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					    Brief Assessment
            of
PROGRAMME MANAGEMENT
          in the
     MoH, Maldives

      Rajesh Pandav
      WHO Maldives
      ISSUES IN PROGRAMME
           MANAGEMNT
 Based on feed back from senior officials at
  the Ministry of Health and programme
  managers, the following
  – strengths,
  – weaknesses,
  – opportunities and
  – threats
  related to programme management were
  identified.
                    Strengths
 Political commitment to the health master plan
  2006-2015
 Senior officials of various departments have more
  than 15 years experience in managing health
  programmes
 Guidance from senior officials to mid-level and
  junior programme managers is prompt and clear
 Good working relationship between programme
  managers and technical focal points
 Regular feed back on activity implementation
 Access to technical literature via internet available
                      Strengths
 Proposal development is well supported & facilitated (eg. in
  obtaining the required quotations)
 Programme managers receive support from senior officials
  to participate in meetings and workshops – to improve
  knowledge
 Good collaboration between other departments of MoH
  and other ministries (eg. Ministry of Higher Education,
  Employment and Social Security) for health related
  activities
 Programme managers are able to make decisions with the
  help of senior management, and implement activities.
 Good support from the budget unit
                    Strengths
 Technical focal points for WHO related work were
  appointed by MoH and they provide support when the
  programme managers need therefore it has helped to
  conduct program effectively as compared to the previous
  biennium.
 Communication with WHO regarding WHO collaborative
  programmes is easy and feedback/responses are prompt
 Assistance is provided by WHO staff in writing proposal
  and securing funds appropriately on time.
 Continuous monitoring and strong support from WHO Malé
  office has helped in timely implementation of activities
               Weaknesses
 Lack of technical resource personnel
 Lack of appropriate skills for writing proposals,
  project/program management (including the use of
  project management software)
 Lack of adequate number of staff in most sections
  resulting in overload of work to existing staff
 High turnover of staff
 Limited administrative staff in certain sections
  (DMS) to support programme managers
              Weaknesses
 Decreased government fund allocation for
  the various programmes
 Lack of co-ordination and information
  sharing between staff
 Limited understanding of financial
  procedures of UN offices
 Delaying in compiling financial statement
  from budget section, thus delaying the
  submission of final report.
               Opportunities
 Human and financial resources can be shared
  through integration of the programme with other
  programmes
 Opportunities are available to enhance knowledge
  through participation in trainings / workshops
  available.
 Information sharing (regional level) so as to
  integrate implementation of the activities
 Regular programme managers meeting allow new
  programme managers to understand WHO
  financial procedures
               Opportunities
 Improve communication through regular e-mail
  contact between staff within various departments
  of MoH and with WHO
 Utilization of consultants to provide technical
  guidance to other relevant programmes during
  their visits
 Improve communication within the health sector
  departments – eg. DMS & DPH
 Opportunities available for programme managers
  to enhance skills for programme management
                         Threats
 Limited financial allocation to the programme from
  government and other sources
 Frequent change of programme managers
 Lack of technically qualified staff will affect the quality of
  programme management and implementation of activities
 Increase in the cost of transportation
 Although number of ToT have been trained it has been
  difficult to utilize them due to their busy schedules
 Budgetary procedures not streamlined causing delay in
  submission or proposals thus hampering timely
  implementation of various programmes.
              Recommendations
 Strengthening Programme Management in the Ministry
  of Health
  – Achieving local and national health goals depends to a large extent
    upon effective leadership and programme management.
  – This in turn requires a balance between four dimensions: numbers
    of managers, their competencies, functioning support systems and
    an enabling environment.
  – In many health systems worldwide, education of health managers is
    focused on academic training programmes, rather than developing
    adaptable generic competencies.
  – Emphasis should be aimed at outlining improved approaches and
    a wider set of responsibilities for building and sustaining
    management competencies of programme managers to achieve
    national health goals.
              Recommendations
 Strengthening Programme Management in the Ministry
  of Health
  – Achieving local and national health goals depends to a large extent
    upon effective leadership and programme management.
  – This in turn requires a balance between four dimensions: numbers
    of managers, their competencies, functioning support systems and
    an enabling environment.
  – In many health systems worldwide, education of health managers is
    focused on academic training programmes, rather than developing
    adaptable generic competencies.
  – Emphasis should be aimed at outlining improved approaches and
    a wider set of responsibilities for building and sustaining
    management competencies of programme managers to achieve
    national health goals.
    Stakeholders' roles in building
    management competencies -1
 Ministry of Health
   – Define realistic roles and competences for each management
     position based on performance requirements.
   – Develop a national strategy for management competency
     development.
   – Develop an agreed competency framework and establish
     competency assessment mechanisms, which could be used in
     selection, promotion, etc.
   – Develop accreditation or approvals system for management training
     courses
   – Develop and maintain relations with local training institutions –
     share information on health system manager manpower
     requirements and competency frameworks
   – Help raise resources for sustained support for management
     development programs within health sector strategies and plans.
   Stakeholders' roles in building
   management competencies -2
 Sub national health organizations/Managers
  (Regional Hospitals/Atoll Hospitals)
  – Provide feedback on roles challenges and
    responsibilities to central level to help create better “fit
    for purpose” competency frameworks and management
    strengthening strategies;
  – Foster links with local training institutes and provide
    practical sites for training managers
  – Provide mentoring and coaching for new managers .
    Stakeholders' roles in building
    management competencies -3
 National Training Institutions (Faculty of Health
  Sciences)
   – Be proactive with MOHs in designing and developing programs
     together
   – Create opportunities for setting standards, sharing experiences and
     improving quality of training program
   – Develop expertise in designing competency based training
     programs and in conducting assessments of existing managerial
     competencies.
   – Ensure that their academic staff understand and use modern
     experiential learning methodologies.
   – Monitor the effectiveness of the training programs in terms of
     competency development and improved management performance
  Stakeholders' roles in building
  management competencies - 4
 International Development Agencies
  – Share evidence of international good practices
    for building management competencies
  – Support /facilitate networking between local and
    external institutions;
  – harmonize and align their support to the
    government's national management
    development strategy to avoid duplication
       Ensuring availability of
       programme managers
 The first dimension of the conditions
  identified as necessary for effective
  leadership and management is to ensure
  that adequate numbers of managers are
  available and deployed throughout the
  health system.
   Stakeholders roles in ensuring
           availability of
     programme managers -1
 Ministry of Health
  – Inclusion of health programme managers as an
    important component of the health workforce in
    policies and plans.
  – Needs and gaps identification and analysis with
    stakeholders;
  – Prioritization of needs
     Stakeholders roles in ensuring
             availability of
       programme managers - 2
 Sub national health organizations (e.g.
  Regional Hospitals/Atoll hospitals)
    Participate in needs analysis and gaps assessments
 National Training Institutions (Faculty of Health
  Science)
   – Assist to determine national capacity to produce
     managers
   – Develop capacity to provide adequate number of
     competent health services managers
   Stakeholders roles in ensuring
           availability of
     programme managers - 3
 Managers
  – Being prepared to stay in post for reasonable
    periods
  – Improving their own competencies and
    performance as health programme managers
 International Development Agencies
  – Assist with needs/gaps assessments and
    definitions
Strengthening management support
            systems -1
 The performance of health programme managers is
  dependent in part on how well critical management support
  systems function.
 “Management support systems” must function effectively
  (centrally and locally) in a way that managers are able to
  use well.
 Examples of critical management support systems include:
   – Planning, budgeting and financial management systems
   – Personnel management systems, including performance
     management (objectives/appraisals)
   – Procurement and distribution systems for drugs and other
     commodities
   – Information management and monitoring systems
   – Assets and other logistics, infrastructure, transport
Strengthening management support
            systems - 2
 Functional systems should have:
  – clear rules and regulations;
  – good guides and forms;
  – effective monitoring and supervision,
  – specific training and appropriate support staff
    (e.g. account staff, supplies and information
    staff, secretarial support, etc).
     Stakeholders' and Roles in
Strengthening management Support
            Systems - 1
 Ministry of Health
  – Generates appropriate policies, rules and regulations for
    support systems
  – Assess management support systems for effectiveness
  – Ensure that the management support systems
    procedures are followed are in place throughout the
    health system and that they support management of
    service delivery
  – Regularly monitor support systems
     Stakeholders' and Roles in
Strengthening management Support
            Systems - 2
 Sub national health organizations and
  managers (Regional/Atoll level)
  – Ensure that the operational requirements for critical
    support systems are in place or if not these are
    communicated to the appropriate quarters
  – Should be a monitoring and evaluation partner in
    assessing whether systems are producing results;
  – Share experiences and good practices
     Stakeholders' and Roles in
Strengthening management Support
            Systems - 3
 National Training Institutions (Faculty of
  Health Science, Ministry of Education)
  – Ensure that the generic aspects of a support
    system included in training courses
  – Conduct studies, assessments and evaluate
    effectiveness and impact of management
    support systems
  – Design programs that help managers to
    negotiate existing support systems better.
     Stakeholders' and Roles in
Strengthening management Support
            Systems - 4

 International Development Agencies
  – Strengthen and use national management
    support systems for programs and projects
  – Share technical experiences, knowledge and
    evidence of international good practice
  – Support investments in management support
    systems strengthening
Questions/Comments?



    THANK YOU

				
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posted:9/23/2011
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