|Description of Project Outputs
Strengthened MOH capacity in leading the NHSPA
1.1 Build capacity of the MOH secretariat for NHSPA
1.2 Prepare the roadmap for developing the NHSPA
1.3 Track building blocks for sector coordination and the NHSPA
1.4 Prepare and disseminate orientation packages for the NHSPA
Designed and agreed NHSPA and platform for external support
2.1 Obtain views from experts and stakeholders on the design of the NHSPA
2.2 Design and obtain approval for the NHSPA
2.3 Prepare detailed procedures for the NHSPA
2.4 Reach consensus on the design among ministries and partners
Improved provincial and district financial management capacity in the sector
3.1 Complete assessment of provincial and district financial management capacity initiated under the PPTA
3.2 Review and improve guidelines on the flow of funds
3.3 Prepare budget norms and tools for provincial plan formulation for program funding
3.4 Prepare provincial and district financial management guidelines
3.5 Provide financial management training for all provinces and districts
3.6 Evaluate provincial and district performance in financial management
|Status of Implementation Progress (Outputs, Activities, and Issues)
The TA produced an inception report, a midterm review report, a manual on financial management and a manual on planning, monitoring and evaluation, and a final report. The final report is comprehensive and contains all the major outputs, including the discussions and presentation of the information sharing meeting with the development partners.
The TA produced the major outputs as planned. Under output 1, the CDTA team, together with the counterpart, (i) made an initial assessment of the financial management capacity of the provincial and district health offices, (ii) reviewed relevant laws, policies and guidelines of the Government regarding the flow of funds to provinces and districts, (iii) developed a design for the flow of funds including the approval process, eligibility criteria, and budget norms, (iv) sought support from stakeholders through consultations and a national workshop, and (v) facilitated MOF approval of the flow of funds mechanism in September 2010 (earlier than specified in the DMF), through a specific Memorandum of Understanding between MoF and MoH.
Under the second output, a manual on financial management (FM) was drafted by the CDTA staff to be applicable for ADB Program funds being disbursed from MOF to PHOs and downwards to the DHOs and HCs. This manual is based on the Government accounting procedures and can easily be used for other funding sources. The manual was discussed and tested with the PHOs in 3 pilot provinces and was used for the first tranche released in early 2011. The manual was approved, translated, and distributed by the Government to the PHOs country-wide. PHO batchesfrom the northern, central and southern regions were trained in the FM manual in Vientiane and follow-up visits were conducted by the team to provide additional training, especially to enable provincial accountants to train lower level accounts staff. 22 DHO participants from 11 districts in the pilot province (Xayaboury; selected as it is supported directly by the H-SDP) were trained in the manual by the PHO accountants with the support from the CDTA team. Subsequently 38 HC staff in one district (Hongsa) were trained. Direct coaching by the team to these staff proofed useful and led to improved performance in disbursement and accounting. In pre -and post test training on financial management concepts such as the documentation process for submitting financial statements, external audit, procurement, the objective of the Program (H-SDP) grant fund and its budget nomenclature, the tested staff performance improved by 53% (DMF required 50%)
For the third output, the CDTA team developed a Planning, Monitoring and Evaluation (PM&E) manual. The initial draft manual was tested in the 3 pilot provinces and after refinement through participatory workshops, a revised but simple manual that provides guidance on the process of planning, problem identification, prioritizing and reporting. It introduces monitoring concepts, and practical ways of conducting monitoring and evaluation. The manual contains a number of simple and practical tools which will be used in planning, monitoring and evaluation by with procedures for each level (HC/DHO/PHO). The ambition of the Department of Planning and Budgeting, MOH, is that the manual will be used country- and sector-wide for heath sector operations at all levels. The manual was translated into Lao language. Together with the budget norms (output 1) and the FM manual (output 2), H-SDP noticed an improvement in the planning of the program support by the provinces.