3: Other technical support to countries on health financing Activity Title: ToR 2 - A2.1: Skill development training on health financing and evidence generation Activity A2.2: Learning and networking workshops/ conferences on health financing;... 7 Activity A3.1: Improving national capacities through evidence based policy dialogue, analytical work, workshops, e-learning platforms... 8 Activity A3.2: Success factors and approaches for national health planning and implementation... 9 Activity A3.3: Networks and mechanisms for exchange of experiences and learning Collaboration with WHO Interactions with other WHO Collaborating Centres Support received from WHO Part III: Professional staff involved in the activities of the WHO CC Part IV: Technical meetings, publications WHO and GIZ... 13

4 Preface The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH is a federal enterprise of the German Government in the field of international cooperation for sustainable development. GIZ is presently cooperating with nearly 80 countries in Africa, Asia, Latin America and Europe, and in a growing number of regional and global projects on health-related matters. GIZ works on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ) and other national and international clients and partners. These include the governments of other countries, European Union institutions, such as the European Commission, the United Nations and the World Bank, private enterprises and foundations. In its work, GIZ uses approaches aimed at all levels of health systems and of societies, from national and international agenda setting and policy advice in partner countries, to targeted interventions, such as improved access to services and promoting community involvement in addressing local health challenges. Throughout, it places emphasis on capacity development, quality and sustainability. Approaches are sectorwide, systemic, cross-cutting and often transnational. Bilateral, multilateral and regional cooperation covers a wide range of topics, such as: Preventing and tackling disease o Infectious and non-communicable diseases o Nutrition o Climate change and health o Pandemic preparedness Addressing health across the lifecycle o Sexual and reproductive health and rights o Maternal, newborn and child health o Adolescent health o Health promotion and demographic changes Improving systems and structures o Health systems development and strengthening o Health workforce o Health financing o Systemic quality improvement o Hospital management Working together for health o Health partnerships GIZ WHO CC Annual Report 2015 Page 1

5 Projects and programmes implemented by GIZ take political, economic, social and ecological factors into account. They are culturally appropriate, gender-sensitive and inclusive; dedicated to improving cooperation between donors, institutions and organizations; and committed to improving the access of women and girls, the poor and the most marginalized groups to quality health services. Some of our achievements: In Malawi, where GIZ has worked to strengthen the health system, the number of medical and paramedical staff graduating from public and private health training institutions rose by 50 % between 2007 and 2011, contributing to improved access to primary health care services for Malawians. Quality improvement efforts have been launched in Yemen in more than 330 health facilities offering reproductive health services; half of them have already been assessed and certified for quality. Between 2012 and 2013 almost 18,000 people, more than 5,000 of them women, participated in health-related capacity development courses offered by GIZ in partner countries around the world. In Ghana more than 200,000 people have participated in activities organised by GIZ Employee Wellbeing Programmes in workplaces: some 160,000 have been tested for HIV, 180,000 for blood sugar and nearly 180,000 have had their blood pressure measured. At a regional hospital in Tanzania where the GIZ-supported No Baby Left Out initiative on newborn health began, the neonatal mortality rate was reduced by nearly 50 % between 2011 and 2012, dropping from 34 to 19 deaths per 1,000 newborns. More than 2.5 million primary school children in the Philippines participate in the GIZsupported Fit for School initiative, which has contributed to reducing underweight, serious worm disorders and dental caries. The GIZ-assisted introduction of protective equipment and health and safety trainings for all Western Marine Shipyard Limited workers in Bangladesh has resulted in a 99 % decrease in accidents and injuries, leading to reduced work stoppages and greater productivity. Further information about GIZ s health portfolio is available at and GIZ WHO CC Annual Report 2015 Page 2

6 GIZ was designated WHO Collaborating Centre (WHO CC) for Health Systems Strengthening: Financing, Governance and Service Delivery in The second report of GIZ WHO CC covers the period GIZ is committed to continue working with WHO with the objective of strengthening health systems and sustainable health financing mechanisms, thus achieving universal health coverage and health for all. Dr. Inge Baumgarten GIZ, Competence Centre for Health Bonn/Germany, July 2015 GIZ WHO CC Annual Report 2015 Page 3

7 Part I: Terms of Reference as designated in 2013 General Framework The overall objective of the terms of references for the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, as a WHO Collaborating Centre (CC), is to support WHO in strengthening health financing and social health protection, in the capacity development for developing and extending sustainable health financing policies and strategies and to develop national capacity for effective health system governance and leadership. During the period covered by this annual report (May 2014 July 2015) GIZ has supported WHO activities and human resources for the development of specific projects and meetings focusing on financial health issues. Additionally GIZ was involved in the development and organization of training courses and workshops concerning health financing and Universal Health Coverage (UHC). Details of these activities are described in Part II. Part II: Implementation of the Workplan in relation to the terms of reference Activity 1 A1.1: Evidence building for national health financing strategies and policies Description: Support WHO in building evidence towards the development of national and global health financing policies and strategies (focus on countries where GIZ is supporting health financing reform); GIZ contributes via its staff. GIZ will mobilise further expertise through consultants, should this be required. This will be done in agreement with WHO. WHO provides technical guidance and participates in the health financing reviews and situation analyses. Nepal: P4H members GIZ and WHO jointly supported a study tour to Thailand and the Philippines in October 2014 for staff tasked with establishing the future Nepalese National GIZ WHO CC Annual Report 2015 Page 4

8 Health Insurance Authority (NHIA) and preparing the correspondent legal basis. Interesting to know as background information is that the Government of Nepal is planning to roll out a national social health insurance scheme. In 2014 a policy on National Health Insurance (NHI) drafted by the Ministries of Health (MoH) and Population (MoHP) was endorsed by the cabinet. The vision is to establish a semi-autonomous agency under MoHP that collects contributions on a voluntary basis, pools them with government subsidies for the poor and purchases services from the public and the private sector. A committee is currently drafting an act to form the legal basis for this new entity. Mongolia: a long-term strategy ( ) for the development of a Social Health Institute (SHI) was designed and launched in July P4H partners WHO and GIZ decided to foster the process with further evidence and to support it by co-financing a social marketing study that will also look into the financial burden of health payments, including a benefit incidence analysis and a review of the health financing strategy. Due to government changes in January 2015, some of the processes have been slowed down and the review of the health financing strategy has been postponed to a later stage in First results on the social marketing strategy are expected in July Activity 2 A1.2: Document reform experiences Description: Support WHO in documenting and sharing country experiences and good practices in social health protection, universal coverage and national health financing strategy/policy (focus on countries where GIZ is supporting health financing reform); GIZ, in close collaboration with WHO, carries out comparative analyses and prepares reports and presentations via its experts or consultants. Tajikistan: in 2014, GIZ together with WHO supported Tajikistan in the Joint Annual Review (JAR) by developing and drafting all technical background documents for the working groups on health financing and governance to advance the national health strategy which includes the roadmap for UHC and the action plan. Consultations took place with all stakeholders including MoH, MoF, MoE and the P4H local partners (GIZ, DEZA, WHO, KfW, EU, WB). The JAR comprised a one day health summit. Mozambique: in August 2014, GIZ, WHO, WB and ILO conducted a joint P4H fact finding mission to assist the Mozambican MoH in the development of a Health Financing Strategy. It was recommended and accepted by MoH to deploy two advisors and to post a local GIZ WHO CC Annual Report 2015 Page 5

9 specialist by WHO and an international policy specialist by GIZ. Both will work in tandem to assist the MoH. In 2014 and 2015, GIZ supported the project Capacity development on gender, equity and human rights at all levels of WHO in developing core minimum criteria for human right programming to mainstream human rights into WHO programmes. Based on the Roadmap developed with GIZ support three strategic directions were identified. Building on the findings, the GIZ team commissioned and conducted a review of both internal and external stakeholders to gather their experiences in the application of human rights to health, and published a call for proposals to gather evidence of successful strategies and ongoing challenges. Activity 3 A1.3: Other technical support to countries on health financing. Description: Support WHO in responding to country requests for technical support on health financing (focus on countries where GIZ is supporting health financing reform). GIZ provides technical advice via its experts or consultants and WHO provides technical support and participates in the activity. In June 2014, the P4H network received an invitation from the Ministry of Health and the Prime Minister of Madagascar for a fact-finding mission on the situation of social health protection and possible reform strategies. The mission took place in September 2014 and was jointly carried out by WHO, GIZ, AFD/GIPSI, and ILO. The P4H partners took stock of the situation and discussed at the debriefing further steps with the respective ministries, one of which was to create an inter-sectoral working group to allow further support by P4H. Madagascar: P4H partners WHO, AFD and GIZ further support the development of a health financing strategy towards Universal Health Coverage (UHC) lead by the inter-sectoral working group with a P4H-coordinator during five missions in 2015.The aim is to elaborate a first draft strategy by the end of GIZ WHO CC Annual Report 2015 Page 6

10 Activity 4 Title: ToR 2 - A2.1: Skill development training on health financing and evidence generation. Description: Support WHO in the organization of trainings on health financing, health financing strategy, social health protection and evidence generation (focus on countries where GIZ is supporting health financing reform); GIZ provides technical expertise via its experts or consultants, provides logistical support and participates in the funding of participants. WHO provides technical guidance on the design and conduct of the training by involving its experts as trainers and might fund (where feasible) additional participants. Cairo, Egypt: in December 2014, GIZ together with WHO under the P4H network implemented a flagship course on health financing and UHC including a policy dialogue for a delegation from Yemen. Tajikistan: in April 2014, P4H partners WHO, GIZ and EU (local) implemented a countryspecific health financing training (flagship course) including a senior policy dialogue to develop a roadmap for UHC with 35 participants from MoH, MoE, parliamentarians, local authorities among others. Activity 5 A2.2: Learning and networking workshops/ conferences on health financing; Description: Support WHO in the organization of workshops, conferences or networking events (focus on countries where GIZ is supporting health financing reform); GIZ provides technical expertise via its experts or consultants, provides logistical support and participates in the funding of participants' travel cost. WHO provides technical guidance on the workshop design, involves its experts as speakers and might co-fund (where feasible) the event. Cambodia: in January 2015, GIZ together with WHO under the P4H network - and together with the Cambodian Ministry of Health organized an international workshop concerning financial implications of accessing health care for people with disabilities, elder people and persons with non-communicable diseases. Participating countries were those of the Mekong sub-region: Thailand, Laos, Cambodia and Vietnam. Cambodia considers expanding its social health protection scheme for the poor health equity funds initially established for people with disabilities. GIZ WHO CC Annual Report 2015 Page 7

11 Activity 6 A3.1: Improving national capacities through evidence based policy dialogue, analytical work, workshops, e-learning platforms Description: Support WHO in improving national capacities in Member States through activities such as evidence based policy dialogue, analytical work, workshops, e-learning platforms. Cambodia: in March 2015, the Ministry of Economics and Finance revised the Health Financing Policy prior to submission to the Council of Ministers. Upon request, a costing study concerning the financial implications (and returns) for reaching universal health coverage in accordance with the roadmap specified in the Policy will be jointly performed by GIZ, WHO and ILO to inform policy makers under the P4H network. The costing exercise is planned for July August Tajikistan: from May 2015 to March 2016, GIZ is supporting P4H in further facilitating the political dialogue on moving forward towards UHC. This coordinator role of P4H is carried out by WHO health financing staff. Furthermore, GIZ and WHO supported the implementation of a financing gap analysis for the revision of the PHC basic benefit package for nation-wide implementation. In 2014, GIZ supported a conference on measuring UHC through ICT by ADB, WHO in Manila. The conference engaged various participants to pursue a policy dialogue on increasing information and communication technologies and information infrastructure investments that accelerate UHC progress in Asia Pacific. Technical input came from GIZ supported partner Ministry of Health Bangladesh. GIZ took part in the plenary panel session Developing the Investment Case for ICT for Achieving UHC. The session was designed to equip participants with lessons learned and success stories, allowing them to better build their arguments for increasing investments into ICT within their country s health systems. Strengthening_the_Routine_Health_Information_System_in_Bangladesh.pdf GIZ WHO CC Annual Report 2015 Page 8

12 Activity 7 A3.2: Success factors and approaches for national health planning and implementation Description: Support the identification and application of success factors and approaches for national health planning and implementation. From November 2013 to September 2014, GIZ supported WHO s global initiative Every Women, Every Child which is implemented by the Commission on Information and Accountability. The primary aim is to focus on better information for better results, better tracking of resources for women s and children s health, and better oversight for results and resources, nationally and globally. From 2013 to 2014 GIZ supported WHO financially and with technical knowledge in developing the WHO Consolidated strategic information guidelines for HIV in the health sector. The guidance describes key indicators to monitor the health sector s national and global response to HIV. The guidelines aim to help countries choose, collect and systematically analyse strategic information to guide the health sector response to HIV. Activity 8 A3.3: Networks and mechanisms for exchange of experiences and learning Description: Support the development of networks and mechanisms for intra- and intercountry exchange of experiences and learning. GIZ supports the development of networks and mechanisms for intra- and inter-country exchange of experience and learning, for instance by contributing to the work of IHP+. It contributed financially to the IHP+-programme of work Assistance was requested for consolidating and accelerating effective development co-operation through global action, enhancing accountability for results and for IHP+ management and communications. Cambodia: in December 2014 a high-level one-week study tour to Indonesia was organised jointly with WHO, World Bank (WB), and the Australian DFAT under the P4H network as well as a P4H delegation from Nepal to learn about the country s approach to achieving universal health coverage by Participants were vice ministers, director generals and directors of GIZ WHO CC Annual Report 2015 Page 9

13 departments of the Ministries of Economic and Finance, and Health. The Prime Minister ordered a review of the country s social protection arrangements, including health insurance. As a global activity the P4H German desk based at GIZ Head Office concluded a financial agreement with WHO to develop a UHC interactive web platform, the UHC interactive guide. The guide is aimed at practitioners in countries with a commitment to moving towards UHC. Specifically, the UHC interactive guide helps to navigate through the huge body of evidence and material available on how health financing and social health protection reforms can contribute towards UHC. This serves to find relevant information and guidance on current policy questions that users may have. The guide will include publications as well as training material and interactive features. It is hosted on the P4H internet and the protected intranet side. A draft design of the interactive guide was presented at the 2015 PMAC conference in January in Bangkok and is currently being revised, based on the comments received. From June 2014 to March 2015, GIZ together with WB headed the Leadership for UHC Programme in the field of capacity development. WHO, ILO and GFATM joined on different sessions. The pilot with three modules and a practical project with remote coaching for six Anglophone African countries with around 33 participants received excellent feedback. So far, the programme seems to be an effective tool to broaden the horizon of senior management in Government and other stakeholders for the socio-political ( adaptive ) challenges of UHC reform, making it more likely that well-designed reforms are actually and sustainably implemented. Additionally, the first francophone Flagship Course on Couverture Santé Universelle took place in April 2015 for over 100 participants in Dakar, Senegal. It was implemented jointly by the P4H partners WHO, WB, GIZ, AFD, and DEZA and for the following countries: Burkina Faso, Benin, Ivory Coast, Guinea, Cameroun, Mali, Niger, Democratic Republic of Congo, Haiti, Djibouti, Madagascar, Mauretania, Senegal, Chad and Central African Republic. The large number of participants reflects the high demand and thus the training is planned to be continued within the P4H network. GIZ WHO CC Annual Report 2015 Page 10

14 2. Collaboration with WHO Please briefly describe your collaboration with WHO in regards to the activities of the WHO collaborating centre during the past 12 months (e.g. means of communication, frequency of contact, visits to or from WHO). Please feel free to mention any difficulties encountered (if any) and to provide suggestions for increased or improved communication (if applicable). Since its re-nomination as a WHO Collaborating Centre in 2013 GIZ has been working on the agreed Workplan. The cooperation between WHO and GIZ is close, especially in the context of the P4H network. Regular communication takes place via , skype and personal meetings during joint activities. The latest formal event within the P4H network was the steering group meeting and the technical group meeting in Berlin in June 2015 hosted by the BMZ with the participation of WHO. In addition, regular visits of GIZ at the WHO Headquarter in Geneva and occasional visits of WHO to the GIZ Headquarter have taken place. An example is the participation of GIZ in the Executive Board meeting 136/2015 ; attendance of the 68 th World Health Assembly in 2015 and the attendance in WHO conferences and events such as the High Level Meeting on Ebola in December 2014 or Building Health Security Beyond Ebola in Cape Town in July The GIZ sector initiative on population dynamics, sexual and reproductive health and rights takes part in the monthly PMNCH donor and foundations constituency phone calls and occasional in-person meetings. It actively supports the renewal of the Global Strategy for Women s, Children s and Adolescents Health, coordinated by PMNCH, and provides technical inputs in writing and in discussion forums. Similarly, GIZ actively participates in the PMNCH accountability working group. GIZ is open to broaden cooperation with WHO and to also include other aspects of health systems and health systems strengthening. For example, in the last year new focus themes arose: health systems in the context of Ebola, fragile states and international health regulations. GIZ WHO CC Annual Report 2015 Page 11

15 3. Interactions with other WHO Collaborating Centres Please briefly describe any interactions or collaborations with other WHO collaborating centres in the context of the implementation of the above activities (if any). If you are part of a network of WHO collaborating centres, please also mention the name of the network, and describe any involvement in the network during the last 12 months. None 4. Support received from WHO Please briefly describe any type of technical, programmatic, advisory or other support received from WHO during the past 12 months for the implementation of the agreed activities listed above (if any). None (other than in the realm of the P4H network activities) Part III: Professional staff involved in the activities of the WHO CC Providing for Health (P4H) Initiative Jean-Olivier Schmidt Kai Straehler-Pohl Martina Pellny Health and Health Systems Strengthening Dr. Andreas Stadler Dr. Inge Baumgarten Dr. Sabine Flessenkaemper Sexual and reproductive health and rights Dr. Gerd Eppel Adaptation to Climate Change in the Health Sector Ute Jugert GIZ WHO CC Annual Report 2015 Page 12

16 Part IV: Technical meetings, publications WHO and GIZ The development of the WHO Consolidated strategic information guidelines for HIV in the health sector has been technically and financially supported by GIZ. Attendance of GIZ in first international WHO conference on Health and Climate in Geneva in August In December 2014 GIZ co-hosted and financially supported the third Climate and Health Summit 2014: A Road Map to 2015 taking place in Lima, Peru during the Conference of Parties of the UNFCCC., with WHO and PAHO and other stakeholders. tml World Health Summit: In October 2014 GIZ together with the European Centre for Environment and Health of the WHO organized and co-chaired a symposium on Climate Change and Health in Berlin. -ist-besondere-herausforderung-fuer-gesundheitssysteme-in- Entwicklungslaendern/index.html (German only) Participation of GIZ in the first bilateral consultations between Germany and WHO. and the German Mission pr/aktuell-en/ ebola-whodeutschland-en.html Potsdam spring dialogues on Disease Control and Prevention in Africa: Current Reforms to Strengthen Regional Cooperation, March 2015, Potsdam organized by SEF in collaboration with GIZ and in participation of WHO. GIZ WHO CC Annual Report 2015 Page 13

17 Participation of GIZ in the 136 th Executive board meeting Attendance of GIZ in the 68 th World Health Assembly in May P4H technical meeting at the PMAC conference in Bangkok in February 2015 P4H steering and technical meeting hosted by BMZ in June 2015 in Berlin. GIZ WHO CC Annual Report 2015 Page 14