National Department of Health Corporate Plan

National Department of Health

Corporate Plan

2009– 2013

Our Way Forward

Version 2.168 05 08

Reference Manual

Healthier Communities

Improved Support for Service Delivery

Better Management

INSIDE FRONT COVER – TO BE LEFT BLANK

Also need to add 2 pages at back of document (inside back cover and back cover)

Contents

Foreword by Minister for Health and HIV and AIDS

Message from Secretary

Introduction

Our Mandate

Our Role

Our Vision, Mission, Goals, Focus and Values

Our Need for Reform and Recovery

Our Challenges

Our Strategic Objectives 2009-2013

1. Healthier Communities

2. Improved Support for Service Delivery

3. Better Management

Our Performance Framework

Our Planning Framework

Our Governance

Our Way Forward

Glossary

Appendix 1: Legislative Responsibilities

Appendix 2: Other Legislation having Relevance to the NDoH

Appendix 3: NDoH Response to MTDS Objectives

Appendix 4: Health Indicators

Appendix 5: Mapping of Health Outcome Priorities against our key Result Areas, Our Core Business & our Health Sector levels

Appendix 6: Worked Example: Annual Activity Plan for the National Strategic Objectives

Appendix 7: NDoH Response to Public Sector Reform Strategy

Endnotes

Foreword by Minister for Health and HIV and AIDS

One of the core goals enshrined in our Constitutionof the Independent State of Papua New Guineais for integral human development and for improvements in “the standard of public health to enable our people to attain self fulfilment”.

Another of our Constitutional goals is to preserve our Papua New Guinean ways and for traditional villages and communities to remain viable units of our society.

Most of our people live in rural areas and this is our way.

Following our independence in 1975 there were steady improvements to the key social and economic indicators including literacy, life expectancy and infant mortality rates. However, in the early 1990’s for a variety of reasons, this progress slowed to a point whereby we are now one of the poorest performing countries compared to our pacific neighbours. This has required government to rethink its priorities and introduce a program of recovery and development through the Medium Term Development Strategy. For health, we know that people are dying from preventable and treatable diseases such as pneumonia, malaria, tuberculosis and measles.

We also know that our maternal and infant mortality rates are too high and this must be a government priority to ensure a stable family structure is the key to our continuing growth.

The HIV and AIDS epidemic is another threat to our Papua New Guinean ways. We must work with our Development Partners across all sectors to raise public awareness, change behaviours and prevent the spread of the disease, ensure early detection and provide treatment and counselling.

We also need to improve the services we currently deliver to our rural communities, with a particular focus on enhancing primary care.

I am pleased to see this Corporate Plan recognises these as specific strategic objectives and reinforces the Government’s commitment to improving the health of our people.

Hon.Sasa Zibe MP

Minister for Health and HIV and AIDS

Message from Secretary

The Corporate Plan 2009–2013 is another step forward in integrating the various responsibilities of the National Department of Health into one plan that links our health priorities, our statutory obligations and the Government reform agenda to the organisation performance and capacity development issues that need to be effectively managed to deliver “better management, improved support for service delivery which will result in healthier communities”.

Our goal is to improve the health of all people of Papua New Guinea through the development of a health system that is responsive, effective and affordable, acceptable and accessible to the majority of people.

Our challenge remains to ensure treatable illnesses such as malaria and tuberculosis are prevented, children are immunised and mothers can safely give birth.

The increasing rate of HIV and STIs must be reversed.

We must focus our efforts and attention to improving support for service deliveryby taking a total picture view and concentrating on having the right staff, with the right skills, with the right supplies, in the right place, to provide the right care. We also must improve our management systems and in particular finance,human resources and procurement practices. Our facilities need to be rebuilt and properly equipped, and this may require us to act differently and consider new and innovative models.

We must also provide improved access to health services to the urban poor and strengthen primary health care and basic sanitation for the rural majority.

The role of the National Department of Health is to provide clear policy direction to the health sector, develop standards that are evidence based and sustainable, to work closely with our Development Partners to support effective and affordable service delivery when and where they are needed and to accept accountability for our performance.

I welcome and endorse this Corporate Plan as further evidence of our commitment to the health reform process and another step towards our vision. I urge all those interested in improving the health of every Papuan New Guinean to work together and implement this Plan.

Dr Clement Malau

Secretary for Health

Introduction

The National Department of Health Corporate Plan 2009-2013 Reference Manual has been developed both in response to the Government’s reform agenda and the need to ensure our leadership and management frameworks are keeping up with international best practice. The Corporate Plan brings together in one document the health outcome priorities, the legal mandate of the Department, contribution to the public sector reform agenda and the internal enabling and improvement activities required to meet the Department’s various obligations.

Each chapter is headed as Our to illustrate the fact that improved health is a shared journey and can only be achieved through a collective and cooperative effort. It is also important to recognise it is the Department’s responsibility to ensure there is a clear sense of purpose and direction at the national level. Each level of Government and the various providers have their own challenges and that is respected. It is also incumbent on leaders to lead and this is an important step in mapping our journey.

The strategic objectives are not new; they are well referenced in current plans policies reviews and reports. What is different is the greater emphasis on making sure there is one big picture and not just scattered parts of a jigsaw. Our health outcome priorities are linked to our strategic objectives and areas for organisational improvement and growth. Integration of our planning activities and businesses processes will see clearer links between strategy, structure and process.

We will work with our internal and external partners to create a shared vision and common goals and ensure we do our job well so that others can perform at their best.

The Reference Manual provides a more in-depth explanation on how the strategic objectives were framed and what the key issues are to be addressed over the next five years. The Manual includes planning templates to map the health outcomes across the organisation and translate the objectives into annual business plans. The Corporate Plan will be released in an eight page brochure format highlighting the key messages from the Reference Manual.

The summary table below shows how the health outcome priorities relate to the three key result areas (KRAs) for the Department and the interdependencies that exist to ensure we achieve our goals.

Each chapter contains references to theKey Result Areas which have been numbered for ease of reference.

Our Mandate

The National Goals and Directive Principles enshrined in the preamble of The Constitution of the Independent State of Papua New Guinea are the guiding values that underpin the National Department of Health’s mandate. They are:

Integral Human Development including a call for improvement in the level of nutrition and the standard of public health to enable our people to achieve self fulfilment

Equality and Participation

National Sovereignty and Self Reliance

National Resources and Environment

Papua New Guinean Ways.

The functions of the various levels of Government are defined in Part IV of the National Health Administration Act1997.

The main function of the National Government is to oversee the health care system and the implementation of National Policy. It has a role to coordinate and provide technical advice and support to lower levels of Government. It also has a role to oversee the management of public hospitals.

The National Health Board endorses the National Health Plan and recommends its adoption to the National Executive Council. It also approves standards and monitors progress against the National Health Plan. The Board may be also requested or directed to conduct enquiries.

The National Department of Health provides assistance and support to the National Health Board in the development of the National Health Plan and provides the secretariat support to allow the Board to discharge its functions. The Department also develops standards, and monitors and ensures compliance against the standards, as well as provide technical assistance to the Provinces to assist them to implement the National Health Plan and meet the relevant standards. The Department is required to maintain a National Health Information System.

Provincial Governments are responsible for the implementation of the National Health Plan through service delivery at the District level. They must fund health activities to a level that allows minimum standards to be met. Provincial Governments also have powers under Section 42(1)(n) of the Organic Law on Provincial Governments and Local Level Governments Administration Act 1997and Section 19 of the National Health Administration Act1997 to make laws in relation to rural health.

Local Governments are responsible for funding health activities and should participate in planning.

Hospitals have specific functions described under the Public Hospitals Act1994and are required to support rural health care delivery. Provincial health authorities have specific functions under the Provincial Health Authorities Act2007andProvincial Health Partnership agreements which are broader than public hospitals because they incorporate the old functions of Provincial Health Boards.

Non Government care providers must operate a facility or provide a service/program in a manner that complies with the National Health Plan, policies, standards and operational directives as a condition of any grant. Powers are contained in the Public Hospitals Act1994and the Provincial Health Authorities Act2007 for public hospitals or provincial health authorities to delegate powers and functions to non government organisations and enable a declared health service to be run by the non-Government organisation. A summary table of the various levels of legislative responsibility is contained at appendix 1.

The proper administration of the National Department of Health also requires compliance with the Public Service (Management) Act1995and the Public Finances (Management) Act1995. Other acts and subordinate instruments that have relevance to the National Department of Healthare listed atappendix 2.

For the purpose of this Corporate Plan, the strategic objectives have been developed to ensure the Department performs the functions required of it under the Act. These functions as listed at Part IV Section 20, National Health Administration Act 1997 are:

1. oversee the carrying out of the National Health Plan in the country
2. provide advice to the National Health Board in relation to policy matters
3. act as executive to the National Health Board
4. provide advice to the Provincial Government and the Provincial Administrators as to steps which should be taken to ensure the implementation of the National Health Plan
5. provide technical advice to members of the extended service of the National Department in the Provinces concerning the operation of health facilities and the delivery of health services and programmes
6. provide training to members of the extended service of the National Department in the Provinces
7. provide:
8. technical services
9. specialist medical equipment
10. pharmaceutical supplies

to Provincial Governments for use in the delivery of health services in the province

1. maintain a national health and information system and a national health planning and data system in relation to health.

Table 2demonstrates how the Corporate Plan 2009-2013 will allow the National Department of Health to meet its statutory obligations.

Table 2National Department of Health Statutory Functions

Statutory Function / Strategic Objective
Oversee carrying out of the National Health Plan / Plan recognises need to commence process for the preparation of a new National Health Plan (KRA 1.4) and ensure existing plan remains current (KRA 1.1).
Provide advice and support to the National Health Board / National Health Board will be revitalised (KRA 3.2) and linked to new governance process (KRA 3.1, KRA 3.3) and structure (KRA 3.5). Monitoring and evaluation on progress to be improved (KRAs 1.6, 1.7, 1.8, 1.10).
Provide advice to Provincial Administrators on the implementation of the National Health Plan / Support will be provided both directly (KRA 1.2) and through developing capacity for better costing (KPA 2.5), workforce planning (KRA 2.6) and asset management planning (KRA 2.7).
Provision of technical assistance to support improved service delivery / Continued implementation of the Public Sector Reform Agenda (KRAs 2.1, 2.4) with particular emphasis on ensuring timely and reliable supply of drugs, equipment and supplies.
Maintain the National Health Information System / Implementation and sector wide roll out of improved NHIS (KRA 1.7), use of data (KRA 1.8) and reporting on performance (KRA 1.10).

Whilst the National Health Administration Act1997was introduced to remove confusion and clarify the roles of the respective levels of government, there are still two aspects of Government provided health services covered by different laws, that being the hospitals under the Public Hospitals Act1994and primary health care, and other hospital services under the Organic Law and National Health Administration Act(1997).

The provision of Church and other non-Government services is covered by the Christian Health Services of Papua New Guinea Actand other non Government organisations.

The Provincial Health Authorities Act 2007is designed to allow Provinces to integrate non hospital and other health services under one piece of legislation. This however, is on a voluntary basis and will take the life of this plan to roll out, assuming all Provinces elect to go down this path.

This will mean two parallel government based jurisdictional systems.

The need for leadership of the ongoing legislative reform process by the National Department of Health is therefore an important strategic objective.

Our Role and Our Focus

Our Role

The Strategic Plan (2006-2008) defines the core business of the National Department of Health and its branches as:

policy and planning

monitoring and evaluation

service improvement

support or enabling services

governance

advocacy and partnership coordination.

The role of the National Department of Health is to provide clear direction to the health sector on the health priorities, ensure there are evidence based and sustainable policies to assist the development of implementation plans, work with key stakeholders to ensure effective and affordable programs are able to be delivered where and when they are needed, and implement the governance and performance management strategies that will promote accountability and transparency across the health sector.

Our Focus

The delivery of health services is the primary responsibility of the Provinces and Districts as described in the Our Mandate section. One of the key objectives of the National Department of Health is however to support the delivery of services at the regional and local level and to facilitate this there needs to be a focus on the following:

Targeting critical vacancies, supporting our front line staff and having a plan for our future needs that gives us the capacity to achieve the health improvement goals we have set

Strengthening our management systems to ensure we are making the right investment choices, the release of funding occurs in a timely and efficient manner and supplies get to where they are needed when they are needed

Rebuilding and maintaining our health facilities with particular attention to our villages, rural areas and Provinces without hospitals

Aligning our governance systems,processes and structures with our corporate objectives

Looking at new and better models of support for service delivery including innovative partnerships with other providers and moving resources out into the Regions.

The above objectives are interdependent and require all aspects to be in place to make the sector work more effectively. We need the staff and supplies, the facilities and the funding to be working as a whole not considered separate parts. This must be our focus for the next five years.

Our Vision, Mission, Goals, Focus and Values

Our Vision

For the people living in Papua New Guinea to be a nation of healthy individuals, families and communities where self reliance prepares all for healthy living in a healthy islands environment.

Our Mission

Monitor the physical, social and mental well-being of people in their communities, and to promote and encourage the maintenance of community health at an acceptable level by planning and delivering preventative and curative medical and other health services.

Our Goal

To improve the health of all people of Papua New Guinea through development of a health system that is responsive, effective, affordable, acceptable and accessible to the majority of people.

Our Values

The Department values are those clear and important beliefs, ethics, attitudes and work culture that staff are encouraged to apply and demonstrate in all aspects of their working lives which include: