Minutes, DPG Health 15thJanuary 2014, USAIDConference room

Present

  1. Alisa CameronUSAIDChair
  2. Dr. Sudha SharmaUNICEFIncoming chair
  3. Leticia RweyemamuWHOSecretariat
  4. Ibadat DhillonDANIDAMember
  5. Nadia HamelCanada, DFATDMember
  6. Abe KimioJICAMember
  7. Catherine ShirimaJICAMember
  8. Olivier PrazSDCMember
  9. Kira ThomasSDCMember
  10. Inge BaumgartenGIZMember
  11. Philip MannUN REACHMember
  12. Carol HannonIrish AidMember
  13. Janean DavisUSAIDMember
  14. Florence FanelliUSAIDMember
  15. Susna DeUSAIDMember
  16. Patrick BrennyUNAIDSMember
  17. Yahya IpugeWorld BankMember
  18. Rekha MenonWorld BankMember
  19. Dr. Ritha NjauWHOMember
  20. Conrad MbuyaWajibikaGuest
  21. Peter KilimaWajibikaGuest

AGENDA

  1. Presentation: Wajibika project's district strengthening interventions and outcomes (USAID/Wajibika Project)
  2. Welcome and introduction of members
  3. Adoption of the Minutes, Agenda and Matters Arising
  4. Updates on SWAp events
  5. Updates on the Health basket fund, Audit Sub-Committee
  6. Updates on Global Fund
  7. Broadening of P4P scope
  8. Critical issues from TWGs
  9. Update on key events
  10. Upcoming events, missions
  11. AOB
  12. Next DPG-Health meeting 5thFebruary 2014

Matters Arising:

Agenda / Action point / Responsible person/Agency
Contributions to the development of HSSP IV / Follow up with MOHSW on a meeting with DPG H troika to discuss about MOHSW contribution to the development of HSSP IV. / DPG H Chair
Global Fund Performance Incentive Scheme / A presentation made at the DPG Main meeting by DPG Health and DPG AIDS on Performance Incentive Scheme will be shared.
Minutes of the meeting to facilitate a link between DPG Main and Public Service Remuneration Board will be shared.
A letter to be sent to TNCM Chair requesting for GF Performance Incentive Scheme issue to be re-tabled in the next TNCM meeting. / DPG H Chair
DPG H Chair
DPG H Incoming Chair
Rapid Budget Analysis (RBA) / Follow up with MOHSW on a meeting date with the troika to present onRBA. / SusnaDe (USAID)
Stock outs and donor funding / A concept paper to be presented to MOHSW will be drafted and circulated to members for inputs. / DPG H Troika
  1. Presentation: Wajibika project's district strengthening interventions and outcomes (USAID/Wajibika Project)

The project has come to an end and it aimed at supporting Tanzania Local Government Reforms by empowering those who provide services under D by D and strengthen programmatic and fiscal accountability to Local Government Authorities (LGAs). Some of the best practices from the project include: Wajibika mentors formed their own organisation and percentage increase of the Councils with clean audit reports from 44% to 85%. One of the lessons learned from the project is that it is better to use the existing government systems rather than coming up with new ones as the government systems are sustainable. Other achievements, lessons learned and challenges are shared in the presentation through the following link:

Discussion:

The project was well commended by the members and some of them asked if they can be linked with the mentors’ organization. Their brochure and contact will be shared with the members through the Secretariat. Members also wanted to know how the project handled the issue of transfers of the health workforce. It was responded that Wajibika made an agreement with the Councils that the transfers should be made when it is only necessary. What methods did you use to triangulate data on clean audit reports? Wajibika reported results of the Councils’ clean audit reports from the Controller and Audit General (CAG) report. Are the plans/priorities of the CCHPs fully funded? Councils would work from what they have in hand and from the envelope they would receive from the basket fund. It was recommended that the government should find a way to link Epicor and Plan Rep and that there is a need for DPs to have longer commitment in supporting local government health system strengthening. USAID was requested to share end of project documents with the members so that they can continue to learn and pick some experience from it.

Main DPG-H meeting:

  1. Welcome and Introduction of members

All members were welcomed to the meeting by the DPG Health Chair who also introduced a new memberfrom World Bank, Dr.Yahya Ipuge who is the Senior Health Specialist.

  1. Adoption of the Minutes, Agenda and Matters Arising

The minutes of the December 2013 meeting were approvedby the members with minor changes on agenda items no. 1 and 8 on JICA presentation and TWG issues respectively. Agenda for the January meeting wasadopted.

  1. Update on SWAp events
  • Contributions to the development of HSSP IV

It was reported that there were no taskforce meetings in December 2013, but ToR and the proposed budget for HSSP IV have been circulated by the MOHSW. The MOHSW will also look for internal sources to support HSSP IV. Additional information will be sent to members when shared by the MOHSW.

  1. Updates on Health Basket Funding (HBF)

The meeting was informed that almost all Basket Partners have disbursed except Canada. The Basket Financing Committee will meet on 29th Jan 2014 to discuss about HBF including its future.

  • Audit Sub Committee (ASC)

There will be an exit meeting with Innovex, among the issues to be discussed include LGAs Income and Expenditure Report, PPRA Assessment and HBF. A list of issues that will be raised in ASC meeting will be shared to all Basket Partners.

  1. Updates on Global Fund

A letter to TNCM for re-tabling GF performance incentive scheme issue is being finalized for circulation. The meeting was informed that DPG Health Chair facilitated a link between DPG Main and Public Service Remuneration Board to discuss about remuneration issues, minutes of the meeting will be shared.

  1. Broadening of P4P scope

Different stakeholders met in November 2013 to have a common understanding of Result Based Financing (RBF) concept which is an umbrella for P4P term and to be able to come with the way forward. The idea of RBF is an initiative which will become part of Tanzania’s broader health financing system. RBF is not a scale up of Pwani but it draws experiences from different partners and stakeholders inside and outside the country. It is not HRH system rather health financing system. More information at

Discussion:

Many commented favorably about the RBF design taking on an HSS approach and in alignment with the health care financing strategy. When will a costing of the design (and its expanded scope beyond Pwani) be conducted? It will be good to get a sense of these costs as soon as possible. Recommend greater inclusion of faith-based facilities (similar to public facility consideration). Similarly, there are opportunities to adapt the service agreement into the design. This will really help improve the viability and accountability of these agreements. There are a lot of next steps amidst an ambitious timeline to start roll-out in July. Will we be ready by then? What is the timing for the various next steps? Suggestion from Rwanda experience: In Rwanda, there was a set of menu options to the facilities on how to use bonus payments (e.g. that they could reach more targets if say they used some of the funds to incentivize community health workers). This may be something to consider for Tanzania. Encourage the inclusion of mechanisms that articulate the voices of the community and users (e.g. client satisfaction, health facility governance committee) in the design. Commend the focus on prevention; however, the design is largely facility based and many prevention activities occur beyond the facility. How will this issue be addressed? It will be important to articulate the criteria for rolling out. What will the role of DPs be in the design? How will the GOT contribute? Why not focus on PHC only? This would help recruit HCW to remote areas. How will facilities become service ready? NGOs’ were not mentioned in the presentation. What will their role be in the P4P program? Note, in Rwanda they were used as the fund holder. NHIF was piloted in Pwani P4P. If NHIF is being considered to serve as purchaser in the long-term, then it should be involved in the interim somehow while its capacity is being built.

The meeting was informed that there will be a mission from World Bank on the 4th week of February to discuss about RBF where RBF Taskforce members will also be invited. WB will give update on this in the next DPG H meeting.

  1. Critical issues from TWGs

RMNCH

  • The MNCH MTR Desk Review completed and final report will be shared. Costing of the One Plan and updating of the MNCH Action Plan will follow after completion of the Qualitative assessment.
  1. Updates on key events
  • No updates.
  1. Upcoming events, missions
  • Canadian Minister of International Development will visit Tanzania on 4th – 5th February 2014 for a high level roundtable meeting on engaging the private sector to improve MNCH at Serena hotel. The Minister will also have an opportunity to visit one health facility.
  • US Government agencies under PEPFAR will visit Tanzania in February 2014 to look at the HIV portfolio. They will work with the internal HIV partners to prepare the annual HIV assessment report.
  1. AOB
  • Ministry of Science and Technology through the Commission for Science and Technology (COSTECH) will organise a meeting in March 2014 on e-technology where DPG H members will be invited.
  • On-going preparations by TACAIDS and the NACP with local partner support to prepare and submit the Global AIDS Results and Progress Report (due to the UN by end of March 2014)
  • A field visit by a Congressional Staff Delegation sponsored by UNAIDS and the US Congress to see UN- and USG-sponsored HIV programme implementation in action here in Tanzania.
  • The Deputy PS PMO-RALG – Health is of the view that the language of the CCHP guideline should be harmonised to enable the Councils to clearly understand it. Troika with other DPG H members will visit him in Dodoma to get more clarification on the matter.
  • DPG Main Field Trip - members were asked to send their suggestions to the Secretariat by Thursday 16th Jan 2014 on the outstanding sites for DPG Main to visit.
  1. Next DPG H meeting

Next DPG H meeting will be held on Wednesday 5thFebruary 2014 at 12pm at the USAID.

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