Name of Activity: Task Team Leader: Division: Bank-Netherlands Partnership Program CY05 Capacity-building: Full Proposal Submit to bjuntunen@worldbank.org, with cc to rencarnacion@worldbank.org, and Manager of the designated TTL by e-mail c.o.b. September 13, 2004. There will be no extensions. Building Capacity in Africa for Private and Public Sector Partnerships in Reproductive and Child Health Abdo Yazbeck, Lead Economist, HNP Program Leader, WBI WBIHD Extension: 81638 E-mail: mhelleranta@worldbank.org 1. Program-related Information (Max. half a page) a. Expected Outcomes: 1) Develop the capacity of key actors in the health sector (government, academia, and civil society) in Africa to design and implement appropriate policies to promote the development of the private sector in Reproductive and child health to help the achievement of the MDGs. This outcome includes the capacity to conduct an appropriate assessment of the health sector which understand the appropriate role for the private sector which will optimize the achievement of the MDGs, and ultimately contribute to poverty reduction; 2) Strengthen the capacity of existing institutions in Africa (including WBI s 3 existing partner Training Networks in Africa) to customize and deliver learning products designed to support the development of the private sector in the health sector to help achieve the MDGs; 3) Two customized courses for the Africa region on private and public sector partnerships for the health sector, with specific emphasis on reproductive and child health. b. Target Audience in general (give reasons for selection): Since the objectives of the course are to develop the capacity of key actors to design and implement policies to promote the development of the private sector, and of existing institution to train key actors to achieve the primary goal, the courses will target: 1) Senior and Mid Level Government Officials Government officials not only need to have an appropriate level of understanding of the policy options available to translate in the most effective way their constituencies interests, but also an overall strategic understanding of the issue is key to ensure proper dialogue other actors in the process. 2) Development Agency Officials Development agencies are key actors in the process of policy making for the health sector in Africa more than any other region of the world. These agencies are the source of significant inflow of resources in the Africa region, as well as a key source of technical assistance. 3) Civil Society and Academia Civil society and academia contribute to the policy making process through technical inputs, consultations, and ensuring transparency. 4) Private Sector Players Business entrepreneurs and Not-for-Profit groups in the health sector are an important aspect of the equation to build effective policies to promote the development of the private sector. They will benefit from developing policy making skills, and provide inputs to the policy process.
2. Strategic Alignment (Max. one page) Bank-Netherlands Partnership Program CY05 a. How will this program enhance the value of specific Bank projects? The role of the private sector in the delivery of reproductive and child health services in Africa has grown significantly over the past 10 years. Recent household surveys from many African countries indicate that private providers play a substantial role in health care delivery, even to the poor. Most experts agree that ignoring the private sector, given its large sphere of influence, is unwise, and - in the long term - unsustainable as a strategy to deliver health. However, the knowledge base on policies to enhance the contribution of the private sector to health objectives is weak. The availability of rigorously evaluated interventions in developing countries is especially low. Nevertheless, some knowledge does exist. Given the critical influence of the private sector on key health targets, it is imperative that policymakers, analysts and technical specialists are exposed to a conceptual framework, best practices, tools and insights of the early experiences of working with the private sector. WBI developed a highly successful learning program on this issue that is targeted for Asia. The Africa Region has requested that WBI adapt this learning program for the Sub-Saharan Africa region. The World Bank Africa region has developed an extensive health sector strategy note to establish the principles and prioritization criteria for the Bank engagement in the health sector and coordinate the VPU actions in the region. In the strategy note, the regulatory environment for the private sector was considered one of the main limitations to its growth, and promoting the development of the private sector was prioritized as a key element to increase the provision of health services for the poor in the region, including increasing services to the poor. Therefore, the proposed adaptation of this learning program for Africa is consistent and aligned with the World Bank Africa region health sector strategy b. How does it link to the PRSPs of the countries involved? The Public-Private Health (PPH) program at WBI is directly related to PRSPs and the Poverty reduction agenda in Africa. Most PRSPs have prioritize to strengthen the role of private sector, including in the health sector, not only to pursue economic growth, but also to expand the pool of scarce resources for the delivery of social services This proposed learning activity will support this process by building targeted capacity in key IDA countries for impacting PRSPs and other government policies and programs related to private sector development in the health sector to achieve the MDGs. c. How does the program differ from the regular work of the Bank? This will be the first learning activity designed to address the need of capacity building to develop and design policies that promote the development of the private sector in health care. 2
3. Program Components (Max. half a page per component) Component: Total Cost (US$): 74,520 Material Development, Training of Trainers, and a Course in West Africa (Benin, Burkina Faso, Chad, Ghana, Senegal) Expected Outcomes: Development and delivery of learning activity, which comprises customized tools, and knowledge that are delivered and maintained by local institutions in IDA West African countries. Description: The proposed learning program will be a face-to-face course which will cover in depth: Analytical framework for assessing the role of the private sector and selecting a strategy to increase the contribution of the private sector to health sector or health program goals Seven key policy instruments for engaging and influencing private service providers Implementation strategy plan for (political economy issues and unique challenges associated with initiating and maintaining interaction with private actors Assessing and addressing skills and resource requirements/ planning needed capacity development to implement instruments Target Audience: The participants for this course will be the following profile of participants from 05 West African countries: (1) Senior and mid level government officials, (2) development agency officials, (3) Civil society and academia, and (4) private sector players Capacity Building and Knowledge Dissemination Tools used: The course combines a mix of conceptual lectures, case studies, analysis of policy options, and panel discussion with private sector experts. The faculty for this course will be experts in the above topics, using where possible experts from Africa. Part of faculty will be formed by real entrepreneurs to present their perspectives on the issue to participants. Measurable Monitoring Indicators: Content developed and customized for regional and language needs No. of trainers trained No. of trainees/cadres A course developed and delivered by training institution Component: Total Cost (US$): 74,520 Material Development, Training of Trainers, and a Course in East Africa (Kenya, Nigeria, Ethiopia, Tanzania) Expected Outcomes: Development and delivery of learning activity, which comprises customized tools, and knowledge that are delivered and maintained by local institutions in IDA West African countries. 3
Description: The proposed learning program will be a face-to-face course which will cover in depth: Analytical framework for assessing the role of the private sector and selecting a strategy to increase the contribution of the private sector to health sector or health program goals Seven key policy instruments for engaging and influencing private service providers Implementation strategy plan for (political economy issues and unique challenges associated with initiating and maintaining interaction with private actors Assessing and addressing skills and resource requirements/ planning needed capacity development to implement instruments Target Audience: The participants for this course will be the following profile of participants from 05 West African countries: (1) Senior and mid level government officials, (2) development agency officials, (3) Civil society and academia, and (4) private sector players Capacity Building and Knowledge Dissemination Tools used: The course combines a mix of conceptual lectures, case studies, analysis of policy options, and panel discussion with private sector experts. The faculty for this course will be experts in the above topics, using where possible experts from Africa. Part of faculty will be formed by real entrepreneurs to present their perspectives on the issue to participants. Measurable Monitoring Indicators: Content developed and customized for regional needs No. of trainers trained No. of trainees/cadres No. of courses developed and delivered by training institution 4
4. Partnership (Max. half a page) Describe the role of : a. The Regional/Sector Board partners named in the Proposal Outline Ok Pannenborg (AFTHD), Khama Rogo (AFTHD), Elizabeth Lule (HDNHE) b. Capacity building institutions in the countries involved This activity will benefit from WBI s existing engagement with three African Networks of training institutions. Based on the interest of countries and World bank operations, this project will work with, build the capacity of, and deliver courses with a subset of the institions that form the three network: The three network currently include the following institutions : Francophone Africa :Association Burkinabe de Sante Publique; Centre Africain d'etudes Supérieures en Gestion (CESAG), Senegal; Centre de Formation et de Recherche en Matière de Population (CEFORP), Benin; Centre d'etudes de la Famille Africaine (CEFA), Togo; Centre d'etudes et de Recherche sur la Population pour le Développement, (CERPOD), Mali; Institut de Santé et Développement (ISED) at the Université Cheikh Anta Diop, Sénégal; Anglophone Africa: African Population Advisory Council; Commonweath Regional Health Community Secretariat, Tanzania;Intellfit african Training Centre Inc., Nigeria; Makarere University, Uganda; Population Council Kenya; Eastern and Southern African Management Institute, Tanzania; Cape Town University; Family Guidance Associatio Ethiopia; and Family Reproductive Health Association, Eritrea. c. What is the involvement of other donor partners? No other donors support the Africa adaptation of this content. The original Asia course was supported by the government of Singapore as well as technical assistance from WHO and is expected to receive support for country customization in Bangladesh and Pakistan by CIDA and DfID respectively. d. What other partnerships are expected to arise as a result of this program? We hope to develop partnerships with the Africa Development Bank, AFRO, and WHO. 5
(Max. one page) 5. Sustainability Identify a minimum of 2 specific steps that have been incorporated into the program to ensure sustainability beyond the timeframe of the program. WBIHD will ensure technical sustainability by Planning activities to develop local capacity, aiming to ensure that these activities will be conducted even beyond Bank presence in the region/country Involving the African Diaspora Learning from experiences from other programs in WBIHD Working with local institutions to ensure continuity of programs even when there are changes in leadership Working with country networks for large countries, and regional networks for the smaller ones WBIHD will ensure financial sustainability by Implementing cost recovery as a source of financing of training activities Coordinating of other resources in the country/region, including MAPs and country HIV/AIDS resources More specifically, the program entails sustainability as well by 1) By strengthening the capacity of existing institutions in Africa (including WBI s 3 existing Networks in Africa) to customize and deliver learning products designed to support the development of the private sector in the health sector to help achieve the MDGs, WBI ensures that the knowledge is institutionalized in Africa. This process of institutionalization will ensure continuity of the program; 2) By strengthening the policy making process to promote the development of the private sector, WBI expects to improve the policy environment in which the African private sector works. As a result of this process, WBI expects that the subsequently growth of the private sector will generate demand for good policy options, which in turn will put pressure and focus in the countries to maintain and grow the capacity built in the first place. 6. Gender Explain how Gender Issues will be mainstreamed in the program. The focus on Reproductive Health outcomes means that gender norms and social factors will have to be addressed. Furthermore, analysis developed under WBIHD s Gender Health And Poverty course will be used to set in the course 7. Evaluation What provisions have been made for evaluating the program? The evaluation of each training activity will be carried through standard WBI evaluations, which includes level 1 evaluation. Tools related to monitoring and evaluation will be given to regional institutions which will can develop the methodologies further to suit their institution interests. Donors will be provided with performance review at mid term and a final evaluation addressing no. of expected outcomes reached, level of knowledge, level of policyrelated content on HIV/AIDS and Reproductive Health, appropriateness of dissemination, level of sustainability, level of impact of the program. 6
Please read the appended Notes (and ineligible items) before completing this section Expense Category Details Unit Rate Person- (US$/Week) Weeks Estimated Costs (US$) Component 1:Material Development, Training of Trainers, and a Course in West Africa (Benin, Burkina Faso, Chad, Ghana, Senegal) Consultant Fees International (3 consultants for 20 days) $ 2,000 12 $ 24,000 Local (4 consultants for 20 days) $ 1,000 16 $ 16,000 Total Travel (unit = no. of round trips) $ 7,000 3 $ 21,000 Total Subsistence 6 Consultants for 7 Days $ 60 42 $ 2,520 Other costs (please identify) 1 - Learning Materials for Participant $ 2,480 1 $ 2,480 2 - Renting of Facilities $ 5,000 1 $ 5,000 3 - Reception Dinner and Contingencies $ 4,000 1 $ 4,000 Sub-Total Component 1 $ 75,000 Expense Category Details Unit Rate Person- (US$/Week) Weeks Estimated Costs (US$) Component 2: Consultant Fees International (3 consultants for 20 days) $ 2,000 12 $ 24,000 Local (4 consultants for 20 days) $ 1,000 16 $ 16,000 Total Travel (unit = no. of round trips) $ 7,000 3 $ 21,000 Total Subsistence 7 Consultants for 7 Days $ 60 42 $ 2,520 Other costs (please identify) 1 - Learning Materials for Participant $ 2,480 1 $ 2,480 2 - Renting of Facilities $ 5,000 1 $ 5,000 3 - Reception Dinner and Contingencies $ 4,000 1 $ 4,000 Sub-Total Component 2 75000 TOTAL GRANT COST 150000 7
Bank-Netherlands Partnership Program Capacity-building CY04 TABLE 2:Estimated Disbursement Schedule Calendar Year CY05 75,000 CY06 75,000 CY07 0 Total 150,000 8