country accountability framework: assessment* sierra …€¦ · developed during a national...
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1 2 3 4 5 Govt Partner
The plan follows a logic framework that is based on the
objectives and targets of the NHS, organized around the 6
pillars.
Review the plan to incorporate
-The plan was developed under auspices of DPI with input
from HDPs, NGOs and private sector but did not include all
relevant stakeholders.
- social accountability
Addresses the monitoring results but weaker on addressing
social accountability
- resource tracking
Does not address resource tracking - monitoring flagship programmesFlagship programmes and share the plan with all the HSSG
- compacte.The plan provides a brief situation analysis and lists the
following among the key challenges: capacity, data quality,
feedback, lack of coordination of M&E activities. ,
2 M&E of specific programmes (e.g M&E of MNCH) is
aligned with the national M&E plan.
x The plan does not explicitly reference how it links to
programme specific M&E plans
DPI provide M&E framework & guidelines to specific
programmes and support in review and identify key activities
for harmonization /alignment Costing is in process as part of the JPWFIt is not clear how the major partners /stakeholders are
supporting/contributing to the M&E planThere are 2 sets of indicators. 1/ 19 indicators for
monitoring results that are consistent with the Compact.
They are mostly outcome indicators, 2/21 "key
performance" indicators (mostly inputs and outputs) that
are reported quarterly
Use M&E logical framework for mapping indicators across
result chain, and across programme areas in line with the NHS
objectives and targets
Baseline and targets for 2015 are well specified and hve
annual targets. Standard metadata is provided.
Finalise the core indicatorrs
ActivitiesAdequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)
3 The monitoring, evaluation and review plan of the
National Health Strategy is costed, and funded with
partner support.
x
1 There is a comprehensive M&E and review plan
addressing the main goals and target s of the NHS,
involving stakeholder involvement
X
Cost the priority areas for strengthening
M&E of the national health strategy (NHS) as the basis for information and accountability
Actions
4 There is a balanced and parsimonious set of core
indicators with well-defined baselines and targets.
x
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 1/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
The plan focuses on the routine HMIS. Explicitly list all data sources and dataSome weaknesses in data availability are identified but
there is no coordinated plan to address gaps/weaknesses.
Vital Statistics - there is a good section on plans for CVRS
Health surveys: This is missing.(see section on CRVS)
Strengthening DHIS Develop a coordinated survey plan with calendarThere are problems with timeliness/completeness and
quality. There are significanty capacity issues at the PHU
level (reports required by 8 of every month)
Fragmentation and burden of reporting systems (HIV; TB;
malaria)
Convene key stakeholders (DPI, DPC) and develop a plan for
strengthening a robust common HMIS (based on a cost
effectiveness analysis)
Weekly and monthly reporting systems but hospitals are
not includedBuild capacity at chiefdom level for data collection, entry and
consolidation and transferChallenges in accessing HMIS data at all levels
Training and supervision of PHU Facility assessments (e.g SARA) , quality of care
assessments,Enhance data analysis capacity at the district level
HR databaseImplement an independent data verification mechanisms
Logistics Information management system InfrastructureNHAs (see section on resource tracking)
6 Responsibilities for data collection and management
and analysis for the M&E of the NHS are specified.
X The responsibilities for HMIS are provided. Not clear who is
responsible for other data collection efforts (surveys, etc..)
Mapping of roles and responsibilities of different stakeholders
Data quality will be assured through periodic DQA 1. An annual system of data verification through annual facility
assessments, including record review2. Training and supervision
8 Analytical outputs (performance reports, statistical
abstracts etc.) are defined and produced.
x The content of the analytical products are not detailed (eg.
Analysis of progress towards goals, equity, efficiency,
district performance etc),
Define analytical outputs
9 There is an effective data sharing mechanism
specified , including public access to date and reports
X Country health observatory (including web based access )
5 The data sources for the core indicators are clearly
specified including plans to strengthen critical data
gaps/weaknesses.
X
7 Regular data quality assessment and analysis work is
specified.
X
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 2/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
StrengthsHighlight the broad themes (pillars) focused on health system
strengthening that are fundamental to MNCH
Free health care initiativeReview and finalise RMNCH strategy (mandated by the national
strategy) with broad consensus
S: Use of MDG indicators related to RMNCH are in place
Weaknesses/gapsFormat (pillars) of strategy gives the emphasis to health
systems strengthening but MNCH is actually a goal of the
strategyS: There are many indicators on MNCH in the M&E draft
plan of the operational plan (JPWP)Develop / strengthen M&E component of the RMNCH strategy
W: Some of the indicators in the RMCH strategy do not
match the JPWF M&E plan or international standardsRevise RMNCH indicators in M&E plan to international
standards before finalisization and ensure RMNCH plan is in
line with national strategy, JPWF and its M&E plan
3
The M&E plan for RMNCH covers all aspects of
reproductive maternal, newborn and child &
adolescent health
x
S: the M&E framework of the RMNCH strategy covers all
issues; but is not well situated in national strategies, plans,
context
Revise RMNCH strategy and M&E framework to fit within JPWF
4The monitoring, evaluation and review plan of the
MNCH strategy is costed. x The RMNCH strategy has been costed
A final, revise RMNCH strategy and plan will also need to be
costed
5The monitoring, evaluation and review component of
the MNCH strategy is funded with partner support.x
RMNCH activities are funded through MOHS with donors
support but it’s insufficient
Secure donor support for critical aspects of the MNCH activities
in the JPWF
6
There is a balanced set of core indicators with well-
defined baselines and targets (covering input, output,
outcome and impact )
x
M&E plan for the JPWF has a fairly balanced set of RMNCH
indicators but some are not according to international
standards
Revise list of indicators and standardize
7
The data sources for the core indicators are specified
clearly, with an analysis of gaps and plan to address
those deficiencies
x
M&E plan’s Indicator matrix for JPWF does not list HMIS as
a source of data for key indicators but in the Indicator
Definitions section of the same document - it is correct
Make sources of data for indicators consistent throughout
document
DPI should coordinate but they need to be strengthenedPeople are specified but they need support in terms of training,
additional staff, and logisticsCoordination between programmes is weak
Shortage of human resource (MCH aides are overloaded)
A coordination mechanism could be strengthened between the
different programme to avoid parallel systems of data
collectionLogistical problems (transport, cost)
Supervision needs to also be standardized across the sector (ex.
Checklists, forms and registers)
Supervision is done quarterly, collection of data monthly –
weakness See above
See section on HMIS for actions related to data qualitySupportive supervision for RMNCH staff, and training
2
There is a comprehensive M&E and review
component of the MNCH strategy addressing the
main goals and targets, and linked to M&E plan of
NHP.
x
1MNCH is a prominent component of the National
Health Strategy,x
8Responsibilities for data collection and management
for the M&E of the MNCH strategy are specified.x
9Regular data quality assessment and analysis work is
specified.x
Bulletins are produced (but not quarterly as planned) due to
work load
Recruit staff and increase capacity of existing staff in the DPI to
create programme specific reports with statistical analysis of
the data
10Analytical outputs (performance reports, statistical
abstracts, profiles etc.) are defined and produced.x
M&E plan of the (R)MNCH
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 3/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
There is database “DHIS” which produces core indicators
covering different areas, but the timeliness and
completeness, accuracy of the data are challenges.
Recruit Data entry clerks as permanent staff for data entry at
PHC and Hospitals.
District capacity for data management is weak due to staff
shortage
Scaling up of supportive supervision activities for improving
data Hospitals do not have capacity to summarise their data at
district level due to lack of M&E staff and patient base
system
Employ part-time teachers for supporting PHUs to complete
and analyse data at PHU level
Provide supports such motorbikes, fuels and DSAs for zonal
supervisors to collect monthly returnsThere is a plan for household survey and some are regularly
conducted while there are some other surveys which are
not regular. However, those are not integrated effectively.
Conduct annual DQA for all routinely collected data.Carry out annual DQA in sample of facilities, using verification
and assessment of readiness. (Adopt EPI module to guide the DQA)
Performance report was produced in this year but it was not
for annual reviews.
DPI and DPC jointly coordinate quarterly reviews to realize
integrated review meetingsReview meetings conducted at program level, not
integratedDPI, jointly with DPC conduct annually review using data
DPC holds quarterly review meetings using the data
collected from DHIS of DHMTs, but not integrated with
other programs
DPI also holds annual review for performance assessment of
the districts, but it does not include analysis of data
Enhance analytical capacity, e.g. MOH, country institutions,
social statistics health branch of statistics office
5Equity analysis and reporting receives special
attention.x
All surveys disaggregate their data into urban rural, district
and by wealth quintiles. Continue such disaggregation for all surveys.
6
Each year a health statistical abstract is produced
within one year of the preceding year, with district
details.
XNot yet produced. A performance report is available but not
yet produced.Produce regular annual health statistical reports.
7Each year, a comprehensive analytical report is
produced to inform the annual reviews.x MoHS produces analytical annual review report Continue reporting
DHIS launched online with a Dashboard
Develop a web based Observatory.
Develop / strengthen national database or warehouse
1
There is functioning database of up to date health
facility and administrative data by district for the core
indicators.
X
To assign M&E sub-committee to coordinate the
implementation of the national household survey plan
(including costing).
3There is a publicly available annual assessment of the
quality of data generated by health facilities.x
2There is a regular household survey programme that
collects data on the key health indicators.x
Assessment is done for EPI program and not for all
routinely collected data.
4Data analysis for annual reviews is done, using all data
sources in a systematic manner.x
MoHS has a website at which some data is published.
9Web-based and other electronic reporting systems
are used increasingly and work well.x
8
All reports and data are available on the web (mostly
MOH website, example through national health
observatory).
x
There is electronic reporting system such as DHIS and
CHANNEL, but they are not web-based
Monitoring Practices
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 4/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
1Institutional roles and responsibilities are well
specified in the M&E of the NHS.X
Institutional structure is defined but roles and
responsibilities are not definedDefine the roles and responsibilities clearly
2
there is an active M&E coordinating committee that
provides a platform for support to the one country-
led M&E of NHS
X M&E coordinating committee has been reactivated. Expand partnerships / memberships including all stakeholders
of various groups
3The statistical office has the capacity and is
supporting MOH in the M&E.X
The statistical office conducted survey and assigned
statisticians to MOH, but the office do not attend some of
the important coordination meetings
Develop the capacity of the statisticians on health issues and
analyzing health data.
4
Academic and research institutions have well defined
roles in the data quality and analysis work related to
M&E of the NHS.
X Not yet Define roles
Capacity is lowCollaboration is not proper among institutions
7
The country's institutions are used to carry out
independent verifications of administrative and
facility data.
X It has been done but mainly with external experts Build the capacity
6There is good analytical capacity in the country's
institutions.X Build the capacity for analysis of health data
Institutional capacity
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 5/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
Human resources are weak (e.g. numbers, and skills –
inadequate in-service training; computer skills)
Situation analysis of CRVS (e.g. UNICEF review) needs to be
disseminated to all stakeholders for policy and planning
purposesNo computerized data base
All Districts have district registriesUpdate the Birth and Death Registration Act and develop a
Policy to advance implementationActivities contingent on birth and death registration act –
policy needs revisionsPositive aspect is CRV is in MoHS which is aware and
support need to strength registration system ….in parallel to …
Birth registration is increasing as awareness (free health
campaign; mass registration, etc) grows – people also
register deaths
Develop and identify funding for implementation of a National
Strategic Plan for Civil Registration and Vital Statistics system
(CRVS) strengthening including Human resources, training,
infrastructure, computerized database, logistics, transport,
community sensitization, and financing)
Currently being used; Establish a data base for district and national offices;Annual Statistics report of births and deaths are
disseminated and followed publicly.Data disaggregated by age, sex, and location but more
analysis needs to be done
Recruit and train data entry officers, statisticians to do the
analysis
Pilot
projects;Private
sector
supportMedical certificate of cause of death (hospital certified
deaths) is working
Improve hospital reporting, e.g. through introducing IT, ICD
trainingNon-certified deaths at community are not all registered
especially in rural areasSensitizing campaign with community leaders to ensure
community deaths are reportedExplore options to create a DSS in SL.
Community surveillance system for vital registrationNeed external assistance to raise the priority of strengthening
CRVS
Raise awareness of the critical value of vital registration for
social and economic planning
MoHS TA
2Results from the birth and death registration are used
for vital statistics.X
1There is a national birth and death registration system
that functions well.X
MoHS TA
MoHS TA
4There is use of innovative methods to strengthen
birth and death reporting.X ICT coverage is weak nationally
Create a pilot project to test approaches to improve
community reporting, with the help of innovative methods
using ICT
3An assessment of the CRVS status and practices has
been done in the last 5 years.X UNICEF did assessment but did not provide report Carry out systematic assessment using WHO tool
5Hospital reporting are reporting deaths, with a cause
of death, using the ICD.X MoHS
No DSS exists currently
MoHS Partners
Univeristy Partners
7The government is highly committed to strengthening
the CRVS and make investments.X
Accessing adequate funds and even those funds that have
been allocated for CRVS remains a problem
6There are local demographic surveillance sites and the
results are used for monitoring progress.X
Civil Registration and Vital Statistics
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 6/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
1
There is a national policy requiring notification of all
maternal deaths (maternal is a notifiable event -
within 24 hours)
Yes – but community death are not well reported; ok for
institutional deaths
Death reviews require a revision of national law which is not
beginning)
System has been developed but just beginningSupport the scaling up of the WHO/UNFPA maternal death
audit system
Hospital investigations are taking place but investigations in
community are few
Ensure District Health Sister is on the investigating team along
with the investigating midwife as this is her jurisdiction.
Yes, mostly being done Reinforce the importance of reporting deaths (provide training)
Past silence about maternal deaths; review found
inaccuracies in some facilities; others were correct
Need clarity on working definition (issue of days after
pregnancy, abortion)
4The maternal death reports are of good quality and
forms the basis of actions to improve the situation.x
Training is focused on leading cause of death in SL; but
analysis is not local, or regularly analysed to be district of
community specific.
Districts are supported to analysis their data on maternal
deaths and define their training needs; national training
support is targeted based on district needs
6Innovation (IT) is used to get faster and more
complete reporting of maternal deaths.x IT for referral but not reporting of death See action under Civil Registration and vital statistics (CRVS)
Maternal death reviews have not been done regularlyNew system being established and scaled up
2There is a system of maternal death reviews / audits
that works well (facility, community ).x
7The maternal death review and response system is
regularly reviewed and the results are used for x
3Hospital reporting of maternal deaths is nearly
complete, with an accurate cause of death.x
Maternal death surveillance and response
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 7/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
The MoHS has start the process of developing a healthy
financing policy.
Support and complete the development of health financing
policy
There is a system for tracking govt budget and expenditure,
the IFMIS. The IFMIS however only track govt expenditure.
It does not track donor, FBO or NGOs expenditure.
Get secure funding to institutionalize NHA.
One NHA has been conducted in 2007 to track budgets and
expenditure. There is an ongoing NHA.
Facilitate the capturing of all donor health expenditure in the
IFMIS.
There is a committee to coordinate NHA implementation.
Funding for NHA (two year cycle) has not been regularly
available. Initiate the conduction of an MNCH sub-accounts.Secure funding for MNCH sub-account
There is a protocol that is followed.
Low capacity for analysis.
5
The institutionalization of resource tracking data (in
particular RMNCH resources) is planned and on its
way to being implemented.
x It is not yet planned. Include in the HIS plan as a sub-account.
Results have been used to inform policy. The previous NHA
contributed to the FHC policy and increasing budget to the
health sector. Policy briefs were not widely disseminated
7Technical programme officers are involved in the
system.x Yes
Only one NHA has been done since 2007. It is not done
every yet and data is not produced every-year. The current NHA is planned from 2007 -2010. There is
however doubts over the accuracy of the data.
9Review of resource tracking information, its
indicators, its production, and its use, is ensured.
Validation of the NHA information is conducted.
Information is disseminated and used by policy makers and
at policy dialogue
Strengthen communication and use NHA results.
2 There is a system of tracking expenditures for MNCH. X
1There is a national system of tracking budgets and
expenditures.X
No system for MNCH. There is a plan to initiate MNCH sub-
account.
Institutionalize NHA and make it timely.
4
Government and donor budgets and expenditures are
tracked annually, consistent with the national health
accounts framework
x Strengthen capacity for analysis.
3There is an effective country-led coordination
mechanism for tracking health expenses x
The HF sub-committee and an NHA technical working
group. These coordinate the implementation of the NHA.
Disseminate policy brief widely to increase its use.
8Data is produced every year and easily accessible by
all.x
6Results are used and integrated in the development
and monitoring of policies.x
National Health Accounts/resource tracking
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 8/16
1 2 3 4 5 Govt PartnerActivities
Adequacy (1–5) Situation analyses
(strengths, weaknesses, gaps)Actions
Roles/Responsibilities
COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra Leone
S: Partners are increasingly showing commitments to health
sectorWHO Programme review guidelines to be shared
W: Lack of a calendar for reviews at sub-national levels
Develop a calendar & a standard format for reviews at
subnational level and programs.
2The results of the review meetings are used
extensively in the planning process.X
S: Planning tools sent to districts using review report as
baselineS: Health for All Coation active in country. Revise existing TORs
W: Overzealous behaviors of some Civil Society personnel (Further dialogue/engagement of Civil Society personnel)
W: Low orientation of roles of Civil society in health Involve/orientation of Civil Society in M&E activitiesCSOs to support Facility Management Committees to be more
functional.Evaluate Pilot Community Self-monitoring mechanism; and
scale up as appropriate
4Development partners are well represented in the
national reviews of the NHS.X S: Existence of Compact
Develop progress and performance reports
Develop summary bulletins, dashboards for decision-making
S: DHIS system exists by district. Further analysis of data at sub-national levels
W: Hospital data not included in DHIS.Implement more District performance assessments to guide
resource allocation Weak linkages between Program & reviews. Make data more accessible to programs
Weak coordination mechanism at central level for reviews Reconcile the dates for program, subnational and national
reviews (review calendar for health sector)
President’s Flagship projects.The presence of Parliamentary oversight Committee on
Health is not felt in most places.
3At least one high level event per year to share findings
and agree on follow up actions to be takenX Health summit is being planned
4At least one national Countdown meeting is
conductedThink about it!
Review practices
1Regular annual multi-stakeholder review meetings are
conducted.X
Action and advocacy
6The reviews are informed by a good synthesis of the
available monitoring data.X
W: programs are experiencing problems in access & use of
analyzed & synthesized data
3Civil society organizations have a strong voice in the
review of progress and performance.X
X
Involvement of Local Councils in the decision making
process1
There are mechanisms in place to translate
results/evidence to make resource allocation
decisions,
X
8
Programme specific reviews (e.g MNCH reviews) are
aligned with and the results/decisions feed in the
annual sector review
X
Strengthen their engagement in monitoring2High level parliamentary group is engaged in
monitoring of results and accountabilityX
7The reviews have a strong subnational focus which is
well informed by data.
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 9/16
2012 2013 2014 Total
Finalize health sector M&E plan (results
and accountability framework) for launch
end 2011,
Consultant (10 days) to finalize plan
1 day stakeholder workshop (50 people ) for final review and
validation, including costing and funding by partners
Production, dissemination and launch (290 copies)
Health sector M&E plan finalized, endorsed
and funded by the HSSGDone Printed and launched by the end of 2011
Develop National HIS policy Short term technical assistance (14 days), fund for consultative
workshops and dissemination meetings56,300 56,300 GAP
MOHS expectes to be covered by WHO; therefore
WHO needs to mobilize resource
Review and update HIS strategic plan Short term technical assistance (4 days), fund for consultative
workshops and dissemination meetings 29,900 29,900 GAP
This is revision of the A&R Framework MOHS expectes
to be covered by WHO; therefore WHO needs to
mobilize resource
TOTAL 86,200 0 0 86,200Output: Strong M/E plan of
RMNCH acceleration plans,
with strong alignment to NHS
M/E Plan
Align MNCH M/E plan with NHS,
including harmonization and alignment
of core indicators
Consultant to review and work on harmonization of MNCH plan
Hold a consultative meeting with stakeholders
Harmonized set of core indicators and
extended set of programme indicators for
MNCH GAPThe output/activity is not costed and not captured in
JPWF
Develop and implement plan for
strengthening of nationally integrated
routine HMIS that provides timely and
accurate monitoring
Convene key programme stakeholders (DPI, DPC) and develop a plan
for strengthening a common HMIS
Design harmonized data collection forms/tools
Recruit firm for further customization of DHIS including development
of revised forms, electronic medical records and improvement of
performance and functionality
Train national counter parts to manage national HMIS
Plan for integrated HMIS developed and
validated by all programmers
Number of facilities with revised harmonized
tools 287,350 485,604 171,804 944,759
WB and GF; but
there is GAP of
265,158
Resource avialable = 440,000 from WB for DHIS
customization and training; 239,600 from GF for
training, printing of tools, anti-virus- a total of 679,600;
WHO provides technical support
Build capacity of district HIS units Recruit data technicians for all districts to support chiefdom level HIS
activities
Employ existing teachers to provide part time support to PHUS to
complete and analyse data at PHU level on time
In-service training for district and hospital levels (1 week in-service
training for 260 district and hospital staff)
Procure vehicles and motorbikes to coordinate HIS activities at district
and hospital levels ( 50 motorbikes, fuel and DSAs for zonal
supervisors)
Strengthen supportive supervision to include activities to data
collection at PHU
42,760 64,498 28,453 135,711
WHO and GF; But
Gap for training,
and salary of the
M&E staff for year
2013 and 2014
Resource avialable =(700*13*12=109200) from WHO
for M&E officers and the procured ICT materails;
Training is for year 2012 covered from GF. WHO is
expected to continue support - therefore, mobilize
resource for continueing support
Strengthen ICT to enhance collection,
analysis and dissemination
Strengthen equipment and ICT infrastructure for DHMTs and hospitals
(50 computers & accessories, 50 LAN equipment, 22 internet modems
for hospitals)
Develop web-based DHIS in all districts
91,500 45,000 45,000 181,500
WHO and GF; But
Gap for anti-virus,
modem/internet -
for 2013 and 2014
WHO procured ICT materials for Districts; GF paid for
anti-virus and internet service of 2012
Revise standard case definitions for all diseases under surveillance15,300 0 0 15,300
Train DSO and laboratory officer on specimen management 15,300 0 16,868 32,168Establish functional epidemic management committees at national and
district levels10,200 10,710 11,246 32,156
Train technical staff in basic epidemiology, public health surveillance
and outbreak investigation0 26,775 0 26,775
Conduct refresher training for PHU staff in IDSR 0 133,875 421,706 555,581
Train personnel to master degree level competency in epidemiology,
public health surveillance and lab management at national and regional
level
0 78,750 82,688 161,438
Payment for telephone connectivity 1,000 1,050 1,103 3,153
Train staff in use of electronic transfer system for IDSR 0 44,625 93,713 138,338
TOTAL 41,800 295,785 627,323 964,908
Output: Strengthen and
Integrate IDRS
Strengthen and Integrate IDSR into
national HMIS
Output: Districts have
functioning and up to date
databases of health facility
and administrative data for
the core indicators
Sierra Leone
Catalytic
funding
request
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap*
Remark
2.1 Strengthening Monitoring of results
1. Strengthen M&E plan based on the IHP+ criteria
Budget from JPWFActivity Area Activities Inputs
Objectively verifiable indicators
Output: Strong M&E plan of
NHS, including the HIS
strategic plan
Source
2. Monitoring results - practices
The MoHS is expecting fund from DFIDGAP
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 10/16
2012 2013 2014 Total
Sierra Leone
Catalytic
funding
request
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap*
RemarkBudget from JPWF
Activity Area Activities Inputs
Objectively verifiable indicators
Source
Assess HRIS at district and national level and develp an an induction
plan (assessment ) - Done
Conduct workshop to discuss design of the HRIS (1 day x 25 people)
Develop a data base for HRIS (consultant x 60 days)Install database and forms in DHMTSImplement Phase 2 and 3 using the lessons from phase one:Conduct a short training on HRIS for HR staff and responsible staff in
DHMTs (Training of 12 national plus 26 DHMTs)Printing of revised forms (print 1500 copeis of forms)HR data collection, verification, and populate to HRISConduct reviews and produce reports
TOTAL 458,255 0 0 458,255
Develop a coordinated survey plan for
implementation of household surveys,
facility assessments including quality
assessments
Development of survey plan and calendar Coordinated survey plan
0 0 0 0 WHO provides technical support
Conduct DHS or MICS 2,310,000 0 0 2,310,000
WB and others for
DHS; but MICS-GAPWB is supporting as contribution
Complete mapping of health facilities0 52,500 0 52,500
WB supported 2012;
but Gap for 2014
WB is supporting HF mapping in 2012; but there may
be gap if it is going to be conducted in the next years
Provide TA to conduct the assessmentn (SARA 2013) 80,000 84,000 88,200 252,200 25,300
Conduct training of data collectors (SARA 2013)
Provide Hands-on training on analysis and report writing (SARA 2013)
Edit and print SARA 2012Conduct District level household survey
540,000 0 595,350 1,135,350 GAP
Develop annual DQA report for routinely
collected data
Consultant 1 month to develop DQA report on routine data40,000 40,000 44,100 124,100
GF supported 2012,
but GAP for 2013
&14
2012 is covered from GF (40,000)
Conduct independent data
verification/record reviews and service
delivery assessment to verify data quality
(for PBF etc)
Annual sample of health facilities (data colleciotn , teams, supervisors,
transport. 80,000 84,000 88,200 252,200
WB supported 2012,
but GAP for 2013
&14
2012 is covered from WB
Output: Data analysis,
including equity analyses is
completed and ready for
health sector reviews
Conduct analytical and data use
workshops at national and district level
bring all data together, conduct analysis
and build capacity
a one week workshop for hands- on capacity building in data analysis
for national and district M&E officers54,675 45,360 47,628 147,663
WHO supported
2012, but GAP for
2013 &14
10,050 WHO provided hands-on training on analysis for 2011
performance report preparation for national and
districts. WHO has plan to continue support for 2013
and 2014 but needs resource mobilization
Develop comprehensive annual analytical
report of progress and performance
based on data from all available data,
with adequate attention to equity
Technical support to produce the report
5 day retreat to consolidate and get consensus on health sector
performanc report
Production and printing and dissemination of annual report
28,964 29,844 30,404 89,211
WHO supported
2012, but GAP for
2013 &14
10,137
WHO has plan to continue support for 2013 and 2014
but needs resource mobilization
Develop summary bulletines, data
visualisations (dashboards) for decision
making
1 month consultant to support in production of statistical abstracts23,500 23,875 24,268 71,643 GAP
Develop web-based observatory/data
warehouse with dashboards, HIS
summary bulletins, reports, analyses for
reviews and decision making processes
GAP
The output/activity is not costed and not captured in
JPWF; But JPWF/HIS component 6.3.9 says Health
Sector Resource Center established and functional
Conduct systematic qualitative analysis
of al policy and other health information GAPThe output/activity is not costed and not captured in
JPWF
25,625
Conduct annual facility survey of service
readiness /in conjunction with DQA -
record reviewWHO supported
2012; but Gap for
2013 & 2014
Output: Strengthen and
Integrate HRIS system)
2012 Minis SARA is covered by WHO. WHO will provide
TA support 2013 and 2014 SARA and needs to mobilize
resource
WHO
WHO supported establishemnt and is continuing
supporting implementation. Therefore, mobilize
resource for continuing the support (implementation
of phase one and two)
Strengthen and Integrate HRIS into
national HMIS
Output: All reports and data
are publicly available on the
web (e.g. MOH website,
observatory)
Output: A regular mechanism
for data quality assessment is
in place
Output: Each year, a progress
and performance analytical
report and a statistical
summary is produced to
inform health sector reviews
Output:
Regular household and facility
surveys are conducted to
collect data on key health
indicators
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 11/16
2012 2013 2014 Total
Sierra Leone
Catalytic
funding
request
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap*
RemarkBudget from JPWF
Activity Area Activities Inputs
Objectively verifiable indicators
Source
There is an active M&E
coordindating committee that
provides a platform for
support to M&E plan
Regular meetings of the M&E SG
committee
Actively engage and invite key
stakeholders
Map out instituational roles and
responsibilities for all the key
stakeholders
20,000 21,000 22,050 63,050 GAP
The coordination mechanism at national levekl is
functioning well. But district level is not yet
established; WHO provides technical support
Recruit 2 statisticians, 1 demographer, 1 epidemiologist, 2 planning
officers, 4 IT officers, 1 web master
In-service training for HIS staff at national level (2 weeks x 30 staff)
Strengthen ICT infrastructure (computers, LAN equipment, transport 91,500 45,000 45,000 181,500
GF, WB & WHO for
2012. but GAP for
2013 &14
164,388
GF covered the expense of VSAT, in-service training,
printing of tools for 2012; And WHO supporting as
requested MoHS district-level M&E Officers and TA for
all M&E and planning processes.
Recruit one international consultant and local M and E officers
Provide technical support (capacity building) in planning,
implementing, and monitoring of health sector planning and M&E
activitiesSupport study tour and international
conference on best practices6,000 6,300 6,615 18,915 GAP
Strengthen capacity for analysis in the
country institutions
Analysis workshop at national level for all statisticians , including data
quality work 8,000 0 0 8,000 GAP
Output: Country institutions
are used to carry out
independent verification of
data
Engage country institutions to carry out
independent verifications of
administrative and financial data GAPThe output/activity is not costed and not captured in
JPWF
Strengthen capacity of DPI and DPC Institutional capacity is
srtrengthened
2.2 Strengthen Institutional capacity
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 12/16
2012 2013 2014 Total
Sierra Leone
Catalytic
funding
request
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap*
RemarkBudget from JPWF
Activity Area Activities Inputs
Objectively verifiable indicators
Source
Conduct systematic assessment of
current situation to be conducted and
disseminated to all stakeholders for
policy and planning purposes (or obtain
UNICEF assessment)
TA from WHO to adapt and implement assessment tool
2 day workshop for situation analysis
Develop and identify funding for
implementation of a strategic plan for
strengthening CRVS (including HR,
training, infrastructure, database,
logistics, transport, community
sensitization and financing)
Consultant x 6 months for policy and plan development and costing
Workshop for validation and dissemination of plan
Output: The government is
highly committed to
strengthening the CRVS and
make investments
Update the Birth and Death registration
Act and develop a Policy to advance
implementation 126,300 128,385 1,874 256,559 GAP
Develop a database for district and
national offices to access data
Firm hired to develop database and train users
2 computers in all districts (26) plus 4 at national office
Cell phones for each district and national office
Improve hospital reporting through
introducing ICT and ICD training
Convene meeting with hospital directors on vital reporting on ICD
Training of providers (100) on use of ICD codes, accurate identification
and compilation of cause of deaths
Increase capacity to strengthen CRVS -
data entry and analysis of vital event
data
Recruit and train data entry staff for all districts and national office (13
plus 2)
Training of trainers
2 week training for 30 district and national level staff
Conduct sensitization campaign for
community reporting of deaths
Sensitization campaign in 13 districts with 10 staff - 2 weeks
13 vehicles - hire
Output: There is use of
innovative methods to
strengthen birth and death
reporting
Create a pilot project to test approaches
to improve community reporting, with
use of ICT
Contract institute to develop and conduct pilot study on ICT
xx computers and equipment
Evaluation of cost effectiveness of pilot study
Convene meeting of the taskforce and other stakeholder to assess
options for scaling up
57,478 8,528 8,528 74,534 GAP
Output: There are local
demographic surveillance sites
and the results are used for
monitoring progress
Explore options to create a DSS Map district for DSS data collection
Training of data collectors for DSS0 210,000 220,500 430,500 GAP
Output: An assessment of the
CRVS status and practices has
been done in past 5 years
GAP
8,500
Output: A national birth and
death registration system that
functions well, with increased
quality of data and capacity
for analysis
127,410
0 0 8,500 GAP
183,11045,70010,000
2-3 Strengthen Birth and Death registration
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 13/16
2012 2013 2014 Total
Sierra Leone
Catalytic
funding
request
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap*
RemarkBudget from JPWF
Activity Area Activities Inputs
Objectively verifiable indicators
Source
Output:
A national policy requiring
notification of all maternal
deaths (maternal is a
notifiable event -within 24
hours) is developed
Develop and adopt national policy on
maternal death notification
Conduct an assessment of maternal
death reviews, using standard tool
Support scale up of existing system using
mobile phones at facility levelsOutput: Hospital reporting of
maternal deaths is nearly
complete, with an accurate
cause of death
Review and update guidelines on
maternal death review/audits
Provide training to hospital providers
Revision of guidelines
21,800 10,000 10,000 41,800 GAP
Output: Quality of care
assessment in health service
Conduct at least one quality of care
assessment in health services GAP
Support districts in analysis of data on
maternal deaths
Number of districts trained in revised guidelines
GAP
Develop results-based advocacy
materialsGAP
Support and complete the development
of health financing policy to track overall
resources for health 57,750 1,575 0 59,325 GAP
Secure funding to institutionalize NHA
(for 2 year cycle) (NHA 2011 in progress)
Conduct NHA in 2013
0 0 33,075 33,075
WB is supporting
the current NHA;
GAP for the next
Current one is covered by WB; WHO is providing
technical support and has plan to continue support but
needs resource mobilization
Expand IFMIS system to track
expenditure by FOBs & NGOS Unkown
Initiate implementation of MNCH sub
accounts
Conduct NHA subaccounts for RMNCAH
0
Institutionalize resource tracking is
planned Output: Health expenditure
estimates are produced
annually, using consistent
methods of the national health
accounts.
Introduce standard methods and build
capacity to routinely undertake analysis
of expenditure data 18,500 7,613 7,993 34,106 GAP Unkown
Output: There is an effective
country-led coordination
mechanism for tracking health
expenses
Unkown
Output: Results are used and
integrated in the development
and monitoring of policies
Produce and disseminate policy briefs
widely to be disseminated and discussed
at the annual reviewsUnkown
Output: Data are produced
annually and easily accessible
to all
Develop a national data repository and
facilitate open access to data Unkown
682,405 716,525 2,048,838 GAP WHO provides technical support
GAP63,000 63,0000
Output: There is a national
system, with national policy
and coordination team for
tracking budgets and
expenditures
Output: There is a system of
tracking expenditures for
MNCH
649,909
Output: Data are used for
advocacy and community
mobilization
2.4.Maternal death reviews and Quality of care assessments
Output: There is a system of
maternal death reviews that
works well (facility,
community)
2.5. Resource tracking and NHA institutionalization & sub accounts (MNCH)
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 14/16
2012 2013 2014 Total
Sierra Leone
Catalytic
funding
request
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap*
RemarkBudget from JPWF
Activity Area Activities Inputs
Objectively verifiable indicators
Source
Develop and disseminate a calendar and
standard format for national and district
reviews
Conduct 4 regional and one national
health sector performance review as
mechanism to hold DHMTS and national
level to account for implementing health
plans
Conduct one district review and implement district performance
assessment
1,186,725 1,246,061 1,308,364 3,741,151 GAP
14,500
WHO is providing support and has plan to continue
support but needs resource mobilization for minimum
3 district performance reviews.
Conduct Joint Review Field Mission for
Annual Health Sector Performance
Report 34,091 34,091 34,091 102,273 GAP
WHO is providing support and has plan to continue
support but needs resource mobilization
Actively engage involvement of all
development partners and CSO in the
results processes and in the reviews
CSOs are actively engaged through the district reviews,
the national coordination mechanisms. WHO is
providing technical support
Output: The reviews have a
strong subnational focus
which is well informed by
data.
Implement district performance
assessments to guide resource
allocations 100,000 100,000 100,000 300,000
WHO, GF, DFID
supported the 2012
budget; but there is
GAP for 2013 & 14
WHO, GF, DFID supported the 2012 budget to review
district level annual review of 2011 performnace. WHO
has plan to continue support but needs resource
mobilization
Output: The results of the
review meetings are used
extensively in the planning
process.
Improve capacity to correctly use data on
results and resources, including equity
considerations to strengthen national
policies and district plans of action
GAP
WHO supports some activities like training and
technical support and has plan to continue support but
needs resource mobilization
Output:Programme specific
reviews (e.g MNCH reviews)
are aligned with and the
results/decisions feed in the
annual sector review
Reconcile the calendar of programme
reviews to feed into the annual health
sector review 17,500 17,500 17,500 52,500 GAPWHO supports some activities like training and
technical support
Output: There are
mechanisms in place to
translate results/evidence to
make resource allocation
decisions
Coordinate and monitor annual
operational plans and update JPWF
144,600 151,830 159,422 455,852 GAP
WHO supports some activities like training and
technical support; JANS is planned with support of
WHO. In this regard, WHO has plan to continue
support for the 2012-2014 activities but needs
mobilizing resource
Output: Country report
provided to the global ERG
with relevant information on
annual basis
Produce and provide a detailed report to
the ERGGAP
The output/activity is not costed and not captured in
JPWF
Mobilize commitment of high level
parliamentarians in health investment,
with attention to the President's flagship
projects
GAP The activity is not captured in JPWF
Develop advocacy materials based on the
results GAP The activity is not captured in JPWF
Mobilize communities to create demand
for adequate health services (CSO
community monitoring project)154,000 54,600 169,530 378,130
WB supports
150,000; The
remaining is GAP
WB through the RCHP supports involvement of CSOs
(community) but there is still gap
Output: At least one high level
event per year to share
findings and agree on follow
up actions to be taken
Conduct joint annual health summit to
share findings of the annual health sector
performance report and agree on follow
up actions
38,250 38,250 38,250 114,750 GAP
WHO provides technical support and some
expenses like organizing workshops for the the
preparation iof the docs, printing of docs. WHO
has plan to strengthen its support but needs to
mobilize resources
Produce country profile annually ,
reporting on core indicators proposed by
the Commission on Information and
Accountability for Women and Children's
Health
GAP The output/activity is not captured in JPWF
Organize one Countdown meeting GAP The output/activity is not captured in JPWF
Output: Regular annual multi-
stakeholder review meetings
are conducted.
Output: High level
parliamentary group is
engaged in monitoring of
results and accountability
Output: At least one national
Countdown meeting is
conducted
4. Advocacy and outreach
3. Review and action
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 15/16
2012 2013 2014 Total
Sierra Leone
Catalytic
funding
request
COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap*
RemarkBudget from JPWF
Activity Area Activities Inputs
Objectively verifiable indicators
Source
Strategic Objective 6.5: To
Strengthen monitoring and
evaluation, research and
knowledge management
capacity in the health sector
6.5.2 Health Sector
Research Capacity
strengthened
99,450 85,913 89,443 274,806
GAP
6.6.1 Integrated Supportive
supervision strengthened at
all levels
271,775 296,073 299,631 867,479
JICA
TOTAL 250,000
Additional from JPWF
Developed during a national workshop involving a broader stakeholder group,
based on the National Health Sector Strategic Plan Joint Programme of Work and Funding (JPWF) 2012-2014 (zero draft) and the Country Accountability Framework Page 16/16
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