Report of the committee set up under resolution SEA/RC34/R11 to review the organization's collaborative programmes

fell as recommend fresh project proposals &id to .&lve a long-+&-m perspetitive plzq for inteqwqxy pq~jg~~~f;s. ,@-A3 Committee met Q-4 tl-je Regional,Office from 8 to‘10 PI ry &$8i‘,@@, dik@qsed the &+-ties ,for the evaluation (a) A pcrspeckive plan for E:a Inter-country Programme in the South-East &sia Region, and .- ' (b) Modalities for‘the evaluation .of"cou~&y and inter-country programmes, and I (ii) To '*note" the inter-country progrsmqe prop,osals for:\ .i.. 1984-85.. _'. . . I. I i .., : . . .-. Indonesia a& Chairman and Dr Samlee Pliangbangchang af Thailand as Rapporteurt A list of participants 2. PERSPECTIVZ PLAN FOR IHTER-COUNTRY PRCG&'U&S"-.. 1.. The Committee discussed in detail the ba&..principles on which a perspective plan for the inter-country programme should be developed, using working document SEA/IGP/Ideet 2/4 as the basis for deliberations. It, felt that the whole gamut of health developm&t.activities that would,. ,three General Programmes of Work. It was, the&fore, feasible to organize I *the needed developmental activities under the inter-country programme in ?propriately phased manner, depanding on the.priority grading, as all the needed activities could not be taken up simultaneously. It was gratifying, however, that the HP3 goal had..been universally accepted by all the Member States in the Region and national, regional and global strategiesand corresponding plans,of action to achieve this goal were now on a sound footing. *Background documents: SEA/ICP/Meet 2/4 and SEA/ICP/Meet 2/6. -2- The Committee emphasized that the perspsctivti~~plan far the inter-country programme should. not only-,include activities which were..;::,.of' immediate priorit~;%ut &so those activities tihich were to be ':' &&&ted t& t&&i& t& en-&&ins hr&lems, so'.: that; L'th&se codla-be :'t&ev &ssumed alarming prcporticns'-of- $ublid;bealth -i . . M - -I . .’ .i : 'contrcQ.ed'&for~ _ ,, ,, ,_ : ., .,_.. : . ,,,.l,impartance;‘ c . .. L.._,' . :, "_ .1 :, ., ;..'. "', (. : 'i .-.,' The‘ Codttee",,". :,; also agreed that while.dratiing,up the.'perspective the'scope for'technic~l' cooperation,., ,,: plan for the inter&country programme, 9 : :.,&c&j developing'~cbuntries ,'mobilizatidn~of~~ektra~budget~ry 'r&zources and..,. ooor&inated utilization of ail av&Llable~~resources shoiild be"kept in mind.. . I i_,' .:,, ,,,.s. . . . .'1 . . . . . :, ,, _\"- : ,,.( :"1 -) :li.. . ..i . ,: .' The Committee; gfter a detailed revie@of document $Ed/'ICP/Meet 2/4 on "Guidelines for Perspective Plan 'for' the Inter-country*Programme in the Sou~th~East Asia Region", agree,d that the following seven programme areas " should b.e given 'priority in developing the,-perspective'plan for the inter-:,' "' . country programme in the South-East Asia Region:' :. ' :"' I .: '. '. ;.ji .t, (1) Information SjTste!X DeWlopmcnt (2) Development of Managerial Capabiiity and Capacity (3) 1?9enpower Development . (4)' Health, Services,pesearch '.' '. (5) Environmental Health '. (6) Disease Control and Prevention (7)" Family Health including Fami~y',Planning, Nutrition and Health Edbcatfoh; " '-' ' I It was emphasized by the Committee that these priority'areas should be given preferential attention in terms of both financial allocation as well as concentration of development efforts under the inter-country programme. ,- I ,. .< '. ;;, .> ,.,,,.:._ : .:... -i : :a' (i) The development of Information systems should be given maximum attention in 'the perr;pectivd:.plan ;for the inter- country prograzze beceuse reliable and appropriate 'qua non'both:for identifying the probl.ems‘GY well as for planning,' implementing,.~ i monitoring and evaluating the intervention'progra&nes.Situation tinalysis and tread assessment under 'infrastructure development, as-included in the programme, classifi&tion :: ;.i: i' of the Seventh C;eneral.Progrme of Wo&.,?wouid basicallydepend onthe dcvclopme~t.of.sound inform&ion systems, both.:," in terms of health information as well as information for:: ; '. ' programme .&nagement,. In view of this,‘ the Committee.._ recommended that WHO should intensify its .c&laborative efforts with Member States in this area. i'.,, 'I ., J . ..I perspective,plan should'lay adequate empha&.s on ', developing management capabilities ,and capacities eboth:.:. .,. .' in the Member States 'as well as in the'organization. -?- .I ,;,‘. * : ,. ‘. I’ :. “L:, .(i.i$! All hea?th, manpower development activities should.Sb&Jpleced ~ and'managed.hnder one procjri-imme~i~ viz., 2&&ilth &Iiintii&r I ~DeveBopm&-&, in order ~%o.~faoil-itate coorddintit&d'&iningdevelop@%& andCutiliz'ation-of health manwwer 'in%& ivery of health care servicesr in contrast to the presentde11 practice of.di&$ersing these activftges under many different'.i.,, " proQram@si; -:iPechnical in&&, 'hotje@r;smight be dr&& from ~reievak progrdmmes as ,might benecessary: .: 0 -j i'.'a:. 1. *,..: ,,.', (il' - .- on tile. b'asis'of ,the,pe&@xtive plak Gti inter-country.* .'.. . .- :. . i . T) While drawing up the inter-country programme for the Region of these activities would_ actzv&tlesI It~must be ensured that theessentia'Z purpose be .to m,iljEiiegent .&& n&i&j$al efforts for ED?A/~Q,O~.~ ‘To thfs end;the 'inter-&iintry : _.: Following detailed dis&ssions on. the basic'prih~i~~es;,~~e Committee considered the proposed perspective plan for the-'-inter-country ., *: f“ '>‘ -programme as given in document SEA/ICPj'Meet2j6 (anne~edj,~,,,~~~r~Tied the .. :. perspect+ve plan as contained in the aforesaid~'do&ament-and %&xnmended :. ne should be immediately re-o&en&d on the -basis of this perspe+ive,plan. It, however, emphasized th&t,the inter- I.,,:,i that the inter-country programs country programme planning process must be a dynamic one an&periodic reviews must be made an the light of progress made in the realization of_ 'es as well as ihe changing need&and requirements of+I 'the set'objectiv : l'@@er States in pursuing.their efforts for achieving, the'U$A:'goal. ' ,. ..',‘ 3. ‘i$@ ;,. I ,, . .'. COiJNTRY AAJR 1WEEFWZOW~RY~PRCCRAMi.i. W&kI,UATI&J*~ ' :*i..l:;,. .! : 1 ,‘. While, reviewing WHO's past efforts in promoting ev&uation ..'. activities for.its country and inter-country pro&am&s, 1.I .emphasized. that evaluation.wasnot a one-time tiiti' tiiittee .:. , statio.pro&ss but was a._ . ._conclnulng activity with the main purpose of taking corrective action -, to bring about desired orientation in order to achieve the objective. '.. fnfact, evaluation should be kept~in'mind'ak the very earli stage of 1.. planning a programme'so that-the objective could'be well-defined"and precise enough,to be amenable. to measurement/assessment~ '.'.‘ r ',' .j ,,,i ":.' The Committee, while agreeing to th& siir-levels at-whi&h'*‘- evaluation could be undertaken, including relevance, adequacy, progress, effectiveness and impact, discussed in .greater:.detai'l theikwo aspects, viz., assessment of progress and asses soundness. Thes '., two.very specifi I. / : ,:' i'i:;.;.,: 'f :'? *k&ground document SEA/ICP/Meet 2/5.'. * ., -. i"' '. ;:: ,,,.i.:l. . I": '. ;: 'y : (i : -1I ,.._ isment of effectiveness. While the :former was related, to monitoring,' the latt&was con&rne&w+th iechnical #e two types of assessment rnust.~~~cessakil~--d~~~;iai:on c Fd'different types of information< &melfj,"programme management,informatiom and country-based health information r&pectively. programme should, wherever possible;‘ in&.cate~ how 4% -proposed jactivitps ,would.be.supportive of'the nat+5nal \_: progiabes. : ~ "Z, ‘;; j:, : . i',.f ../ : ,. .,_ <; ,:..,:: , : :. .I j I z ."‘, . :. .ii**-s. I'. i‘ I ,:. *j:. “” 4- The Committee felt that there was urgent need for extending ~~0's \' '_.," assi$Janpe tor-!$%ber Sta.~~q;~~..s~ranqtBen n~tional~,healt;h :information. . . so . . ..qystem inorder Jo. geqsrat~,rel~vant,p~l~~ health ,:,qs well as managerial +#wwt~~~tl,fp.r prgg+qe. development, I.A., i Siq~l.~n~y~~J.y, WHO should also stqm+heq.~i+ oyn ppqqpmg$ .,informatio,n system,. ::, . : . . .I.4:: .T’ I’-:. j I,:, :, ,, ,.. .! .“ ::' .:. * :' .) '.y“::..;: ;,t ,ygs I :haweye& emp&wipq,thaf geneG&i.on of information alone., ,. ,. ?; I, i vould ~r@t.iprod!-&~.$lfe desired reguL$ Y.~nl+sq t&3, f,&w of information was maintained topermit continuous .evaluqtion..and qec63qsary corrective action bask'& evaluative 'kindings. , : ,.‘,jJ “! ,:-., “ ! ./ ‘ ( :,-:_ ,:. ; ‘I: ” : ‘..>.i ,,, ,! , ‘!(: .’ ; ,.,“’ ,TQe~,Committee. s$r,es=d.that ;any qvq&,u,@op of!WHOqs programme., : .@Gtiv;it&ejs +ou<ld bg.meani.ngfully done, only if,, it was> undertaken along with .&at.,;pf therelevant national .p,rogr+me. .I +sncer..it yas essential that s~~~,,~F?T&ative .effOr.ks ty ,assess health prograqmes must be a combined and. iete9r?t~,j~ifort,of,,~~ q.nd the patiqn~l- q#hority, starting from ..~llfo~tion.ge~~ration. to actual analysis.for ,+We~~rnent of progress or ef.fedtiveness and impact. This would alsq facilitate simultaneous 1 application of corrective measures by both the national authorities and .the ~gqn+ttiop as necessary..,, $+le orditner.ily the..ev#uation of national ,, ,.,' I, programmes and WHQ's .collaborative.ac~ivities.w~~~~d,,~e undertaken,,d . . . . . Wnjointly by ,the government.and the Organization: in .an integrated manner, ,,, y':,': :' ',il. $p+K&~~~~~ m&&T; grtjlize,- .if, rgguire~,.,~g,;suppQrk~ in .,evaLuating,the ':L.' ;:,. national..programmes.I is,:, L.(_, This would be es;sentia~~y,~undes~rkpn,witih a'view ._ : ,. F?: id!qtifying, fog .t@e .governpent;s,:,the bottlenecks. in programme :.:,,.:. $qple~entation. .! : : ,' . ..:: :: ,: ,, :i- .:, r,.-:'i,? [ ., 1 IL :.., .‘, !,‘.. t, ‘),', '.. , ' i!‘: ‘,' ', .; '.j f>'.,' '. ; ,; 2: ! _ . . TheI ,. : : ., . Committee' agreed ..shat to facili;ate'these,act~yities,,, aimedth cilitate 't&e+ ac,tiyities,: aim .at information generation and flow as.welL as.~sse,s~mep,~t;:.33ased;on thesewell information, the WHO Programme Coordinator and Representative (WC&R) should be provided #ith an asqistant,,.,preferqbly .a national.uld be provided #ith an ass,istant,,. ferqbly ,a na l. _,., , .,._ . . The Committee felt that all relevant .info,rnation, generated at the &Ltry.,level,,: sepecipl,ly.that concerning t~e.irn~~ementatiq~.~~~~~ss,, .' ,: : /'I,. qhould,be conveyed by theJ?PCaR's office‘both t? thego~ernment-as well ; as to I,$4 Regional Office.:. ,', '.: ,‘y. y'. : '..b':!..).: ,*. / ': ::.: ":.: :. ..' , -. .,. .-.. ('.', .. " :), ;.“.$': .,',j ;'> :: ., ,* i' '- _! .' The Committee recommended that the..~egio~~.l,lqirector.hould devise an...appropriate mechanism not. only to ensure-,WHQ'.s., pr~gr~~!..e~.a,lqation., I.... effectively but.also to,ntegrate the,ef,f,orfs of ,the.,$qg.az&~tien with those of Member States in undertaking evaluation of health prggrarknes, in cons,ultation,..and cooperation with .the gover~ents, . . ...; : ,, : ., :., \ ,:: ; ,I' ; ; .: ./ , ., .; : .,_, . . ;., .'!. j, cy.: : :, ,g. INTER-&~1+& PRCX+WE PRQl$SAI& &&98&19,8,5 :A# .,,: 11 ;::i:;, :,'?,. ::'I .:‘- '. i 8 '$. ?:' ; .,,:T,'. ; ,..":: I ,,, :. ..:; * ,.., . ..) ,,,, , .'. : _,.: " t '~e'Cormnittee'examipea:the inter-country progrqme,,pro~s~ls for‘.. It.,, s .i984~~985.as~'~6ntai~e~ in' ~~c~g~t,:~~~~ICF/Meet.j2~~~~~~.,.,T~~,~p~~:Chat,,: ..:. ;.. .I ,.,.,,.~QiL .spelling .,out ,fhe:imain strsltegi~~.,toI~~liver .essential .heaPth care .id t&i entire-population, .it..sbould&e indicated :~leerLy:,~~a?;~~~e:..._.< iL '".",. ..( ,, .>1 _. strategies would be implemented conjointly by WHO and Member States and that the Organization would make all efforts to mobilize the needed.._ ." __ ._.. resources from external sources. .:, 'I ,-' ,' ., :,: :), :..,.,S:. .+ ;i i:,i:~i~;,:‘,:j;l ;" ,. ft felt that- the emphasis of the pro&unme activities under programme,@rea ?.I$.$ should be on community-based mental health activities. reti@@s.@ t~@*nt:of neurologic& disorders should be deleted,:. The comm$$tee felt.thst beh+$.+al~aepects~ of yesear& should be considered for .inelusion $the'&ter-$ou&zy progr&me,~proposals to supplement the th,educ+ion programme. It not&d- that add&$o@l:resources from UM)P being maie ~available Eor'thiEi purpose.';,;.. : '. L Qn page '(viiil, %‘._ under “IGain Thrustof Regxonal Progyamme'", para 3 ld'be.emend&d to read: 'r"res~arch-and 'development,i.n health and health- ted systems to support most efficient~and effective operation of health The Committee reiterated fts approval;of.the interccountry programme _ )sals for 1994~-198$, as contained in document~SEl;i/ICP/Meet ~/INF.~ '&bject,to the-un&rst&nding that there was scope. foe r.ealigning the lled a#ivities to the needs of Member SAzates!when the detailed budget ', for the ~nte~~country'pro~r~~,for,~he period,1984r198$ was finalized mmittee made the following recommendations: ,' ; Iramme areas, viz., infarction systems development, .capability and &apac$ty, manpower :es resear@h, .environmental health, disease control and prevention , family planning, and family health including nutrition and health education, should receive'preferential. attenti0nJ.n the allocation of resources and'developmental efforts under the inter-country programme. lijhile, in general., the above priorftLes should be adhered to in developing the inter-country programme, the areas of information systems development and development of managerial ea&bility and capacity should tieceiys special attention. (ii) Ths,perspective plan should provide ,for tackling emerging pr6blems so that these,oould be controlled before they become major public health'problems, :.,,,, (iii) Health manpower development activities should be undertaken under one pragramme, with technical inputs flowing from the other relevant programmes. progress made in the accomplishment of objectives mentioned in the plan for attaining the HE% goal and the changing needs and requirementis of Member States. Such modifications ,; : ,- I^ ., .y, :, should be .geared toyards. fqster&ng teehnica& qoo&$+ion .ng developing countries,,. attqact&ng extrasbudgeta'q ,-:,,. , ,,, 1' ." ;esowoes.:.to.priority programmes and..br&ng$~"about :: coordinated utiAi.~atiqn~of~sll avalla~le~r~snwrces, .; (v) :' ~heintsa-country programnq.qf:.tlr?e,~Reg~on should be .:‘,I ;“’ .i,: iL reoriented as saon,as practicable, in the,.&$ght ofi,the .:*:,.. /_ s." .perspective plan contained,in gocumenf S?$A/ICE/ga!eeti2/6 which has been qqzoved by the Committee. ._, 7!,::,. .;, (i) To.:camiy.out a meaMngfu1 evaluat$on, ,+t.Js essegtfq$,that t,;,;.;.:,. ,';., : ,, evaluat)on should~be.done in an integrated manner!,,@ere ..; : a .: 3~0th We ~WKWssi.stgd cow&q and ,, inter7co~n~y,:pro4,~~es I '- and the national programpes are.mosit~red.:~~~,eo~~~~~~velyevaluated together. The Organization should devise effective mechanisms to bring ahout~.thiY.,integ~ated ,_", . . . . _.: L :‘ ..Y'. alralrlzsi-inn : ” ,“.. I.’ :i (ii) Suitable mechanisms should be established'for undertaking co-Frective. measure.s~ both for the .~,~~,ional:programmcs and.I .,. ." .' '. i" "those supported&y the Organzzat$&i, ":.j .I . :.::, :. qi .' '. .,, ',, ' (iii): The Organization should. support efforts for health (iv),‘.::hP.& information col.lected and processed at the country . .1 .I .level, for monitoring program? development and iqlemen-. . . I tation should be channelle.d.to the governments and the -A--J ^ -- 1 (v) With a view to strengthening the WpC&s and in the activities at the country level, it is necessary to appoint.an appropriate nationalso that he woul,d be able to '_ assist.in.proger development and. coord+ation 'of both the national programmes and.HH0F.s .qollaborntive activities. Annex LIST OF PARTICIPANTS BANGLADRSH i : : , Mr Md. Siddiquer Rahmsn Secretary, Health, Division, Ministry of Health and Pooulation Control Director, Department of Health Services Thimphu Dr Anayat S.Y. Coordinator, TB and Leprosy Control " ' Department of Health Services Thimphu Dr U Kyaw Sein 1 ,Director, Planning, Finance, Administration' : and Training, Department of Health Rangoon I Mr Lo Kong su Third Secretary, Embassy of the Democrat:tc qartment of External ReIations;.:.,, lis?m'of Public Health aongvas ,% 3 ,.;,.: r: ,' ., Ministry of Health and Pam$ly ve.Ifare, . . ,_ New Delhi INDONESIA Dr'Bahrawi Wongsokusumo Inspector-General,,~Ministry of Health, .: Jakarta Dr Soediono Bureau of Planning Secretariat General, Ministry of Health Jakarta MALDIVES Mr Abdul Latheef Qasim Under Secretary, Ministry of Health Male