COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Papua New Guinea

Transcription

1 COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Policy Context Global strategy on women and children/ commitment National Health Sector Plan and M&E Plan Country team present at the National Accountability Workshop, August 2012 NATIONAL DEPARMENT OF HEALTH Dr. Lahui Geita Technical Advisor Women s Health Dr. Ismael Kitur Manager, Research & Monitoring Dr. William Lagani Manager, Family Health Services, Mr. James Noah Health Economist Mr. Enoch Posanai Executive Manager, Publich Health NATIONAL STATISTICS OFFICE Mr. Dennis Gonnisso Mrs Shirley Kali WORLD HEALTH ORGANIZATION Dr. Paulinus Sikosana Health Services development & Health care financing, Technical Advisor Dr. Laura Guarenti MCH Advisor UNICEF Dr Grace Kariwiga Advisor - Health Situation Analysis To improve midwifery education and register 500 new midwives by 2015; To increase the number of obstetricians from 17 in 2011 to 40 in 2020; To improve access to drugs and equipment necessary for maternal, newborn and child health; To introduce maternal health audits in all districts; and To develop comprehensive plans to improve existing health services in all four regions of the country by The National Health Plan (NHP; ) which was launched in August 2010 is aligned to the PNG Vision 2050, the Medium Term Development Plan ( ) and the PNG Development Strategic Plan ( ). The NHP renews PNG s commitment to Primary Health Care, is MDG responsive and targets strengthening of the WHO health system building blocks. The NHP aims to achieve coordinated development assistance mechanisms based on a revitalized Sector Wide Approach in line with the Paris Declaration. A Health Information System Policy (draft) and a Monitoring and Evaluation Strategy and Plan (final draft) are currently under consideration by Senior Executive Management. Measurement of health sector performance is based on joint assessments of 29 core indicators agreed to under the health sector Performance Assessment Framework (PAF). The health MTEF for the NHP is in its second rolling period, UNFPA Dr. Gilbert Hiawalyer Acting Country Representative ADB COUNTRY PROJECT OFFICE Mr. Marcel Minc Director SUSU MAMAS INC. Ms Caroline Ninner Manager WORLD VISION Ms Agnes Tali Dr Curt Bougslawski Country Director ADB/AusAID Dorothy Keys Pais /ADB/AusAID Rural Primary Health services Development Program Suzanne Syme /ADB/AusAID Rural Primary Health services Development Program FAMILY HEALTH INTERNATIONAL 360 Dr Anup. S. Gurung Program Manager MARIE STOPES PNG Ms Belinda Bowling Country Director * This final version has been reviewed and validated through a national accountabilty workshop involving a broader stakeholder group. Page 1/20

2 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Civil registration & vital statistics systems Context Possible actions Assessment & Plan 1 No assessment has been done however there have been discussions on strengthening the CRVS. No assessment has been done however there have been discussions on strengthening the CRVS. Pursuing Conduct an assessment of the CRVS. Develop a CRVS improvement plan on the basis of the assessment. discussions with donor partners on TA to undertake the assessment. There is no interagency coordinating committee in place, however Coordinating Mechanism 1 through PLLSMA(DPLGA) to establish a committee. Establish CRVS interagency coordinating committee involving all key stakeholders. Hospital reporting is not always complete. Hospital reporting of deaths includes a cause of death, but not always using ICD-10- quality Hospital reporting control is not routine. 2 Train doctors on ICD - 10 and coding to improve hospital reporting, and roll out use Not all community births and deaths are reported and ICT is not used of electronic patient reporting system. at community level. Verbal autopsy is done on a very limited basis. Conduct regular quality control of death certification and improve coding practices. Vital statistics are not published every year for national and sub national levels. These are published every ten years from DHS and census. Community reporting 1.5 There are no health and demographic surveillance sites. Train community health workers on community reporting of births and deaths, and where appropriate implement innovative approaches such as cell phone technology, etc. Train community health workers in the use of VA to report on deaths occurring in communities. Vital statistics 2 Strengthen the birth and death registry. Local studies for mortality 2 Enter into dialogue with NSO on possibilities of establishing a HDSS system. * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 2/20

3 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Monitoring of results Context Possible actions M&E Plan 3.5 There is a draft M & E Plan for the National Health Plan, Identify gaps in the NHP M& E plan and align RMNCH indicators as necessary. The majority of RMNCH indicators are aligned with the main M& E Integrate Regularly key review Health the Indicators health sector into performance the whole of assessment government framework monitoring and and Plan of the NHP. There is no multi stakeholder M&E coordination committee - there is M&E Coordination 1 however an NDOH- Health Informatics Committee. Establish M&E multi-stakeholder committee chaired by A DHS is planned for 2016 and a national population a census in Health Surveys PNG has not planned for an RMNCH survey during this period. 1.5 Develop 10 year health survey plan There is a functioning HMIS in place - though with poor data quality and weak reporting systems, coordination and data sharing. No Review available RMNCH data and plan for a subnational survey in selected facility survey for data and service readiness is carried out for Facility data (HMIS) 1.5 RMNCH. Train Provincial Health Information officers in compilation of annual statistics from Quarterly and annual reviews are conducted regularly, however the quality of the data is questionable. NHIS software not able to process all the data inputted. Some data is disaggregated by sex, socio- economic factors and geographical location. facilities, data analyses and data quality assessment. Advocate for Provinces to upgrade the positions of Provincial Health Information officers Plan for facility survey in the later half of the NHP plan period Analytical capacity 2 The website needs updating in both design and content. Training health information officers at all levels of the health system in data review, analyses and presentation - involve key training institutions. Upgrade NHIS software Equity 2 Revise NHIS forms to facilitate disaggregation by sex and socio economic characteristics. Data sharing 2 Procure short term technical assistance to redesign and update the existing website. * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 3/20

4 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Maternal death surveillance & response Context Possible actions Notification 2 Maternal death audit form is in place and currently being institutionalized and rolled out across provinces. There is a policy in Roll out the implementation of Maternal Death Audit to all provinces. Compile & publish Maternal Death audit Report for place. Capacity to review and act 2 There is a Maternal Death Audit Committee established at the national level and the Maternal Health Command Post monitors Maternal Death Audit implementation. There is limited capacity to Accelerate the rate of establishment of provincial maternal death audit committee in the remaining provinces. review and respond at the district level. The national referral hospital and provincial hospitals currently report Hospitals / facilities 2 Train hospital doctors and data recorders in ICD-10 certification and coding to on maternal deaths - though not always ICD compliant. Not all improve maternal deaths reporting by hospitals - link with CRVS. maternal deaths are reviewed at hospitals. Quality care assessment are conducted through the hospital/health facility accreditation system. Include private hospitals in ICD-10 training. Communities currently do not report all maternal deaths within 24 Quality of care 2 hours. It is currently not feasible for communities to do so. Electronic devices are currently not routinely used but trials have been conducted in the application of cell phone technologies. Verbal Roll out implementation on the National Health Services Standards and the Hospital Accreditation System to all the hospitals. Estbalish Quality Assurance Committees at hospitals and health facilities. autopsies are not conducted for maternal deaths occuring within Community reporting & feedback 1.5 communities. Communities do not receive any feedback and neither Review and strengthen existing systems for community based maternal death are they involved in reviews. Maternal Death surveillance is being institutionalized and progressing. reporting and response. Work with relevant stakeholders such NSO, DPLGA, DfCD (CRVS). Apply lessons learned from cell phone trials in diseasse surveillance and NHIS data transmission and roll out their application in maternal death reporting. Adapt and roll out existing guidelines on Verbal Autopsies for maternal deaths in communities. Work with NGOs and CSOs and involve communities in reviews and responses to maternal deaths. Review of the system 2 Undertake a review of the maternal death surveillance and response system and disseminate and use the report for decision making * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 4/20

5 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Innovation and ehealth Context Possible actions Policy 3 A draft ICT policy is in its final stages, and is in line with the M&E Incorporate ehealth strategy in the ICT draft policy. strategy. There is connectivity mainly at the National and Provincial Hospitals Infrastructure 3 Where connectivity exists and there is cell phone penetration, use the and provincial offices - however not all the districts are connected, infrastructure to support health services delivery and information flows. Train staff and internet usage is still limited. in the application and use of ICT. The NHIS is ICT and paper-based and needs strengthening. Data sharing between the systems needs to be strengthened and more Services 2 Assess ehealth services required to support the country s priority health programs, particularly with respect to information flows. Upgrade NHIS software to facilitate data sharing across programs. coordinated. There is a standard software that facilitates data storage, transfer and compilation - needs strengthening. Coordination mechanism is in place but is not specifically designed for Standards ehealth. 3 Determine the ehealth standards and interoperability components required to Legislation (NSO) in place and needs to be reviewed and updated to support ehealth services, applications and infrastructure, as well as to support reflect developments in ICT. The proposed ICT policy and relevant broader changes to health information flows. legislations to provide for data protection. Governance 3 Review TORs and membership of existing coordination mechanism so that it caters for e-health requirements. Protection 2 Incorporate data protection requirements in the health sector ICT policy currently under development ensure that it is in line with national ICT legislation and Regulatory Requirements Enforce compliance to data protection policies * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 5/20

6 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Monitoring of re Context Possible actions National health accounts 2 The Current NHA framework is based on the 10 program budget structure for the health sector and not on international guidelines. NHA governance and coordination system was in place but no longer functional. Procure short term technical assistance to assist to realign the NHA framework to international guidelines. Re-establish NHA governance and coordination mechanism in collaboration with relevant stakeholders. The health Sector Wide Approach (SWAp) and the Health Sector Compact Partnership Committee (HSPC) and disbursements on National Health 3 Strengthen and consolidate the role of the SWAp and HSPC as forum for dialogue plan. and partnership engagement. NHA steering committee was established in 2000, but is no longer functioning. Relevant stakeholders were involved as part of the NHA team. Coordination 1 does not have adequate capacity at the national and subnational Reactivate the steering committee. level to produce NHA data and core indicators. The PNG Accounting System (PGAS) is automated but needs complementary upgrade to convert GoPNG expenditure data into NHA format. There Expand the membership of the NHA team to involve additional stakeholders in the NHA process. Production is no central database for automated production of standard NHA 2 Recruit and train dedicated staff on system of health accounts 2011; Train staff tables. directly involved in NHA and collaborate with other GoPNG Departments and The National Economic and Fiscal Commission produces provincial expenditure analyses, including geographical expenditure analyses - only for the government recurrent budget. There is currently no publicly accessible and up to date NHA data that has been analysed. research institutions. Match government codes to NHA codes and adapt NHA IT conversion tool for PNG NHA. Develop database for production of NHA. There is no current NHA data to use for national policy development. Information from RMNCH annual program reviews is used in policy Analysis 2 development. Ensure that NEFC expenditure analysis data is used for decision making at provincial and national levels. When available to disseminate NHA report and analyses on public website. Data Use 2 Advocate for /promote use of NHA data in policy making process - conduct RMNCH sub accounts. * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 6/20

7 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Review processes Context Possible actions Reviews 3 Joint Annual health sector multi-stakeholder reviews are conducted within the SWAp mechanism and other development partner forums. Key stakeholders are involved in the reviews - private for profit sector yet to be involved. The RMNCH program undertakes its reviews and the annual review process includes RMNCH reviews. Health sector performance reviews are informed by the synthesis of provincial and district health data. Joint reviews are complemented Undertake timely joint annual sector reviews that are based on the goals, targets of the NHS. Involve the private health sector in health sector reviews and synchronize these with GoPNG planning and budgetting cycle, to ensure better quality of the annual review process. Conduct annual RMNCH appraisals and ensure that findings feed into the health sector reviews. by annual qualitative independent reviews. Synthesis of information & policy context 3 The HSPC working group on resource allocation and the health MTEF Train staff in the preparation of analytical reports that inform annual joint help translate results of reviews into planning processes. District health planning processes involve NGOs and church providers of health services. The health SWAp is the main mechanism for the coordination of reviews. Commission qualitative independent annual sector reviews that complement joint reviews based on quantitative NHIS data. From review to planning development partner (DP) planning and resource allocation. Health 3 Consolidate existing mechanisms and processes for resource allocation and DPs are signatories to the Kavieng Declaration which localises the planning. Principles of Paris Declaration on Aid Effectiveness. DP alignment is Provide planning guidelines that ensure district planning is an all inclusive process. based on the Kavieng Declaration. Compacts or equivalent mechanisms 3 Monitor DP compliance and alignment with the health sector M&E Strategy and Plan of the national health plan. Use the HSPC to monitor DP alignment with GoPNG priorities. * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 7/20

8 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Advocacy & outreach Context Possible actions Parliament active on RMNCH issues 2 There are no transparent accountable mechanisms for RMNCH Advocate for parliamentarians to establish a forum to address RMNCH issues at the highest Identify political RMNCH level. champions among the parliamentarians to advocate for RMNCH issues. Civil Society Coalition established by parliament. The Maternal Health Command Post compiles reports which the Minister of Health reports to Parliament. The national Department of Planning & Monitoring coordinates the compilation of the MDG report to the UN General Assembly by the Prime Minister. Parliament does not organise forums for sharing of Advocate for the establishment of an umbrella CSO coalition with a focus on 2 information. RMNCH. Provide guidelines that ensure health promotion messages developed by NGOs are A Civil Society Organization coalition exist for HIV/AIDS - there is however no umbrella coalition for all CSOs. CSO produce materials on in line with health promotion policies. advocacy - these however need to be coordinated under a common Media role 2 Work proactively with with the media to strengthen their capacity to report on RMNCH related issues and identify media champions on RMNCH issues. dissemination strategy. The media reports on a wide range of health issues - however on an opportunistic basis. The media is not currently involved in the accountability process. Whilst the media receive information from key national bodies it is not always on a systematic basis. The Health sector and its partners will conduct a countdown event for RMNCH by PNG regularly reports on MDGs 4 and 5 as part of the UNGASS MDG report. Make relevant information available to the media and train some media personnel in reporting on monitoring the implementation of the Global Strategy. Proactively make information on the Global Strategy available to the media. Countdown event for RMNCH 2 Establish a Countdown Events Coordinating Committee to prepare and convene the count down event. Coordinate the preration of a PNG country-driven Countdown report using all available evidence. SCORE: Not present, 1 needs to be developed Needs a lot 2 of strengthening Needs some 3 strengthening Already present/no 5 action needed * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 8/20

9 CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS) Conduct an assessment of the CRVS 1 Organize national stake holders meeting, apply rapid assessment tool Develop a CRVS improvement plan on the basis of the assessment Establish CRVS interagency coordinating committee involving all key stakeholders Train doctors on ICD - 10 and coding to improve hospital reporting, and roll out use of electronic patient reporting system 1 Apply full assessment tool and develop improvement plan 2 Multi-stakeholder workshop /mobilisation exercise /DCD /DCD /DCD/WHO 2 Invest in strengthening HMIS, Provincial Hospital & PHA DPLGA, UNICEF, UNFPA, WHO SPC, NSO DPLGA, UNICEF, UNFPA, WHO SPC, NSO DPLGA, UNICEF, UNFPA, NSO, CSOs UNICEF, ADB, AusAID, UNFPA, WHO, NZAID x $15,000 $15,000 UNFPA x $100,000 $100,000 SPC x $25,000 $25,000 Funds x x x $200,000 $50,000 $150,000 UN Agencies, ADB Conduct regular quality control of death certification and improve coding practices Train community health workers on community reporting of births and deaths, and where appropriate implement innovative approaches such as cell phone technology, etc 2 Train national facilitators, apply electronic tools 2 Identify short list of variables for birth and death reporting (HMN/WHO), Provincial Hospital & PHA UNICEF, ADB, AusAID, UNFPA, WHO, NZAID DPLGA, DCD, DPs, CSOs x x $50,000 $50,000 UN Agencies, x x x x $50,000 $50,000 Unfunded Train community health workers in the use of VA to report on deaths occurring in communities 1 Test verbal autopsy tool for mobile phones DPLGA, DCD, DPs, CSOs, ADB, AusAID x x $35,000 $35,000 Unfunded Strengthen the birth and death registry. Enter into dialogue with NSO on possibilities of establishing a HDSS system 1 Training in analyses of relevant staff DCD,, NSO DPLGA, DCD, DPs, CSOs, ADB, AusAID 3 Assess and invest in HDSS DPLGA, DCD, DPs, CSOs x x $20,000 $20,000 Unfunded x x x x $25,000 $25,000 Unfunded * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 9/20

10 MONITORING OF RESULTS Regulary review the health sector performance assessment framework and update RMNCH indicators as appropriate. Establish M&E multi-stakeholder committee chaired by. 3 Workshop with key stakeholders 1 DPLGA, NSO,DCD,UN x x $5,000 $5,000 Develop 10 year health survey plan 3 Link with National Statistical Plan, mapping all health surveys Review available RMNCH data and plan for a subnational survey in selected provinces in Use WHO analytical approach including data quality score card analysis WHO, UNFPA, NRI, PNGIMR, NSO x x $75,000 $75,000 Unfunded Train Provincial Health Information officers in compilation of annual statistics from facilities, data analyses and data quality assessment. Advocate for Provinces to upgrade the positions of Provincial Health Information officers 2 TA and training on analyses and development of annual statistical report Plan for facility survey in the later half of the NHP plan period. 2 Plan sample survey of facility (about 100) prior to review using WHO standard instrument * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 10/20

11 (1) Training health information officers at all levels of the health system in data review, analyses and presentation - involve key training institutions. (2) Upgrade NHIS software 1 Build upon current national and regional observatory approaches, WHO analysis and data quality tools NDOH WHO x x x x $75,000 $20,000 $55,000 WHO, UNICEF, UNFPA, ADB Revise NHIS forms to facilitate disaggregation by sex and socio economic characteristics. 1 Technical assistance and training onequity analyses WHO, ADB x x $75,000 $20,000 $55,000 WHO, ADB Procure short term technical assistance to redesign and update the existing website. 1 Technical assistance for national observatory/portal Communication, Telikom x x $20,000 $20,000 * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 11/20

12 MATERNAL DEATH SURVEILLANCE AND RESPONSE Roll out the implementation of Maternal Death Audit to all provinces. Compile & publish Maternal Death audit Report for (a)strengthen national capacity through training/mentoring in MDSR (b) To continue to establish provincial maternal death audit committee in the remaining provinces Train hospital doctors and data recorders in ICD-10 certification and coding to improve maternal deaths reporting by hospitals - link with CRVS 1 Workshop for mobilisation of key decision makers 1 National capacity building workshops 1 District capacity building workshops 2 Training of hospital staff in ICD and coding (link with CRVS) DPLGA, UNICEF, UNFPA, WHO, NSO, CSOs X x $50,000 $50,000 UNFPA WHO, UNFPA x x $50,000 $50,000 One UN Fund WHO, UNFPA x x $100,000 $25,000 $75,000 ADB, UNICEF. UNFPA x x x x $50,000 $50,000 GoPNG Include private hospitals in ICD-10 training Roll out implementation on the National Health Services Standards and the Hospital Accreditation System to all the hospitals. Establish Quality Assurance Committees at hospitals and health facilities 1 Routine reviews/audits x x x x 2 Technical assistance and training for facility assessment DPs x x x x $35,000 $35,000 GoPNG/DPs Review and strengthen existing systems for community based maternal death reporting and response. Work with relevant stakeholders such NSO, DPLGA, DfCD (CRVS) 1 Develop plan for strengthening MDSR in community NDOH, Provincial Hospital & PHA One UN x x $35,000 $35,000 One UN Fund * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 12/20

13 Apply lessons learned from cell phone trials in disease surveillance and NHIS data transmission and roll out their application in maternal death reporting. 2 Introduce/train on community reporting using ICT Adapt and roll out existing guidelines on Verbal Autopsies for maternal deaths in communities 1 Training on VA at community level DPs, CSO,DPLGA,NSO x x $25,000 $25,000 One UN Fund Work with NGOs and CSOs and involve communities in reviews and responses to maternal deaths 2 Develop system for review process and feedback/interpretation of data DPs, DPLGA, CSOs, NSO x x x x $10,000 $10,000 Unfunded Undertake a review of the maternal death surveillance and response system and disseminate and use the report for decision making * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 13/20

14 INNOVATION AND E-HEALTH Incorporate ehealth strategy in the ICT draft policy. 1 Ensure leadership commitment and manage the process leading to development of a national ehealth strategy. Telecommunications; Mobile phone Co; WHO X X Where connectivity exists and there is cell phone penetration, use the infrastructure to support health services delivery and information flows. Train staff in the application and use of ICT. 3 Assess infrastructure status for priority information systems coverage, status, and functioning; develop action plan in line with overall national goals. This should be done with health and ICT sector participation and in the context of a national planning exercise. Telecommunications; Mobile phone Companies $120,000 $120,000 WHO - piloting Diseases Surveillance; ADB - Rural health strengthenin g project Assess ehealth services required to support the country s priority health programs, particularly with respect to information flows. 3 Assess the services and applications being implemented across the sector, and any opportunities this provides. This should be done with health and ICT sector participation and in the context of a national planning exercise. Upgrade NHIS software to facilitate data sharing across programs. 3 0 Determine the ehealth standards and interoperability components required to support ehealth services, applications and infrastructure, as well as to support broader changes to health information flows. 3 The selection, agreement and adoption of standards should be linked to the improvement of priority services and systems. This foundational step should be done in the context of national ehealth planning. * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 14/20

15 Review TORs and membership of existing coordination mechanism so that it caters for e-health requirements 3 Establish a national steering group for ehealth, supported by a project team with planning skills and knowledge of ehealth. Assess which organizations or groups are active in ehealth, and their potential role in the development of a national ehealth program. Incorporate data protection requirements in the health sector ICT policy currently under development ensure that it is in line with national ICT legislation and Regulatory Requirements 3 Assess current legislation, regulation and policies for their appropriateness and potential revision towards supporting improved ehealth environment. This should take place in the context of a national ehealth planning process. Enforce compliance to data protection policies 3 0 * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 15/20

16 MONITORING OF RESOURCES Procure short term technical assistance to assist to realign the NHA framework to international guidelines. 1 Apply/validate one national health accounts framework X X $30,000 $30,000 Funds Re-establish NHA governance and coordination mechanism in collaboration with relevant stakeholders. 1 Stakeholder workshop to establish governance and TOR Treasury, Planning, Finance, PNGDF, CSO, NSO, WHO Strengthen and consolidate the role of the SWAp and HSPC as forum for dialogue and partnership engagement 2 TA (via IHP+) for the development of a "compact" Reactivate the steering committee. 1 Regular meetings of technical steering committee Expand the membership of the NHA team to involve additional stakeholders in the NHA process Treasury, Planning, Finance, PNGDF, CSO, NSO, WHO x x x x $15,000 $15,000 GoPNG 1 Recruit and train dedicated staff on system of health accounts 2011; Train staff directly involved in NHA and collaborate with other GoPNG Departments and research institutions. 2 Technical support and training in NHA at national and district level Match government codes to NHA codes and adapt NHA IT conversion tool for PNG NHA Develop database for production of NHA 1 Development of IT tool for mapping and conversion of data to NHA 2 Consultant for development of database WHO; Academia & research Institutions x x $90,000 $20,000 $70,000 WHO * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 16/20

17 Ensure that NEFC expenditure analysis data is used for decision making at provincial and national levels When available to disseminate NHA report and analyses on public website Advocate for /promote use of NHA data in policy making process - conduct RMNCH sub accounts 3 Training workshops for production of reports 3 Establish central website for dissemination of results (links with national observatory) 2 Meetings with policy makers to identify needs and integration of NHA data in policy process WHO; DNPM; Treasury x x $30,000 $30,000 Funds * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 17/20

18 REVIEW PROCESSES Undertake timely joint annual sector reviews that are based on the goals, targets of the NHS 3 Workshops to prepare for reviews including field visits Involve the private health sector in health sector reviews and synchronize these with GoPNG planning and budgeting cycle, to ensure better quality of the annual review process 3 Use /apply process for assessing national planning process, such as IHP+ JANS Conduct annual RMNCH appraisals and ensure that findings feed into the health sector reviews 2 Prepare report of RMNCH review to inform health sector review Train staff in the preparation of analytical reports that inform annual joint reviews Commission qualitative independent annual sector reviews that complement joint reviews based on quantitative NHIS data 2 Prepare and discuss good synthesis of results and information based on analytical report 1 Conduct workshop with all key stakeholders to analyse/discuss the results and other contextual information DPLGA, UNICEF, UNFPA, WHO, NSO, CSOs X x $200,000 $200,000 WHO,, NZAID, AusAID, Consolidate existing mechanisms and processes for resource allocation and planning Provide planning guidelines that ensure district planning is an all inclusive process Monitor DP compliance and alignment with the health sector M&E Strategy and Plan of the national health plan Use the HSPC to monitor DP alignment with GoPNG priorities IHP+ approach to develop compact 3 Joint field visits as part of preparation of reviews * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 18/20

19 ADVOCACY & OUTREACH Advocate for parliamentarians to establish a forum to address RMNCH issues at the highest political level 2 Identify RMNCH champions among the parliamentarians to advocate for RMNCH issues. Advocate for the establishment of an umbrella CSO coalition with a focus on RMNCH Provide guidelines that ensure health promotion messages developed by NGOs are in line with health promotion policies. Work proactively with the media to strengthen their capacity to report on RMNCH related issues and identify media champions on RMNCH issues. Make relevant information available to the media and train some media personnel in reporting on monitoring the implementation of the Global Strategy Proactively make information on the Global Strategy available to the media Establish a Countdown Events Coordinating Committee to prepare and convene the count down event 1 National Parliament UN Agencies x x x x $50,000 $50,000 UNFPA PNG Media Council and DPs x x x x $30,000 $30,000 Funds 1 2 * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 19/20

20 Coordinate the preparation of a PNG country-driven Countdown report using all available evidence 1 Compile, print, launch and disseminate /CCC DPs, CSOs X $60,000 $60,000 Funds TOTALS $1,750,000 $250,000 $1,500,000 - Needs s CRVS $520,000 $75,000 $445,000 Monitoring of results $250,000 $40,000 $210,000 MDSR $355,000 $25,000 $330,000 ehealth & Innovation $120,000 $120,000 Monitoring of re $165,000 $80,000 $85,000 Reviews $200,000 $200,000 Advocacy $140,000 $30,000 $110,000 TOTAL $1,750,000 $250,000 $1,500,000 * This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. Page 20/20