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Brainstorming session

Brainstorming session. SSWG 2-3 November 2010. Approach. What tools/approaches/knowledge do we have now?) Where have we made progress? What issues/problems persist? (country and global level) What issues problems are tractable for SSWG and where can we most contribute?

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Brainstorming session

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  1. Brainstorming session SSWG 2-3 November 2010

  2. Approach • What tools/approaches/knowledge do we have now?) • Where have we made progress? • What issues/problems persist? (country and global level) • What issues problems are tractable for SSWG and where can we most contribute? Workstreams with leaders and workplans Where are we? Where do we want to go? How do we get there?

  3. Filters for question 4 • RHSC Functions/Strengths • Convener • Harmonizer • Brain trust • Unity of purpose action • Provider technical information • Where are the needs/gaps greatest? And where is the least being done? • Where will you (the voter) assume leadership and meaningful involvement in SSWG? • What will most impact the future in light of changing environment?

  4. Group 2 Victoria John Brian Carolyn Kevin P David Sm Bonnie Eric Group 1 Ben Sandhya David Sa. Louise Lester Kevin S. Lou Morten Brainstorm Groups • Group 2 • Sandra • Enrico • Steve • Mimi • Lisa • Annette • Harry • Jagdish

  5. Adapted WHO HS Building Blocks • Service Delivery • Supply Chain Workforce • Logistics Information Systems • Supply Chain (medical products and technologies) • Health Financing • Leadership and Governance

  6. 1. QA/QC 5 Product quality assurance Optimizing QA Capacity expertise for country QA/QC More SRA/prequalification Procurement Regulatory: MRAs, lack of capacity to respond and partner Five Priority areas • 4. Workforce 3 • Capacity building • Professionalization • Leadership • Accreditation • Task shifting/job description • Performance based incentives • 5. Data and use of data, information systems 11 • Automation of LMIS, PPMR • CS data in DHS • Open source LMIS • Mhealth for SCM • 2. Procurement 9 • Performance & efficiency • Transparency • Accountability • Competition • Efficiency • Public Health objectives • Anti-corruption • * Are these being appropriately balanced in public sector procurement? • 3. Expanding financing conversation to include systems 7 • Financing mechanisms • Advocacy • Technology • Financing tools • Global/country financing for systems

  7. 1. What exists SCACCN (~ SSWG) community based distribution/last mile Not much… TMI (SSWG and MDA) Respond Project “Campaigns” 2. Where have we made progress Long term progress waning Too much focus on product and not enough on use Engage project RESPOND more 1. Service Delivery • 4. Where do we want to go? • Demand/unmet need 1 • Private sector 3 • Service providers • LAPM 4 • Other RH products 7 • Patient safety (surrounding care) • Barriers • Integration • 3. Persistent problems • Strengthening delivery; creating demand; fulfilling demand • Integration of services (what does that mean for the supply chain) • Private sector service deliver • Civil society: raising demand (for what: i.e. generics) • Patient safety/ quality of care • Barriers to uptake? (user perspective) • Define unmet need (outside supply of capacity issues) Notes: Auxiliaries

  8. 1. What exists PRODOPS – Training opportunity for logisticians (JSI) Professionalization of logistician workstream and conference IAPHL Defining qualifications needed for SC manager (HARM) HR critical issue series events Pre-service approach In health tech. Procurement certification District management issues re supply chain 2. Where have we made progress Framework definition exist; reach out to partners is a priority Pre-service training Engaging regional partners/institutes (Bioforce) Remuneration/incentives Task shifting 2. Supply Chain Workforce • 3. Persistent problems • Who is permitted to administer commodity? • Quality of care • Medical and administrative barriers to deliver • Performance based incentives/data • Who is system accountable to? • Mhealth technologies? • 4. Where do we want to go? • Policies and planning (decentralization) link with groups focusing on this issue • * who has responsibility for services performance • * remuneration • * accountability • Leadership (target audience) • Task shifting • * Specialists – LMU • * Parastatal org • Workforce development • * professionalizing, accreditation • Mhealth- effectiveness

  9. 1. What exists Global software packages Countries with LMIS Essential data items DELIVER Guidelines for LMIS PATH Optimize - requirements of LMIS to open source solutions Software tools review Pilot SMS (cycletell etc.) RHI PATH procurement toolkit (Medtech) PATH EC tool Studies on effectiveness of procurement LMIs Spectrum CS Index CS Ready lessons 2. Where have we made progress Procurement systems (transparency, capacity, etc…) Distribution Automation of LMIS Donor Coordination (CARhs): country & global Use of information to avert and correct imbalances Transparency in general (at global level) 3. Logistics Information Systems 3. Persistent problems • Where do we want to go? • Standard open source software for LMIS • Review PATH LMIS requirements from RH perspective (does it meet RH system needs) • Getting consumption and ordering information from lowest level • Performance based incentives • M-health • Identifying tool/approaches for scale up and expand NET Model (share info on Expand Net: IRH) 6 • CS Data (limitation on country data, DHS CS questions) • Automation of procurement/CARhs Issues: No standard LMIS open source software

  10. What exists Who pre-qualification program IRH Cyclebeads Toolkit Registration Quality Assurance activities within RHSC WHO product specs JSI/PATH pricing studies (Nicaragua and Nepal) RH EMC (WHO RH Model List) Total Market Approaches (targeting and market segmentation) CBD programs DHS- data on unmet need Quality testing labs / Protocols WHO inspection certificate of QA labs at national level Where have we made progress Raising awareness at country level (decision-makers) and global level Have never let a country totally fail Financing: country & global level 4. Supply Chain (medical products and technologies) 3. Persistent problems • Where do we want to go? • Focus indicators on procurement efficiency and performance (access) as well as transparency • Document/research alternatives procurement methods (framework, pre-qual., etc) • Optimizing quality assurance • * Incentives to SRA/WHO prequal. • * Capacity and expertise for country QA/QC (what/when/where to test) • * What is RHSC added value? • Last mile access • * Performance based incentives • * Distribution Planning/financing

  11. 1. What exists *Hand to hand * PGH ICA foundation Potential partnerships with UNITAID, GFATM AccesRH Health Insurance Financing system * SWAP and Basket funding * Private sector Advocacy: budget line item; expend; network of some coordinating committees; Global Programme 2. Where have we made progress beginning; pledges, accountability? Exists but no transactions Not proven Rwanda etc. Round 10 Potential for more efficient use of funding WAHO pilot 2 m€, 5 countries 1.9 m€, capacity building ECOWAS Product specific Depends on country Project RMA done Stream one for supplies 5. Health financing systems 3. Persistent problems From existing initiatives: 1. Progress on PGH (consider IFIM model) 2. Hand to Hand Needs more accountability in the model 3. SWAPS and Basket funding Not supporting supply chain 4. Private sector Need to identify information & build confidence around forecasts & finance 5. Technologies (e.g. SMSinfo) for managing money 6. Financing system technologies At the global level: 7. $ for maintenance 8. Global and country financing to support systems is not available to cover all steps ion the system 9. Supply services and products 10. Decentralization: we are reactive instead of pro-active and strategic. 8 11. Advocacy for supply chain system funding need strategy 12. Better use of financing tools e.g. phone banking • Where do we want to go? • Sector-wide funding “fair share” for RH supplies • Commodity SWAP Issues: Donor fatigue *What happened to IFFM?

  12. 1. What exists Total Market Approach (service provision, etc., strategic outsourcing) Certification of SCM Anti-corruption, spec to procurement (e.g. META meds transparency alliance) SPARHCS framework Capacity building Initiatives (HR initiatives) Regulatory capacity/harmonization initiatives RHI AccessRH Guidelines for RH policy (purple book) 2. Where have we made progress 3 countries pilot CIPS + Makere University Prof of PSL Little to none (WB procurement systems: for now negative impact) 15-20 countries Issue with regard to staff turnover What happened to training of leaders? Q/A maybe east African Community ECSA (ECOWAS) West Africa Information availability for evidence based decision making Information on-line exists 6. Leadership and Governance • Where do we want to go? • Mapping of decision chain • Linkages to CARhs • 3. Persistent Problems • Professionalization: needs to address senior leadership more: needs more design input from countries • Anti-corruption: effect has not been positive on supply / procurement. Focus should be simplified on transparency (3 steps backward, 2 forward). • Capacity development: staff turn-over and lack of uptake limit real progress • Regulatory: NRA’s still lack capacity to respond and to partner effectively • CARhs no policy level group 9 • Paris declaration: we need more engagement among implementers

  13. Voted Priorities

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