(WP)MRO/ICP/MPN 005-E
26 July 19117 ENGLISH ONLY
REPO~T
WORKSH0P FOR TRAINERS IN HEALTH SECTOR FINANCIAL MANAGEMENT Convened by the WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Manila, Philippines 20 - 30 April 1987
WHUI WI'I<U J,lHKARY lYlnnilll. fhilippin~
1 r.
~CD
1987
Not for Sale Printed and distributed by the WHO Regional Office for the Western Pacific Manila, Philippines July 1987
NOTE
The views expressed in this report are those of the participants in the meeting and do not necessarily reflect the policies of the World Health Organization.
This report has been prepared by the World Health Organization Regional Office for the Western Pacific Region for governments of Member States in the Region and for those who participated in the Workshop for Trainers in Health Sector Financial Management, held in Manila, Philippines, from 20 to 30 April 1987.
CONTENTS
SUMMARY 2.
...............................................................................................
1
PURPOSE 2.1 2.2
........................................................................................................... . 2 2 2
Objectives •. •••• •••••.••••• ..••• ••••••.••... .••• •.•.••••• Expected outcomes ................................................................................
3.
ORGANIZATION 3.1 3.2 3.3
....................................................................................................
Location and participants ••.•••••••.•••••.••••.••...•••.• Outline of content .......................................................................... Method of work • • • • • • • • • • • • •• . . • • . . • . . . • • • • . . • • • . • . . • . . • . .
2 2 3 3
4.
OUTCOME OF DISCUSSIONS 4.1 4.2 4.3 Describing the works~op proceedings •.••.•••.•.•••.•.•••.. Country experiences •••••••••.••••••..••.•......••........ Country proposals ................................................................................
3 4 5 6
5.
CONCLUSION
........................................................................................................
ANNEX 1 - LIST OF PARTICIPANTS AND SECRETARIAT WORKSHOP FOR TRAINERS IN HEALTH SECTOR FINANCIAL MANAGEMENT • • • • • • • • • • • • . • • • • . • • • • . • • • . • . • . • ANNEX 2 - OPENING ADDRESS BY DR HIROSHI NAKAJIMA, DIRECTOR REGIONAL OFFICE FOR THE WESTERN PACIFIC OF THE WORLD HEALTH ORGANIZATION............... ANNEX 3 - ANNOTATED AGENDA ANNEX 4 - MODULE FOR TRAINING TRAINERS IN HEALTH SECTOR FINANCIAL MANAGEMENT ANNEX 5 - COUNTRY PROPOSALS ANNEX 6 - EVALUATION RESULTS
7
11 13/14
15 23
................................................................
29
1.
SUMMARY
The Regional Office for the Western Pacific of the World Health Organization (WHO) organized the first workshop for trainers in health sector financial management as an initial activity of the Intercountry Project of the Governments of China, the Lao People's Democratic Republic, Malaysia, Papua New Guinea, the Philippines, the Republic of Korea and Viet Nam under the United Nations Development Programme (UNDP). Eighteen participants from four countries~ namely: Malavsia, the Pnilippines, the Republic of Korea and Viet Nam attended the workshop.
The adoption of the re~ional strategy for health for all in 1980 has led to the need for capabilities in the financial management to provide support in tne implementation of the strategy. Thus this intercountry project on financial management planning of the health sector was evolved and implemented.
The project's long-term objective is to develop the financial planning and management capabilities of ministries of health. As an initial activity towards the above-mentioned long-term objective, the purpose of this workshop for the training of trainers was as follows: to develop competencies to design training programmes and facilitate learning sessions in human resource and organization development;
to acquire a systems perspective and develop skills in the systems approach to problem-solving and decision-making processes;
to develop skills in human interaction and cross-cultural communications; and
to develop skills in applying systems approach to financial management towards health development. The conclusion was reached after the workshop that the attainment of self-reliance in ac~ieving national health development goals requires support from the financial management sector of health ministries. Specifically, this means the attainment of capabilities to collect and utilize information at hand and design management tools for appropriate management decisions towards health for all. The workshop was intended to develop a core group among country part1c1pants to work with other core groups in the ministries to implement tne project.
2
2.
PURPOSE
2.1
Objectives The objective of the workshop was to develop a core group of trainers
in financial management. participants to; (1)
Specifically the workshop enabled the
design and develop learning sessions 1n financial management and design a training programme on financial management of the health
identify training strategies and approaches in the conduct of such sessions;
(2) system.
(3) apply the systems perspective and systems approach to financial management in the health system. 2.2 Expected outcomes
At the end of the workshop, it was expected that country project proposals would be prepared. These proposals would show how the project's resources could be used in each country. As a consequence of this training process, the participants would become the core group to initiate, design
and engage others to help implement the project.
3.
ORGANIZATION
3.1
Location and participants
The workshop was held at the Learning Centre of the Regional Office for the Western Pacific in Manila from 20 to 30 April 1987. The workshop was administered and coordinated by the WHO secretariat and conducted and facilitated by a team of three consultants. There were eighteen participants from four countries, namely,
Malaysia, the Philippines, the Republic of Korea and Viet Nam.
These were
senior and key financial managers and trainors in their respective ministries. A list of the participants is found in Annex 1.
3.2
Outline of content The workshop was designed around three themes which served as a
framework for the selection of activities, facilitation of the learning process and monitoring and evaluation of results. These themes are as
follows: (1)
the human person and the learning process the participant's position in the organization and the trainer's roles the participant's profession - expertise and experience.
(2) (3)
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Around these themes the workshop was divided into two modules, namely; The Training-Learning System Module. This focused on the learning processes and styles, learning climate and strategies, the art and skill of questioning, planning and creating learning experiences, and designing learning training programmes and action plans. (1)
The Organization/Financial Management Development System Module. This focused on the systems perspective to understanding organizations, assessing, planning and financing the health systems~ monitoring and evaluating health programmes and management of cross-cultural communications.
(z)
The opening ceremony included the introductory remarks by the Regional Director and the introduction of country participants, guests, consultants and secretariat staff. The Regional Director's remarks are included in Annex Z. The detailed agenda for the 3.3 Method of work ~orkshop
is included 1n Annex 3.
The workshop was organized based on the experiential cycle of learning providing for (a) direct learning or hands-on activities in the training-learning processes; (0) conceptual and reflective inputs on relevant tneories, concepts and principles; (c) actual, simulated and instrumented learning application activities in situating, assessing, planning and financing health systems, and (d) individual and group interactive activities in management and cross-cultural communications.
The outputs of each phase of work were evolved through active participation of members in both individual and group work. Reading materials were used as references for key concepts. The format of the session was outlined based on the stated objectives for each day's session. The detailed outline is found in Annex 4.
4.
OUTCOME
Or
DISCUSSIONS
4.1
Describing the workshop proceedings
The workshop started with the usual opening activ1t1es. However, the moment work started, the participants and the consultants-facilitators found themselves engaged in interactive and stimulating relationships in being, doing and acting.
Tne worKshop exercises were anchored in the following perspectives;
training must be LEARNER-BASED; management communications and cross-cultural communications must
be PERSON-BASED; and
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health financial management planning must be SYSTEMS-RASED. In tune with these perspectives were learning and training strategies and processes that reflected:
instrumented, multi-media and activity-packed training scheme; dialogical, group, interactive (interpersonal) and cross-cultural communications models; and systemic - systematic and experiential - developmental planning alternatives. More concretely, these perspectives and processes were given to the participants through activities where the starting point was always the learner-in-the-participant or the person-in-the-participant. For example: In learning the learning process, the participants were asked to journey back into their own respective experiences on how they learnt or failed to learn. In training in the art of Questioning, the participants were made to answer Questions, thereafter to reflect on the types/levels of questions asked as well as on how the questions were asked and then were to draft/ask their own set of Questions on a given selection. In planning and creating learning experiences, the participants used their kind of work as the source of skills or concepts that provided tne content for their plans. In getting oriented into the systems perspective to developmental health planning, the participants used their respective persons and then later, a mutually agreed focal system among group delegations to get a "working feel" of systems. In managing communications, the participants were made to communicate with others in thought through the use of body language only, then in words and gestures. In benefiting from cross-cultural communications the participants were put into vicarious situations which made them experience cross-cultural communications directly through simulation exercises and indirectly through a video-film presentation. 4.2 Country experiences
The purpose of the workshop activities was to draw from the participants their experiences in applying the systems approach to financial management.
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Each team identified a unit in the health system as the focal system for the assessing, financial planning, monitoring and evaluating process activities in the workshop. The focal systems chosen by country teams were as follows: Malaysia Philippines Republic of Korea Viet Nam workshop process activities:
Planning and development division Financial management system Health care services Health treatment system
The choice of the focal system became the basis for the following formulation of vision-mission statements assessment of systems functioning and identification of problems and needs financial planning and designing of monitoring and evaluation schemes.
The outputs of each of the above process activities were shared and discussed with the whole group to learn both the content and the process of the workshop. ~ 4.3 Country proposals
The workshop provided the partlclpants with an opportunity to prepare a project proposal on how to implement the project in their respective countries. The proposals were to focus on specific areas to develop and activities to conduct as a follow-up of this first activity of the project. The Korean team proposed a series of activities on the (a) development of a training programme manual, (b) training of trainers, (c) training of trainees at national, provincial and local levels, (d) evaluation of the programme at all levels, (e) feedback of evaluation results and (f) routinization of the programme.
The Malaysian team included in their proposal actlvlties as a follow up of ongoing efforts such as: (a) follow up of the completed health services financing study after having forwarded short- and long-term recommendations to Government, (b) national health and morbidity survey, currently ongoing, to complement data gaps (e.g., household expenditures on health) and also incorporate studies as socioeconomic research unit, etc.,
(c) national health security fund study - to identify various options and strategies for implementation and health legislation, (d) establishment of a national health council, (e) organization of a core group for in-country training in health sector financial planning, (f) conducting of one in-country health sector financial planning course in 1987, (g) development of the health financial management information system, setting up the network and developing information designs, (h) later incorporating the health financial management information system and health management information syste~ and (i) proposing a workshop to incorporate health sector financial plan in management-decision systems.
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The Philippine team included in their proposed projects a series of organizational negotiations and activities such as (a) feedback of results of the workshop to top management, (b) creation of core group, (c) training of core group with other members coopted to work with core group, (d) conducting of a study on expenditures and sources of finance and coordination of studies already done in other areas, (e) formulation of financial management plans, (f) training of personnel at regional/provincial/district levels, (f) monitoring and evaluation) and (g) implementation of financial plan. The Viet Nam team proposed the design of training programmes which included training activities for health staff, health network, health management, school health systems and standardization of categories of health personnel, with monitoring and evaluation of such efforts. The country proposals are outlined in Annex 5.
5.
CONCLUSION
The workshop provided a new experience for professionals in health sector financial management to view the health system from a systematic perspective. The focus on learning as an experiential process provided the participants with a direct and meaningful way of learning. The exercises provided the participants with significant insights in: identifying their own learning processes and styles; creating and planning an experiential learning process; situating and visualizing systems perspectives, purposes and
functioning; planning financial sChemes/systems and designing monitoring and evaluation schemes for the health programme; designing training programmes. The outputs generated from the workshop activities and the results of the feedback and evaluation indicate that participants understood the concepts and skills. From the feedback, the insights gained included the following: Teamwork may be time-consuming but learning results of interactions are more complete. Experiential mode of learning becomes more effective if processed. Participation in group work is influenced by one's own person, position and profession.
The sharing and exchanges of experiences provide a rich resource of ideas for all participants. Process and product go together in training. Systems perspectives can fit into various cultural orientations. The vision-mission statement is an important anchor in planning. Skills and depths of being are basic needs of a facilitator. Financial management is an important strategy for health for all by the year 2000. The workshop allowed growth in self-confidence. Annex 6 contains a summary of the participants' evaluation.
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ANNEX 1
LIST OF PARTlCIPAtiTS AND SECRETARIAl WORKSHOP FOR TRAINERS IN HEALTH SEGTOR FINANCIAL MANAGEMENT
1.
PARTICIP~lS
MALAYSIA
Mr Seow Ewe Hoe Undersecretary, Finance Division
Ministry of Health 50590 Kuala Lumpur Dr Wan Azmin wan Ahmad Assistant Director Planning and Development Division Ministry of Health 50590 Kuala Lumpur Mr Mohd Nor Yassin Undersecretary, Service Division
Ministry of Health 50590 Kuala Lumpur PHILIPPINES Ms Carole A. Bandahala Health Planning Officer Department of Health Manila Ms Priscilla G. Camposano Chief Accountant I Department of Health Manila Mrs Antonina U. Cueto Supervising Statistician
Department of Health Manila Mrs Remy B. Dequifta Supervising Manpower Development Office Department of Health Manila Mrs Milagros B. Fronda Health Project Evaluation and Development Officer Department of Health Manila
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Annex 1
Mr Eufrosino I. Icay Budget Officer III Department of Health Manila Dr Alma A. Frondoza Medical Specialist II Department of Health Manila Mr Tommy C. Ual Budget Examiner II Department of Health Manila REPUBLIC OF KOREA Dr Ok-Ryun Moon Associate Professor of Health Administration
School of Public Health Seoul National University Seoul Dr Yeo-Shin Hong Professor of Nursing
Department of Nursing Seoul National University Seoul Dr Chang-Jin Moon Deputy Director Community Health Division
Ministry of Health and Social Affairs Seoul Mr Doo-Chae Jung Senior Researcher
Institute of Hospital Services Seoul National University Seoul VIET NAM Dr Tran Ngoc Duat Director Hai Hung Provincial Health Service
c/o Ministry of Health Hanoi Dr Le Xuan Vinh Chief, Health Planning Bureau c/o Ministry of Health Hanoi
- 9/10 -
Annex 1
Mr Nguyen Van Trong Expert on Financial Management Department of Finance Ministry of Health
~
2.
SECRETARIAT
Mr M.J. Anderson Management and Research Support Officer WHO Regional Office for the Western Pacific Manila Dr V. Ermakov Regional Adviser in Health Manpower Development WHO Regional Office for the Western Pacific
Manila Mr C.M. Lee Management Development Officer WHO Regional Office for the Western Pacific Manila
3.
CONSULTANTS
Dr P.R. Tayko Dean Saidi Information Office Malate, Metro Manila Dr R.O. Barrameda Saidi Information Office Malate, Metro Manila
Mr R. Capalillo Saidi Information Office Malate, Metro Manila
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ANNEX 2
OPENING ADDRESS BY DR HIROSHI NAKAJIMA, DIRECTOR, REGIONAL OFFICE FOR THE WESTERN PACIFIC OF THE WORLD HEALTH ORGANIZATION
Colleagues and staff, It is a great pleasure for me to welcome you to this workshop for trainers in health sector financial management.
I would like to begin by briefly noting the role of financial management in health systems, since this understanding forms the basis for our meeting here today. We believe that health systems have moved from a period of awareness building regarding the importance of health sector financial management to the present situation in which many critical decisions that are being made
include inputs of a financial nature.
We are also seeing a significant For
change in the scope of financial issues that are being addressed.
example, it was not so long ago that financial concerns mainly involved relatively simple matters such as determining programme alternatives on the basis of cost benefits. We are now convinced that the next set of issues
to yield significant gains in health development will involve such topics 8S
cost containment and alternative methods of financing.
Topics which
relate to the health system as a whole, not just to individual health programmes. Clearly, the current types of critical decisions being made in
the health system are expanding the boundary for financial matters. These new factors, however, are also causing uS additional problems. For example, it does not take much imagination to realize that, if we are to effectively manage these latter areas, significant changes must occur in
the way we think about and manage our current health systems. These changes involve tbe way other parties are encouraged to participate in decision-making and how decisions are coordinated. Therefore, we now
realize that decision-making wnich involves this expanding boundary of financial issues should be treated like any other health development issue. This means that there are no standard answers but ratber that various options are possible and that solutions are unique to each country's situation. With these few comments as a oackgrouod, we now come to the purpose of
this workshop. First of all, the workshop is the first activity of a UNDP-supported intercountry project on health sector financial planning and management. The goal of this project is to strengthen the financial management capabilities of participating countries. For us this goal means that the project will help countries to more accurately describe where financial resources are coming from, what they were used for and to
determine how to incorporate this financial description of the health systems into routine management dec1sion-making. To expedite the project implementation, we felt that it would be useful if countries had a core group of staff which could serve as the focal point for activities
supported by the project.
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Annex 2
with this strategy in mind, one of the project's activities will be to provide the national core group with an opportunity to strengthen its management training and facilitation skills. Consequently, the purpose of this first workshop is to provide an opportunity for you (1) to increase your ability to use the team approach in problem solving, (2) to experiment with training programmes based on a participative approach to learning and (3) to share knowledge and ideas on using the system's approach to understand how an organization functions. I am sure you will agree that these objectives refer to fundamental skills that every manager should possess. In addition, we feel that these are the building blocks for managing the specific activities supported by the project that will be conducted in your countries. Also that they address the problems health systems are now facing in terms of using the techniques of financial management. However, as I previously mentioned, this is just a beginning, for as we work and learn together our skills and capabilities will also become improved. I trust you will have a fruitful workshop and look forward to hearing your reactions on the outcomes of this activity. I wish you all a pleasant stay in Manila.
- 13/14 -
ANNEX 3
ANNOTATED AGENDA
1.
INTRODUGTORY REMARKS BY THE REGIONAL DIRECTOR REVIEW OF WORKSHOP OBJECTIVES AND SCHEDULE OF WORK THE LEARNING PROCESS: GROUP AND INDIVIDUAL EXERCISES
2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.
TECHNIQUES OF QUESTIONING PLANNING AND CREATING LEARNING EXPERIENCES THE SYSTEMS PERSPECTIVE TO UNDERSTANDING ORGANIZATIONS ASSESSING THE HEALTH SYSTEM PLANNING THE HEALTH SYSTEM MANAGEMENT COMMUNICATIONS FINANCING THE HEALTH SYSTEM EVALUATING HEALTH PROGRAMMES DESIGNING TRAINING PROGRAMMES EVALUATION OF WORKSHOP
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ANNEX 4
MODULE FOR TRAINING TRAINERS IN HEALTH SECTOR FINANCIAL MANAGEMENT
This module is designed for workshop participants nominated from national health ministries of Malaysia, the Philippines, the Republic of Korea and Viet Nam. It is assumed that the part1c1pants have their respective expertise and experience in health sector financial management in their positions of responsibility and leadership in the Ministry of Health. What this workshop will provide is the training on systems process and perspectives in two areas such as;
COMPETENCIES of trainers as DESIGNERS and FACILITATORS of learning and training processes and COMPETENCIES of trainers as FINANCIAL MANAGERS of the health systems development in the health sector financial management 1n their respective sectorSa
These two areas of competencies are developed 1n this workshop through experiential activities focusing on the following: the Ministry of Health Organization as the CONTEXT of a human social system;
the human learning process as the FOCUS of training and development; and the financial management process and work experience of participants as the CONTENT of the session activities. This module is divided into two unit modules; under each the items for the training and learning sessions as shown on the schedule are interwoven.
The unit modules are as follows: UNIT MODULE 1. Item 1. 2.
THE TRAINING-LEARNING SYSTEM Introductory remarks Overview and review of workshop objectives and schedule The learning process and climate The art and technique of questioning Planning and creating learning experiences and designing learning packages Designing training programmes Evaluation of workshop
3. 4. 5. 12. 13.
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Annex 4
UNIT MODULE 2. 6. 7. 8. 9.
ORGANIZATION/FINANCIAL MANAGEMENT SYSTEMS DEVELOPMENT The systems perspective to understanding organizations Assessing the health systems Planning the health system Management communications
10. 11.
Financing the health system Evaluating health programmes
The activities under each item of the unit modules are designed according to the theme of each item with the ultimate objective of developing competencies in the areas identified above. ITEM 1. INTRODUCTIONS
OBJECTIVES: To provide part1c1pants with management perspectives and information about the workshop. rationale background expected outcomes To introduce participants and staff and get to know each other. PROCEDURE: Opening session - introductory remarks by Regional Director Introductions and overview by management and research support officer Getting-to-know-you activity - dyads and group REFERENCES Programme description and objectives Workshop objectives Schedule Participants' list
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Annex 4
ITEM 2.
OVERVIEW AND REVIEW OF WORKSHOP OBJECTIVES AND SCHEDULE
OBJECTIVES: To surface and clarify workshop expectations and exclusions To establish training/learning parameters anG perspectives PROCEDURE: Participants' written and oral presentation of expectations Facilitators' presentation and discussion of expectations Consensus on general workshop operations REFERENCES: Module description Workshop objectives Training schedule The tra~n1ng
overview
The HRD Curriculum model ITEM 3. THE LEARNING PROCESS
OBJECTIVES: To identify one's learning styles and processes To identify conditions promotive and conducive to effective learning To discuss implications of trainers/trainees learning styles and processes
PROCEDURES: Learning climate activity Learning styles' inventories Dyads and group discussion Session feedback and synthesis REFERENCES: The concept of learning style Identifying learner/trainer styles
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Annex 4
ITEM 4.
THE ART AND TECHNIQUE OF QUESTIONING
OBJECTIVES: To appreciate the value of questions as tools in promoting learning To identify types and levels of questions To demonstrate techniques of questioning To demonstrate skills in listening PROCEDURE: Simulation via socialized activity (Trainor - Trainee) Process to identify types/levels of question-workshop Group sharing of question-workshop results Clincher REFERENCES: Questions (See how to be effective trainer) ITEM 5. PLANNING AND CREATING LEARNING EXPERIENCES
OBJECTIVES: To examine the essence of the following basic elements that go with planning and creating learning experiences: (a) (b) (c) (d) the trainer the learning principles the session-models mapping the learning experience on paper
To evolve on sessions plan PROCEDURES: Socialized activity: Simulation activities (a) (b) (c) On the learning principles Session models Objective writing The trainer/his role
After each simulation - process and clinch with lecturette to highlight key points Workshop: REFERENCES: Training overview
A sample sessi9n plan
Planning the learning experience
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Annex 4
ITEM 6.
THE SYSTEMS PERSPECTIVE TO UNDERSTANDING ORGANIZATIONS
OBJECTIVES: To situate the health sector financial management from a systems perspective of organizations. To visualize the health sector financial management in a systems chart. To articulate the health sector financial management system purpose (vision-mission statements). PROCEDURE: Systems frameworks presentations Individual and group activity on systems perspective Individual and group presentations critique and feedback REFERENCES: On human social system On systems concepts general systems theory On organization as the human social system On systems purpose ITEM 7. ASSESSING THE HEALTH SECTOR FINANCIAL MANAGEMENT SYSTEM
OBJECTIVES: To To To To PROCEDURES: Concepts and process presentation and discussion Individual and group activity on assessment REFERENCES: On system analysis On problem identification identify key result areas of responsibility identify indicators of system functioning define the problem of the system identify needs and courses of action
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Annex 4
ITEM 8.
PLANNING THE HEALTH SYSTEM
OBJECTIVES: To develop awareness and appreciation of the various macro and micro economic, social and political parameters that have to
be considered in health sector planning To exchange information on various planning methodologies and evaluate their effectivity in the light of the peculiar conditions prevailing in each health sector To discuss various ways of upgrading/improving planning methodologies for various health sectors PROCEDURES: Group discussion
Case studies: Group analysis Session feedback and synthesis REFERENCES: Corporate planning perspectives as applied to health ITEM 9. MANAGEMENT COMMUNICATIONS
OBJECTIVES: To increase one's sensitivity/clarify in communication ~ith
others To improve one's communication with different people coming
from diverse cultural backgrounds PROCEDURES: Communication game exercises
Processing the experiences Cross-cultural communication analysis workshop Feedback and sharing Lecturette on communications and cross-cultural communications
REFERENCES: Structured learnirig exper\ences Cross-cultural communications
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Annex 4
ITEM 10.
FINANCING THE HEALTH SYSTEM
OBJECTIVES: To develop awareness and appreciation of the various considerations involved in financing the health system To exchange experiences in various financing techniques for the health system utilized in various health sectors To discuss improved/more creative ways of financing health programmes PROCEDURES: Group discussion
Case studies Session feedback and synthesis REFERENCES: Financing health programmes: ITEM 11. EVALUATING HEALTH PROGRAMMES Some relevant considerations
OBJECTIVES: To provide a framework for monitoring health programmes To exchange information on various ways and methods of monitoring and evaluating health programmes in various health sectors.
To discuss ways of upgrading/improving monitoring practices in various health sectors. PROCEDURES: Group discussion Case studies Session feedback and synthesis REFERENCES: Monitoring health programmes ITEM 12. DESIGNING TRAINING PROGRAMMES
OBJECTIVES: To design and draft a training programme that one can use for the next two years.
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Annex 4
PROCEDURES: Lecturette on the model and parameters of a design for a training programme
Drafting the details of the plan Typing the dummy of the plan Presenting the draft of the plan REFERENCES: Design model sheet Parameters sheet Design consideration in experiences based education
! ,
,
!
, ,
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ANNEX 5
COUNTRY PROPOSALS
1.
Korean project proposal
In response to the visions of the Workshop for Trainers in Health Sector Financial Management, held in Manila, from 20 to 30 April 1987, the Korean delegates are firmly dedicated to the fulfillment of their missions through the conduct of the following two activities: (1) In the light of the importance of health expenditures information in the area of financial management of the health sector, the delegates are fully in agreement with the urgency of conducting health sector financing study in the Republic of Korea, like the one conducted by the Malaysian Government. The details of how to proceed the study remain to the Korean
component of regional core members as their future activities. mission as soon as possible.
The core
members will collaborate/elaborate their expertise to fulfill this urgent (2) In view of the funding constraints in achieving the goal of HSA by the year 2000, it is imperative to use scarce health resources efficiently. There is no doubt that this can be attained through better tra1n1ng. Unfortunately, no appropriate training course is available for the health sector financial managers in the Republic of Korea. Thus, the delegates are unanimously in agreement with the need of conducting the following training activities:
Activities Development of training programme manual
Actors 4 regional core members,
Method Conference for planning, writing and finalizing for the programme Workshop
4 professions and 1 consultant (Trainers) 4 regional core members and
Training trainers
4 professions (Trainees) 30 national resources
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Annex 5
Activities Training trainees national level
Actors (Trainers) 4 regional core members 4 professions and trained trainers (Trainees) Officers in charge of health planning and financial management
Method Workshop
in the Ministry of Health and Social Affairs. MOHA. EPB and other relevant ministries
Training trainees
( Trainers) Trainers at national
Workshop
provincial and local levels
level Training and selected officers in the Ministry of Health and Social Affairs (Trainees) Officers in charge of health planning and financial management in provinces cities, t
counties
Evaluation of the programme for provincial and local level training
4 regional core members and selected officers in the Ministry of Health and Social Affairs
Field observation and reviewing
Feedback of the evaluation result Routinization of the programme
4 regional core members
Revision of the programme Establishment of formal regular education
4 regional core members
4 professions and 30 trained trainers
programme at NIH Workshop Several times per
year
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Annex 5
2. 2.1 2.1.1
Malaysian project proposal Workshop follow-up proposals Introduction
Malaysia started to express the major issues of concern in health care financing in some forums in 1982. The Government had approached Asian Development Bank (ADB) and World Health Organization (WHO), who agreed to provide appropriate technical assistance. Accordingly, actions were taken up to implement the studies, among which was the completed Health Services Financing Study. 2.1.2 Malaysia Completed health services financing study - 1984-1985 Has forwarded short- and long-term recommendations to the Government.
National health and morbidity survey, ongoing, to complement data gaps, e.g., household expenditures on health. Also, incorporate studies by socioeconomic research unit, JPM. National health security fund study 1987/1988 to study various options and strategies of implementation health legislation To establish the National Health Council, under WHO 1988/89, with Secretariat Core Group for in-country training on health sector financial planning by IPH. One in-country health sector financial planning by IPH from 20 to 30 April 1987 To develop health financial management information system (HPMIS) set-up network develop information designs (one possible area for requesting WHO technical assistance workshop for Ministry of Health and State Directors) Later incorporate HFMIS HMIS
Proposed workshop to incorporate health sector financial plan into management decision systems
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Annex 5
3. 3.1 3.1.1
Philippines' project proposal Health sector financial management planning Rationale
The Department of Health is experiencing a rising demand for improved service as well as a worsening situation in the case of some major diseases. At the same time, the allocation of funds for health as a percentage of the total national budget has been increasing. It is recognized, at least in the short run, that health will not be receiving any substantial increases in resources to meet the increasing demands. Therefore, the only solution is to increase the impact of the limited sources that are available. The strategy to increase the impact of financial resources has two components, namely policy and management~ The policy component involves allocating financial resources so that they are directed at the priority needs. The management component involves having people capable of directing and controlling the resources that are allocated for a specific purpose. Therefore, in order for the Department to orient its health services towards a more equitable and efficient utilization of resources, an analysis of the financing of health services should be undertaken. This analysis must review the distribution of the health budget, in particular, its allocations to primary health care to urban and rural, to specified underserved groups and by region, province and district. It is proposed that the Department of Health should undertake certain activities to respond to its identified needs. The following table indicates the planned activities, persons responsible and how the activities are envisioned to be accomplished:
W hat Activities (1)
Who
How
ws (2)
Feedback of results of this
Core group
Conference
Creation of core group
Secretary of Health staff
Department order
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Annex 5
W hat (3) Train core group/othe r members
Who Core group (participants) from this WS WS
Ii
0
w
( a)
Technical expertise
(4)
Conduct of study on expenditures and sources of finance/ coordination of studies (a) Consultancy services
Management and core group
Briefing of regional provincial staff Review/analysis of data Interview Observation
(5)
Formulation of financial
Management and core group
Using study results and other data as basis Using all steps of the planning process
(6)
Train personnel at regional provincial and district levels (a) Technical modules/ consultancy
Management and core group
wS
(7)
Implementation of the financial management plan Monitoring and evaluation
(8)
Management and core group
Quarterly/semi-annual E.O. project
(a)
Preparing protocol and evaluating
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Annex 5
4. 4.1
Viet Nam project proposal Designing the training programmes in Viet Nam
W hat Activities: Training plan of health staff on: health network health management treatment in the
Who
How
(1) (2)
Health school of the Ministry of health
(1)
Training at school opening, seminar
field visit Health school of the province
(2)
hospital system
Hospital and Institute
Training at school and hospital institute
Training system from
centre to locality: doctor pharmacist school system of the Ministry of Health standard of categories of health personnel network monitoring and evaluation
(3) (4) (5)
Guideline of the Ministry of Health Guideline of the Ministry of Health Ministry of Health, Health office
(3) (4) (5)
Organization of health education system
Council of Science-Technology Conference workshop
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ANNE~
b
EVALUATION RESULTS
The workshop results can be viewed both as successful and impressive from the way the participants gave their feedback. In a scale of 1 (meaning POOR) to 7 (meaning EXCELLENT), the overall average score was 5:80. Considering the individual items of the workshop, still the scores tended almost constantly toward excellent. Shifting from figures to expressed statements of insights, the overall assessment of the participants again confirms what has been gauged
numerically. workshop.
All, seemingly, are heaping very positive remarks about the
The following are samples of their insights: (1)
Teamwork may be time-consuming, but learning results of interactions are more complete.
(2)
The experiential mode of learning becomes more effective if processed. One's participation in group work is intluenced by his person, position and profession.
(3)
(4) (5)
The sharing and exchanges of experience provided a rich resource of ideas for all the participants. Process and product go together in training. Systems perspectives can fit into varied culture orientation. The vision-mission is an important anchor in planning. Skills and depth of being are basic needs of a facilitator. Financial management is an important strategy to health for all by 2000. The workshop allowed growth in self-confidence and in whole-brain thinking.
(6) (7) (8)
(9)
(10)
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Annex 6
Words of appreciation were also expressed to the following: (1) (2) (3) (4) to WHO for initiating this valuable project; to all the participants, for each one's active and serious participation in all the activities; to the consultants, for their new ideas on doing things, their willingness to help; to the organizing staff, for a well-structured, well-organized and well-conducted workshop.
The following suggestions were made: (1) (2) (3) (4) (5) the need to follow-up, especially on content of financial management for the health sector; the need to keep in touch on a regular arrangement with various key people from the different groups; the need for WHO to liaise with this network of communicating/corresponding participants; the need to design a workshop that is not packeo with too many items;
the need to inform prospective participants with objectives and content of workshop before they come so they are able to prepare for the workshop; the need for more time, and a field trip to go with this kind ot workshop.
(6)