Meeting of WHO Country Office Planning Focal Points on Programme Development and Management, Remarks, 18-21 October 2008, Bangkok, Thailand.

Remarks By Dr Samlee Plianbangchang Regional Director, WHO South-East Asia At Meeting of WHO Country Office Planning Focal Points on Programme Development and Management Bangkok, Thailand 18-21 October 2008 Meeting of WHO Country Office Planning Focal Points on Programme Development and Management 18-21 October 2008 Bangkok, Thailand Remarks by DR SAMLEE PLIANBANGCHANG REGIONAL DIRECTOR, WHO SOUTH-EAST ASIA Colleagues, This is our internal meeting. But, it deals with an important area of WHO management, that is WHO programme development and management. Even though it is an important area, WHO’s capability and capacity seemed to be declining during the recent past. During the 1970s and the 1980s WHO invested a lot of effort and resources to build up its capacity in the area of WHO programme development and management. In those days, the leadership in this area was provided by its headquarters in Geneva. It was headquarters that developed standard procedures and guidelines for training and coaching of concerned staff members at all levels. Today that leadership is not strong, anywhere in WHO. Therefore, we, in the Region, have to strengthen our own capacity in the area of WHO programme development and management, while working within the programme budget framework provided by headquarters, we need to develop a “learning package” for strengthening our capability in this area. This effort requires leadership on the part of the Programme Planning and Coordination or the PPC unit at the Regional Office, and planning focal points at country offices. Please think seriously about developing this “learning package”. 2 Such package, if available, should also be made available to national staff who work as our counterparts in ministries of health. These counterparts in most cases are staff of international health units. Several important topics have been identified for discussions during the course of this meeting. However, I would like to touch on only few related issues. Firstly, using the “Strategic Objectives” as the basis for Programme Budget formulation and preparation of workplans makes our planning exercise complex because there is a remarkable inter-link and overlap between and among those Strategic Objectives. In a situation such as this, a lot of effort is needed to coordinate planning activities of various technical units, especially at the Regional Office. It requires strong coordination capacity of the planning units or planning focal points. This coordination capacity is required throughout the biennial planning and implementation cycle and planning staff must be able to do this. And, effective coordination requires strong leadership. Secondly, with the advent of the Global Management System (GSM), WHO programme development and management will become more complex. And, the GSM development process will be more complicated, especially during the initial phase of “roll out” or “go live”. We are still going through the period of GSM training. I hope that with such training, we will be able to transit to the new management system without much difficulty. We plan to “go live” in 2009, but do not know exactly when in the next year. The success achieved in solving the difficulty in GSM development is still to be assessed. In this connection, however, we should look forward positively to the days when GSM would contribute to increased efficiency and effectiveness of the Organization’s management system. This situation may seem to be a dilemma for all of us at the moment. Thirdly, Programme Budgeting exercise in WHO is a rather complex process. This is due, to a large extent, to multi-layer planning, i.e. at country, regional and global levels. Planning staff members at various levels must always be aware of what to do at various stages of the development. For example, we are now in the first year 3 of implementation of the biennial workplans for 2008-2009. We are making the following efforts to get the programme activities implemented: − To get funds the committed or obligated; − To ensure that various activities are initiated by those responsible for implementing them, − To ensure liquidation of obligations or disbursement of funds; and − And many more such activities. As part of this process, we also have to monitor the progress of implementation closely. At the same time, we have to finalize our proposed biennial Programme Budget for 2010-2011. Furthermore, we have to prepare the workplans for the ensuing biennium. To facilitate us in managing this situation, we may need to develop a “practical tool” to facilitate our work, a tool that can help us become really strategic and focused in working through this complex process. Guidance from headquarters may not be enough. The PPC unit and planning staff may think of developing this tool together. According to the agenda of the meeting, we will also be following up on the recommendations of our meeting on International Health Coordination, held at the beginning of 2008. International health is a very broad subject, and covers all activities in health, initiated and carried out at the international level. For this meeting, I would like to see that our attention is focused only on those activities that relate to the government-WHO collaboration at the country level. For other aspects of international health, we need another forum or meeting to deal with them, otherwise our discussions on this subject will be superficial and not operational in terms of programme development and management. 4 At the country level, there is “an interface” between WHO management and government management. This is an area of conflict. We need to know how to work efficiently and effectively at this interface. One key issue is how we can ensure adequate capacity of the Ministry of Health to work productively with WHO. At the same time, we have to keep in mind that national staff are not expected to be skilled or proficient in handling WHO management issues This is the responsibility of WHO staff. What we need from ministries of health for our planning purpose is information on country’s needs and requirements for their national health development. This important information could be based on the national development plan and also on the prevailing health situation in the country concerned. The WHO CCS document is also very important in this regard. Such information is for our use and forms the basis for preparing our programme budget and workplans. Moreover, information is also available in the WHO CCS or national health development plan. In this connection, we have to clearly understand the meaning of joint planning at the country level. The key elements of joint planning are policy and programme review; situational analysis; decision on strategy and priority activities; and identification of indicators for monitoring. Do not try to force national staff to do WHO planning, which is the responsibility of WHO staff. Yes, in implementing WHO workplans, national institutions have to help in carrying out certain programme activities. The implementation mechanisms used in this connection may be APW, TSA, DFC or others. The national staff involved in the implementation of WHO activities need to know how to develop proposals. They need to know how to use WHO guidelines and formats in developing such proposals. And not less important, they need to clearly know and understand terms and conditions governing the use of WHO funds through those mechanisms. 5 WHO staff must be very supportive of national staff who help carry out WHO programme activities. Provide them with clear explanation, coach them and help them with good understanding and positive attitude. We need to be as helpful and dependable as is possible. And we have to refrain from using a bureaucratic approach in our work. Also, WHO staff at country level need to clearly understand the managerial practice of government, at least, at the interface. The capability of WHO planning staff at both regional and country levels needs to be increased. Among other means, this can be achieved through on-the-job learning, and by learning from each other. However, we have to create an environment that is conducive to such a learning process. We need role models who can take this idea forward and can spearhead the job-learning exercise or self- learning. Time permitting, we may discuss this matter thoroughly later. In the area of WHO programme development and management, there are many things we can talk about such as the role of AOs and their interaction with BFO; and linkages between the roles of PHAs and AOs. The essential elements of the managerial process for WHO Programme Development and Management, as you may know are: − GPW (General Programme of Work); − MTSP (MTP) – Medium Term Strategic Plan (Medium-term plan); − PB (Programme Budget); and − WP (Work Plan). The Managerial Process for National Health Development (MPNHD) is crucial for strengthening country capacity in national health planning and management. 6 Policy and programme review, both at country and regional levels, is important. Programme implementation needs to be monitored and evaluated right from the state of programme budgeting, and relevant information and feedback should be shared among all concerned. The government/WHO coordination mechanism also plays an important role in this regard. Country Cooperation Strategy or the CCS is an important document in guiding both WHO and countries to effectively and efficiently support the health needs of countries. I will leave the rest of the matters for your deliberations during the course of the meeting. However, before concluding, let me touch on one more thing, which is a soft part of our management. Planners in general tend to be perfect or idealistic in their approach. Being perfect and idealistic is good, but it may not always be compatible with the work situation in WHO. WHO is not an academic institution it is an organization to help countries in the application of knowledge and know-how in their development process. Working in WHO, we need to be realistic and practical. The difference in “working in WHO” and “working with WHO” needs to be clearly understood. We should make sure that the advice given by us is always practical. At the same time, we have to be strategic and focused in our thinking and action. The work approach that we use must benefit us most, with the least cost. WHO’s cost-efficiency and cost-effectiveness should become a model for countries to emulate. In practice, we should always be specific enough to ensure a tangible output or outcome. Certainly, at the same time, we need to have a broad view and a broad vision on all issues facing us. We should be able to link all related events or elements in a systematic and holistic manner. That is why we usually say “think globally and act locally”. 7 With these words, Colleagues, I wish you all all the best and all success in your interactions during the course of this meeting. And, I wish you all an enjoyable stay in Bangkok. Thank you.