Report of the First Meeting fo the Sub-committee on Policy and Programme Development and Management (SPPDM)

SEA-PDM-14 Distribution: Restricted Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) WHO/SEARO, New Delhi, 4 July 2008 Regional Office for South-East Asia © World Health Organization 2008 All rights reserved. This health information product is intended for a restricted audience only. It may not be reviewed, abstracted, quoted, reproduced, transmitted, distributed, translated or adapted, in part or in whole, in any form or by any means. The designations employed and the presentation of the material in this health information product do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this health information product is complete and correct and shall not be liable for any damages incurred as a result of its use. Printed in India Page iii Contents Page Introduction........................................................................................................... 5 1. Inaugural session (agenda 1) .......................................................................... 5 2. Matters relating to Programme Development and Management (agenda item 2) ............................................................................................. 6 2.1 Programme Budget Performance Assessment: 2006-2007 (agenda item 2.1)................................................................................................... 6 2.2. Review of the implementation of workplans for PB2008-2009 including the resource gap analysis and mobilization plans (agenda item 2.2)................................................................................................... 8 2.3. Proposed Programme Budget 2010-2011 (agenda item 2.3).................................. 11 3. Adoption of report ...................................................................................... 12 4. Closure ....................................................................................................... 13 Annexes 1. Agenda ....................................................................................................... 14 2. List of participants ....................................................................................... 15 Regional Consultation on United Nations Reform, Health and Development Page 5 Introduction The First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) was held at the WHO Regional Office for South-East Asia (SEARO), New Delhi, on 4 July 2008. Senior government representatives from Member States of the South-East Asia (SEA) Region participated in the meeting. The agenda and list of participants are attached as Annexes 1 and 2 respectively. 1. Inaugural session (agenda 1) Opening remarks by the Regional Director Welcoming the distinguished delegates, Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region, stated that the main purpose of this meeting of the sub-committee was to discuss the matters relating to programme development and management, viz., (i) Programme Budget Performance Assessment: 2006-2007; (ii) Review of the implementation of workplans for PB2008-2009; and (iii) Proposed programme budget for 2010-2011 biennium. Dr Samlee informed that this sub-committee was established by the Sixtieth Session of the Regional Committee for the South-East Asia Region in 2007. The outcome of the deliberations of the sub-committee would be presented to the Sixty-first Session of the Regional Committee, to be held in September 2008. He wished the delegations success and active participation by all. Nomination of Chairperson, Co-chairperson, Rapporteur and Drafting Group Dr H.A.P. Kahandaliyanage, Secretary, Ministry of Healthcare and Nutrition, Sri Lanka, was nominated as Chairperson and Dr Dirgha Singh Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 6 Bam, Officiating Secretary, Ministry of Health and Population, Nepal, was nominated as Co Chairperson. Dr Sonam Dorji, Chief Planning Officer, Planning and Policy Division, Ministry of Health, Bhutan, was nominated as Rapporteur, while Ms Aminath Rasheeda (Maldives), Dr Win Myint (Myanmar) and Mr Marcelo Amaral (Timor-Leste) were nominated as members of the drafting group. 2. Matters relating to Programme Development and Management (agenda item 2) 2.1 Programme Budget Performance Assessment: 2006-2007 (agenda item 2.1) Introduction The Secretariat presented the outcome of the Programme Budget Performance Assessment for 2006-2006 biennium. The report on the Programme Budget 2006-2007: Performance Assessment was submitted to the Sixty-first World Health Assembly. This report was reviewed by the Eighth Meeting of the Programme, Budget and Administration Committee of the Executive Board (PBAC) in Geneva, 15-16 May 2008. The PBAC welcomed the summary of the performance assessment report for the Programme Budget 2006-2007 and looked forward to reviewing the full version revised in the light of the committee’s comments. The PBAC requested that the full version of the report be discussed at the Sixty-first Session of the Regional Committee, and will be considered by the Executive Board at its 124th session. The SPPDM was requested to comment on the full version of the Programme Budget 2006-2007: Performance Assessment Report for further consideration by the Sixty-first Session of the Regional Committee. Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 7 Discussion points � Regular meetings of programme managers and supervision of programme implementation have facilitated timely implementation of planned activities. � Attention needs to be paid to quality implementation of the programme activities. � Strategic Objective 1 (SO1), SO2 and SO5 have lower implementation rates because of the receipt of more funds than originally planned. � Information on implementation of country programmes needs to be shared in the working paper for the Regional Committee. � The reasons for the disparities in the programme delivery between various SOs need to be analysed and conveyed to Member countries so that they can take necessary remedial measures. Timely availability of VC funds was highlighted as one of the concerns for low utilization. It was pointed out that one of the contributing factors to this disparity is the availability of VC funds at different stages, which could be carried over to the next biennium. � Changes in the financial rules and programme management of the Organization have had an impact on programme delivery at the country level. � The Regional Seminar on Strengthening International Health Coordination at Country Level, held in Jakarta, Indonesia in February 2008 reiterated the importance of providing programme management training to the Member countries. � Due to the complexity of funding mechanisms, programme implementation at country level is hampered. In this regard there is an urgent need to strengthen the institutional capacity and staff capacity of both ministries of health and WHO at the country level to plan, manage and implement country programmes. Recommendations (1) Training in programme management should be conducted for both Member countries, and WHO country offices’ staff for improving the quality of implementation. Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 8 (2) Communication on matters related to programme planning and management should be improved between WHO and Member countries. (3) Experiences gained from the previous biennium should be documented and incorporated into the programme plans for the next biennium. 2.2. Review of the implementation of workplans for PB2008-2009 including the resource gap analysis and mobilization plans (agenda item 2.2) Introduction During the biennium 2006-2007, the total voluntary contributions mobilized were US$ 344 million, exceeding the target of US$ 257.9 million by 33.3%. This represents an increase of US$ 42.5 million compared to US$ 301.5 million mobilized during the biennium of 2004-2005. In 2006- 2007, SEARO intensified efforts for resource mobilization by working with a number of donors/partners at country and regional levels and also in close collaboration and coordination with WHO headquarters to mobilize funding from a number of global health partnerships and initiatives. The size of voluntary contributions of SEARO is the second largest amount among the six regional offices, after AFRO. The approved budget for the Region in 2008-2009 is US$ 103.9 million assessed contributions (AC) and US$ 387.6 million voluntary contributions (VC). As of 11 June, 47% of VC funding is already available, making it likely that the target budget for VC funding will be reached. Although the overall VC target of US$ 387.6 million is likely to be achieved, the targets in several strategic objectives may not be achieved because of insufficient support by donors funding projects in the Region. In the 2006-2007 biennium, a total of US$ 317 million was implemented, meaning that implementation would have to increase 55% in order to reach the total of US$ 491.5 million budgeted for the current biennium (2008-2009). Given that the current rate of implementation in 2008-2009 is about the same as the previous biennium, intensified efforts are needed to increase implementation. Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 9 Discussion points � While the delegates appreciated the efforts and initiatives of SEARO in mobilizing voluntary contributions and supporting the countries, the disparity in the distribution of resources in different countries and in different areas needs to be reviewed. � While acknowledging the limitation faced by WHO regarding donors’ priorities which resulted in the disparity in funding among programmes and Member countries, the Member countries requested WHO to continue exploring unspecified voluntary contributions to support the programmes that are underfunded. � WHO country offices should take the initiative and work with Member countries to have dialogue with donors at the country level for mobilization of resources because most donors have strengthened decentralized operations and delegated more authority to the country level. � As the proportion of voluntary contributions to assessed contributions has increased, from about 20% in 1998-1999 to nearly 83% in 2008- 2009, the capacity at all levels to implement needs to be improved. The management issues, such as increasing the capacity at country level, also need to be reviewed. � Over time, resources mobilized by regional and country offices has been increased compared to resources received from headquarters, which is appreciated. � Country programme managers should be involved in resource mobilization to ensure credibility to donors. They should try to include more activities in the programme areas, that get more funding which could benefit health system strengthening for which less resources are available. � Countries like Bhutan, Maldives and Timor-Leste, which could not meet their targets, need to be provided more support. � The committee appreciated the impacts associated with the growing reliance of the Region on donor funding to finance an ever-larger share of the programme budget. One challenge is the disparities in resources between countries and amongst programme areas. � With regards to programme implementation, the meeting expressed concern about the markedly lower rate of implementation compared Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 10 with the rates of budgetary and resource growth, raising concerns about organizational capacity to implement. � Concern was expressed that direct administrative support costs were not forthcoming with increasing budgets and donor funding. � Delegation of authority has been increased in order to strengthen country office authority and capacity to implement directly and promptly. � The regional budget now integrates both voluntary and assessed contributions. This makes the management of the programme much more complicated than in previous bienniums. The Global Management System (GSM) should help improve administration and management, although the transition to the new system will require some time. � Large increases in VC funding cannot be successfully implemented without more staff resources. Given the donors reluctance to fund staff, more AC funding is needed for staff. Recommendations (1) The Regional Office should continue to provide support to country offices for improved resource mobilization. (2) The Regional Office should strengthen its close coordination with headquarters to mobilize additional specified and unspecified funds from global health partnerships and initiatives, such as the Global Fund, GAVI, GAVI-HSS and TFI, etc. (3) The disparity in distribution of resources for the underfunded programmes should be reduced through proper coordination and collaboration among programmes. (4) Countries’ capacity to implement funds should be strengthened. Specific efforts should be made towards achieving enhanced implementation efficiencies. (5) Efforts to build staff and country capacities should concentrate on country offices so as to ensure support for implementation of activities by countries. The Regional Director has already delegated the maximum authority to country offices in order that they can be more Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 11 responsive to country needs. However, country offices should exercise such authority with appropriate oversight and accountability. (6) Additional efficiencies should be achieved by WHO by enhancing its administrative transaction processing functions. The possible ways to move forward include use of standard transaction agreements and exploration of ways to contract on a larger scale so as to avoid multiple, small and costly transactions. 2.3. Proposed Programme Budget 2010-2011 (agenda item 2.3) Introduction The proposed regional programme budget for 2010-2011 was developed over the last four months through a process of joint planning between the countries, the Regional Office and WHO headquarters. The working paper and budget showed that the overall proposed budget represents a 23% increase over the current biennium, with all of this increase in voluntary contributions (VC). Most of this increase reflects more funds for partnerships (such as polio eradication) and for outbreaks and health emergencies. This increase in resources points to the necessity of ensuring that WHO has the capacity to support and manage quality implementation. It also emphasizes the need to ensure that assessed contributions maximize benefits to countries, given the increasing proportion of VC funding. After a review and comments by the Regional Committee, the regional proposed budget will be resubmitted to WHO headquarters for inclusion in the global budget to be reviewed by the 124th Executive Board and the Sixty-second World Health Assembly. Discussion points � There was concern that some priority programme areas (such as SO4) were not receiving adequate budgeting resources. However, in recent bienniums, it was difficult to mobilize resources for these areas. � There is a quantum increase in the VC funds but at the same time there is a need to look at the capacity of the countries to manage such funds. Donors are reluctant to fund management and administrative costs of country offices and more AC funding is needed. Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 12 � Based on past experience, WHO needs to look at allocation of AC funds to those areas that attract less donor support, such as SO4, including the addition of country office staff to ensure capacity to mobilize and implement VC funding in these areas. � WHO may need to explore the possibility of realigning programme activities in order to strengthen the national health systems in the respective areas of work. � Even if there is some increase in the allocation of AC resources to the Region, it will be offset by cost increases due to inflation and currency fluctuation. � It is rather difficult to measure some indicators according to the information on baseline and targets provided. WHO support is required in developing the capacity to identify appropriate and measurable indicators for programme management. Recommendations (1) WHO needs to support Member countries to identify and develop data-based indicators that can be measured with regard to their achievements. (2) WHO should initiate necessary steps to strengthen, within the Regional Office, inter-programme linkages and collaboration to support programmes in Member countries. (3) Member countries and WHO should make concerted efforts to improve the management and utilization of available resources, regardless of their source. (4) The Regional Committee is requested to recommend that the 2010- 2011 budget appropriation resolution includes authorization that the assessed contributions for the South-East Asia Regional Health Emergency Fund (SEARHEF) be carried over to the subsequent bienniums. 3. Adoption of report The Meeting the SPPDM reviewed the draft report of the meeting agenda by agenda, concentrating on the discussions and observations made by Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 13 Members, and the recommendations arrived at on each agenda item, and adopted it with some modifications. 4. Closure Dr Samlee Plianbangchang, Regional Director, in his concluding remarks thanked all the distinguished participants for their deliberations. He expressed his particular appreciation to the Chairperson, Dr H.A.P. Kahandaliyanage, and the Co Chairperson, Dr Dirgha Singh Bam, for the effective manner in which they chaired the meeting. Dr Samlee also thanked Dr Sonam Dorji and other members of the drafting group for their excellent report. He appreciated the concise recommendations made by the committee and assured the members that the Regional Office would take urgent action to implement all the recommendations made. The Co-Chairperson, Dr Dirgha Singh Bam thanked all the distinguished participants for their active participation in the meeting. He then declared the meeting closed. Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 14 Annex 1 Agenda 1. Opening session 2. Matters relating to programme development and management: 2.1 Programme Budget Performance Assessment: 2006-2007 2.2 Review of the implementation of workplans for PB2008-2009 including the resource gap analysis and mobilization Plans 2.3 Proposed Programme Budget 2010-2011 3. Concluding session Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 15 Annex 2 List of participants Bangladesh Mr Abul Kalam Azad Additional Secretary Ministry of Health and Family Welfare Prof (Dr) Khondhaker Md. Shefyetullah Director (Medical Education) Directorate-General of Health Services Ministry of Health and Family Welfare Bhutan Dr Gado Tshering Secretary Ministry of Health Mr Sonam Dorji Chief Planning Officer Planning and Policy Division Ministry of Health DPR Korea Mr Kim Chang Min Vice Director Department of International Organizations Ministry of Foreign Affairs Dr Pak Tong Chol WHO Desk Officer Ministry of Public Health India Mr Vineet Chawdhry Joint Secretary (IH) Ministry of Health and Family Welfare Dr Sharat Chauhan Deputy Secretary (IH) Ministry of Health and Family Welfare Mr K. Srinidhi Section Officer (IH) Ministry of Health and Family Welfare Indonesia Dr Widiyarti Chief Regional and Bilateral Sub-Division Bureau of Planning and Budgeting Ministry of Health Maldives Ms Aminath Rasheeda Executive Director Department of Public Health Ministry of Health Ms Mariyam Suzana Ministry of Health Myanmar H.E. Professor Mya Oo Deputy Minister Ministry of Health Dr Win Myint Deputy Director General (Medical Care) Department of Health Ministry of Health Dr Soe Lwin Nyein Director (Epidemiology) Department of Health Ministry of Health Dr Ko Ko Naing Deputy Director International Health Division Ministry of Health Nepal Dr Dirgha Singh Bam Officiating Secretary Ministry of Health and Population Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 16 Dr Laxmi Bikram Thapa Director Epidemiology and Disease Control Division Ministry of Health and Population Sri Lanka Dr H A P Kahandaliyanage Secretary Ministry of Healthcare and Nutrition Dr S.M. Samarage Deputy Director General (Planning) Ministry of Healthcare and Nutrition Thailand Dr Sopida Chavanichkul Director Bureau of International Health Ministry of Public Health Pol. Maj. Suriwan Thaiprayoon Plan and Policy Analyst Bureau of International Health Ministry of Public Health Timor-Leste Mr Agapito da Silva Soares Director-General Ministry of Health Mr Marcelo Amaral Head Health Policy Office Ministry of Health WHO Secretariat Secretary Dr Samlee Plianbangchang Regional Director Members Dr Poonam Khetrapal Singh Deputy Regional Director Dr Myint Htwe Director, Programme Management Mr J.J. Kobza Director, Administration and Finance Dr Than Sein Director Department of Noncommunicable Diseases and Mental Health Dr Abdul Sattar Yoosuf Director Department of Sustainable Development and Healthy Environments Dr Jai P. Narain Director Department of Communicable Diseases Dr Dini Latief Director Department of Family and Community Health Dr N. Kumara Rai Acting Director Department of Health Systems Development Dr R.M. Brooks Coordinator, Programme Planning and Coordination Dr William L. Aldis Coordinator, Health Policy and Research Dr Sangay Thinley Coordinator, HIV/AIDS, Tuberculosis and Other Communicable Diseases Dr Chusak Prasittisuk Coordinator, Communicable Diseases Control Dr Khalilur Rahman Coordinator, Tobacco Control Dr Pak Chang Rim External Relations Officer Mr John M. Kennedy Budget and Finance Officer Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 17 Dr Lin Aung Programme Development Officer Programme Planning and Coordination Mr Bruce Murphy Reports Officer Mr Avinash Singh National Professional Officer (Editor) Mr T.R. Swaminathan Programme Planning and Coordination Unit Mr R.K. Arora Programme Planning and Coordination Unit Report of the First Meeting of the Sub-committee on Policy and Programme Development and Management (SPPDM) Page 18 This publication is a report of the First Meeting of the Sub- committee on Policy and Programme Development and Management (SPPDM), which met on 4 July 2008. This sub- committee was established by the Sixtieth session of the Regional Committee for the South-East Asia Region in 2007. Delegates from Member countries of the Region discussed the agenda items of the Sixty-first Regional Committee related to programme development and management. These items involved the programme budget performance assessment for the biennium 2006-2007, programme budget implementation for 2008-2009 and the proposed Programme Budget for 2010-2011 biennium. The outcomes of the deliberations of the meeting will be submitted to the Regional Committee for its consideration and decision. Regional Office for South-East Asia World Health House, Indraprastha Estate Mahatma Gandhi Marg, New Delhi-110002, India