Monitor Sector Performance

Progress of Sector 2003-2007 MTR

• Review and endorse MTR results and report

Final Health Sector Review Report was Completed in August 2007. This includes:
- The Midwifery review outcome was officially disseminated in November 2006.
- The SWiM review report has been adopted by MOH Management and circulated to all health partners.
- The Contracting Review Report and Institutional Development Plan were reviewed at the MoH High Level Meeting in June 2007.

Progress of AOP 2007’s implementation

• JAPR

• Quarterly update at TWGH meeting

National Health Congress and JAPR 2006 was conducted in March 2007
Half year update on 2007 AOP implementation was presented at TWGH meeting in August 2007
- AOP 2008 has been endorsed by HSSC in December 2007 and will be published during the JAPR and NHC in March 2008.

Progress of sectoral financing – MTEF

• Review and monitor Budget Disbursement (JMI)

• Quarterly report and presentation at TWGH meeting

• Discuss and review progress regarding next step’s improvement

• Review and monitor donor support to sector

- MTEF Draft Report was finalized by DIC presented to TWGH-Sec in Feb-08
- Cash Disbursement as of December 2007 was presented in TWGH meeting in January 2008 as following:
-   Overall: 91.1%

-   Central level: 91.4% (93.4% for Non-Program Based Budgeting and 69.8% for Programme Based Budgeting)

-   Provincial level: 90.4%

Update figures will be mad available during JAPR and NHC in March 2008.

NSDP and CDCF Reporting

• Review and endorse NSDP and GDCC reports

- The Progress Reports of TWG-H were submitted to the GDCC secretariat and disseminated to TWGH members.

Progress of HSSP

• Semi-Annual report presented at TWG-H Meeting

• Propose extension of HSSP until end 2008

- The first HSSP semi-annual progress update for 2007 was submitted on time and presented to the TWGH in November 2007.
- The last HSSP Joint Supervision was in January 2008.
- Request for project extension has been approved by both ADB and WB.

GFATM
Semi-annual presentation at TWGH meeting

- Progress Update was presented in TWGH in March 2007
- Semi-Annual Progress Update was presented at TWGH in September 2007

Regular inputs from Civil Society

• Regular representation from NGOs

• Inputs into key sectoral policy discussion

NGO representative is the member of the TWGH and Secretariat.
The representative regularly presents in Health Partner meetings.

 GAVI and GFATM Health Systems Strengthening progress

GAVI formally approved the proposal of HSS 2007 in March 2007; Funds arrived in June 2007. Proposal for scaling up HSS 2008-2010 is being revised for resubmission to GAVI secretariat.
Three Sub-Recipients of GFATM fund for HSS R5 for $1.8M for 2 years.
The 3^rd Semi-annual report is to be submitted to GF through LA & CCC by 15-Feb-08

Sector Harmonization and Alignment

Facilitate salary supplement phasing out and Merit-based Payment Initiative

• Update of progress on MBPI

• Progress in MoH High Level Group & Health Partner WG work to be monitored.

• Follow up of Performance Incentives in consultation with CAR, MEF and HP

- A National Workshop on Implementing the Priority Mission Groups (PMGs) and Merit-Based Pay Initiative (MBPI) and an inter-ministerial workshop on MBPI was organized  in October and November 2007 by CAR with participation of MEF, MOH and DPs
- RGC has formed a Task Force on MBPI for MOH whose recommendations to the Deputy Prime Minister are awaited.

SWiM development toward SWAp

• Review and endorse SWiM MTR Review outcome

SWiM review report had been adopted by MoH Management and circulated.

Monitor Pro-TWGH and Sub-TWGH

• Quarterly report of progress and feedback from TWGH secretariat

Role, structure, and function of Pro-TWGH has been established, regular quarterly progress reports have been obtained. Representative from TWGH Secretariat and Department of International Cooperation regularly join Pro-TWG meeting every month to strengthen the functioning of Pro-TWG and give feed back on its activity.
Representatives of two Pro-TWGHs are invited to joint every TWGH meeting in 2008 to report on activities and progress.

Explore Peer Review System

Peer review system was extensively explored during consultative meeting on review report for Functioning of the TWGH and its secretariat in December 2007. Further discussion, however, is expectied bettween and among MOH and its HPs. 

Strengthen capacity building of DIC for TWGH support 

• Development of secretariat capacity building workplan

• Review workplan Department of International Cooperation based on new mandate (Set up data base for HPs; Manage MoH website)

Policy framework and operational guidelines for DIC have been finalized and a consultative workshop was conducted in August 2007 with participation of all stakeholders.
Result from the 1^st phase of DIC database development have been presented in TWGH meeting in December 2007. T.A. for the 2^nd phase to be formulated by AusAID and WHO ASAP for DIC database development.
The Review of the Funtioning of the TWGH indicated support requirements for DIC. 

Key Strategic Issues

• Strategic Planning

Review and endorse Health Sector Strategic Plan 2008-2015

- A special TWGH meeting was dedicated in January 2008 for the review of the first draft of HSP2
- Final HSP2 is expected to be launched during JAPR in March 2008

Health Service Delivery

Contracting Follow up
Implementation outcome of MTR Contracting review

Strategic Review of Health Contracting is an input study to the Health Sector Review. The final review report is disseminated and was presented in TWGH meeting in June 2007.

• Monitor pilot implementation of Client and Provider Rights

• Present new BCC Policy

- IEC materials packages are ready
- Guideline dissemination and pilot project launching was conducted in May 2007.

- Implementation and Monitoring report will be presented to TWG-H in Q1-Q2 2008

- HPs need more time for review and feedback before finalization

• Present experiences on BCC/IPC toward Reproductive Health

Experiences on BCC/IPC toward Reproductive Health  was presented in TWGH meeting in April

Review and endorse new MoH agreements on linkages Reproductive Health and HIV/AIDS

Agreement has been developed and endorsed by MOH in December 2007

• Health Financing

Review and Endorse Health Financing Strategy

Draft Strategic Framework for Health Financing in Cambodia 2008-15 was presented at TWGH meeting in September 2007. The final version will be presented at the NHC-JAPR in March or April 2008

Equity Fund
Progress report on implementation of EFs

- Current covrage with HES is 36 ODs, 5 ODs with UNFPA supported RH package, plus 6 national hospitals.
- Training on monitoring of HEF is on-going

Linking planning, allocation, budgeting and budget execution

• Follow up Health PETS report

• Program-Budgeting Framework: monitor PBB Pilot implementation

• Monitor PFM WG recommendation on proposed proxies for Budget Disbursement.

Health PETS report was presented to TWGH in April 2007.
Programme Based Budgeting implemented for Annual Operational Plan 2008
Report on PBB  and budget execution for 2007 to TWGH in January 2008.
An International Financial Management Adviser is working with the DBF under financial support of the World Bank through HSSP

• Human Resources

Review and endorse outcomes of midwifery review

The review report has been adopted by the MOH and disseminated in November 2006.
MOH nominated in July 2007 a High Level Committee on Midwifery per recommendation of the review and taking forward the MoH priorityies for midwifery.

• Private sector

Review and endorse Health Professional Registration Workplan

71% of health professionals (3,098 out of 4,364) have registered as of December 2007

Other

• Regular updates to TWG-H on:

• Preparedness planning for pandemic influenza

• International Health Regulation

- Cooperation with the National Committee for Disaster Management (NCDM) and other health partners
- Training of both MoH and other relevant Ministries on IHR (2005)

4. Increase the proportion of deliveries attended by skilled health personnel in the public sector to 45% by December 2007 (38% in December 2006)
Actions:

1. Recruitment and deployment of at least 68 midwives for 68 health centers that do not yet have any midwife by the end of 2007

2. Provide salary incentives to midwives – an incentive based on the number of deliveries was adopted under the Inter-Ministerial Prakas of the MEF and the MoH No 268, April 2 2007 and the adapted midwife salary scales and compensation payments for professional related health risks as proposed by MoH are to be endorsed at a full session of the Cabinet of Ministers.

Proportion of deliveries attended by skilled health personnel in the public sector is 42% by December 2007

On-going implementation

In 2007 there are 188 primary midwives and 40 secondary midwives have been recruited and allocated to 166 HCs out of which 60 HCs which didn’t have any midwife in 2006.

140 primary midwives and 67 secondary midwives is planned to be recruited in 2008.

The Inter-Ministerial Prakas of the MEF and the MoH to pay incentives for attended deliveries is being implemented.

The Royal Decree Nº ns¼rkt¼0607 ¼233 dated June 13, 2007 on midwife salary scales and new age requirement for midwifery recruitment is being executed.

Section B: Alignment – 3. a.:

1.  All sector plans and development programs/projects include an assessment of the existing capacity gaps and a capacity development plan to fill the gaps to achieve targeted development results.

2.  Each sector TWG prepares and implements a capacity development program for their sector ministry/agency to fill identified capacity gaps.

MOH’s Institutional Development Plan (including organisational development needs) will be finalised following the sector strategy review in 2007. Functional analysis was carried out in the central ministry and followed by introduction of Performance Management System in January 2006.
Implementation of Performance Management System at central level since Jan 2006 and extension of MBPI (including PMS) to provinces.
- RGC has formed a Task Force on MBPI for MOH whose recommendations to the the Deputy Prime Minister are awaited.
- The MoH signed in September the International Health Compact as one of the seven first wave countries. The agreement focusses on H&A practices and healt sysytems strengthening to achieve the MDGs

Section C: Harmonization :

1.a .2. Each TWG prepares a plan to increase delegated cooperation within their sector/thematic area.













1.b.2.  . Each TWG prepares a calendar of field missions, diagnostic reviews and studies planned by donors participating in the sector/thematic area of the TWG. 

TWGH workplan 2007 & JAPR; 8 Sub-TWGH established; at the end of 2007 three more Sub-TWGHs have been proposed for establishment; Pro-TWGHs in the process of establishing secretariat and revising membership. MOH has agreed to progress to partial pooled funding for the new phase of support to the Health Sector and established a Task Force for Deepening Harmonisation and Alignment in the Health Sector. Health Partners have established a working group on Harmonisation and Alignment.

Sectoral Joint Annual Performance Review provides guidelines for consolidated annual planning process for all health partners

Joint Review Mission from MoH and HSSP partners -  June 2007;
HSSP MTR is an input to sector review – (completed October 2006)
Subcomponent reviews in midwifery, contracting, and sector-wide management are jointly agreed with government and health partners.

Section D: Managing for results

a.2. Development partners ensure that the Standard Operating Procedures (SOP) for loan assistance and National Operational Guidelines (NOG) for grant assistance are followed in monitoring and reporting on their programs/projects to reduce burden on RGC implementing institutions.

HSSP is implementing SOP