country accountability framework: roadmap* myanmar · country accountability framework: roadmap*...

Priority areas/activities Priority

(1-2=high,

2=medium,

3=low)

Approach/actions Lead govt/ national

institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance

Conduct rapid and comprehensive

CRVS assessment, develop strategic

plan for CRVS improvement and use

it for advocacy and mobilization of

key stakeholders. Implement the

CRVS strategic plan.

1 Organize national stake holders

meeting, apply rapid and

comprehensive assessment tool of

WHO and develop a strategic

improvement plan (with WHO

consultant).

MNPED, MoH, MOHA WHO,UNICEF,

UNFPA, World

Bank, USAID,

AusAID

x x x $810,000 $10,000 $800,000 HMN : usd 15000/-

Strengthen interagency

coordinating committee involving

all key stakeholders (including MoH,

MNPED,MOHA, International

organizations & development

partners), with appropriate terms of

reference and meetings quarterly

1 Regular meetings of interagency

coordinating committee with

expanded membership and new

TORs


UNFPA, World

Bank, USAID,

AusAID

x x x $5,000 $1,000 $4,000

Legislation and regulation review,

update and compliance to be

undertaken.

3 Amendment of Law for mandatory

death certification prior to burial in

rural areas and other changes to

law, hiring of consultant to draft the

documentation, and community

awareness process, advocacy for

enforcement.

MNPED, MoH, MOHA, AG WHO,UNICEF,

UNFPA, World

Bank, USAID,

AusAID

x x $100,000 $0 $100,000

Training of doctors on ICD 10 brief

and death certification; regular

quality control of certification; use

of ANACOD for COD quality

assessment, improve coding

practices through computerized

system at CSO for ICD-10 coding and

Improve reporting data flow from

hospitals to CSO through

computerization.

1 Train national facilitators (TOT - 2

days) at the state/region level (17),

who will train doctors in their

respective states/regions. Same

week training of CSO on ANACOD (2

days). Training strategy developed

and QA process established,

ANACOD implemented for COD

analysis. Computerize ICD coding at

CSO level, undertake workflow

analysis and need assement for

computerization of electronic

reporting system (software &

training support).

MoH, MNPED WHO,UNICEF,

UNFPA, World

Bank, USAID,

AusAID

x x x $525,000 $25,000 $500,000

COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Myanmar

CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)

* This final version has been reviewed and validated through a national accountability workshop involving a broader stakeholder group. /14


(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Strengthen community reporting of

births and deaths through

innovation , multi-sectoral

collaboration to expand informant

base, capacity building for reporting

by community based health workers

(BHS) & community health

volunteers or Local administration

under MOHA, and use of VA by BHS

with automation.

2 Identify short list of variables for

birth and death reporting

(HMN/WHO). Expand to multi-

sectoral scope of informants, with

roles and authority defined. Test

community reporting and verbal

autopsy (VA) tools, VA automation

for inference of COD, followed by

nation-wide scale up. Strategy and

implementation plan to be

developed followed by a short-term

Pilots and nation-wide scale ups.

MoH, MNPED WHO,UNICEF,

UNFPA, World

Bank, USAID,

AusAID

x x x $500,000 $0 $500,000

Strengthen the analytical capacity of

vital statistics office (CSO), including

data quality assessment and ICD-10

coding.

2 Training in analyses of relevant staff

about 200 persons (mainly central

level, 1-2 staff at state/region level

and district level), using TOT

approach.

MNPED WHO,UNICEF,

UNFPA, World

Bank, USAID,

AusAID

x x x $60,000 $10,000 $50,000

Develop as strategy to fill the gaps

in Vital statistics either through

HDSS sites or through Sample

registration system. Implement pilot

sites followed by nation-wide scale-

up.

2 Assess and develop a strategy

followed by implementation.


UNFPA, World

Bank, USAID,

AusAID

x x $200,000 $0 $200,000



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

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sources for

funding unmet

balance



Further develop a comprehensive

common M&E plan including

RMNCH indicators, using logical

framework approach and all M&E

components - result matrix of

indicators, data sources,

compilation methods, analysis

techniques, data quality assurance

methods, communication and use

of data plan as well as institutional

capacity development plan.

Implement the M&E plan and

review/update after 2 years.

1 Review existing M&E component,

revise according to WHO/IHP+

guidance and add all M&E

components. A consultant to be

hired.

MOH DOP, CSO, GAD,

WHO, UN

agencies, Donors

x x x $100,000 $0 $100,000 to identify

alternate funding

source to hire a

consultant

Establish HIS unit under MOH with

required staffing level to cater to

comprehensive HIS requirements.

1 MOH DOP, CSO, GAD,

WHO, UN

agencies, Donors

x $100,000 $100,000

To establish M&E coordinating

committee across all programmes,

reporting periodically to MCCM,

involving broad stakeholders

including MOH, NSO, academic

institutes, civil society, development

partners and UN agencies.

Appropriate TORs and high level

chair to be proposed, with quarterly

meetings and minutes documented.

1 Regular meetings funded MOH DOP, CSO, GAD,

WHO, UN

agencies, Donors

x x x $5,000 $1,000 $4,000

MONITORING OF RESULTS



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Training of BHS (15000 staff) on

Routine reporting system for public

facilities, introduce quality

assurance mechanism such as field

supervision, improve the existing

feedback mechanism up to sub-

centre level to make it more timely.

Mid-term evaluation of the National

Health plan should be conducted.

2 Use WHO analytical approach

including data quality score card

analysis. TOT approach for BHS

training.

MOH WHO, UN

agencies, Donors

x x x $110,000 $25,000 $85,000

Develop national research agenda

and 10 year national survey plan

across all survey lead agencies, as

an integrated component of the

M&E plan.

1 Link with National Statistical Plan,

mapping all health surveys. The

consultant hired for M&E shall

undertake this activity also.

MOH WHO, UN

agencies, Donors

x $30,000 $0 $30,000 to identify

alternate funding

source to hire a

consultant

National census in 2014 should

consider to include a question on

pregnancy related deaths, which

should help conclude MMR. MICS

2010 included 7 of the 11 RMNCH

indicators (2,3,5,7,9, 10,11) and CPR

(4?). Next MICS in 2013-14, shall

include 9 RMNCH indicators (except

MMR as it requires larger sample

size and ART among HIV +ve

pregnant women - shall be obtained

from national aids programme).

1 Link with National Statistical Plan,

mapping all health surveys. Liaise

with MICS, DHS, raise funding,

determine contents.

DOP, MNPED, MOH UN agencies,

Development

partners

x x $20,000 $0 $20,000

Implement DHIS2 for data

warehousing and data analysis,

national capacity building on

customizing DHIS2. Monthly

reporting from private sector on-

line using DHIS 2 & open MRS- both

aggregate data and in-patient data

(simple EMR). System to be

developed to capture data from

hard to reach areas using DHIS2.

2 National capacity building to

customize DHIS2 and open MRS.

Funding to be explored from

NORAD.

MOH WHO,

Development

partners

x x x $210,000 $0 $210,000



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Conduct SARA in 150 sample sites

and use the data for data quality

assessment. Repeat SARA annually

for data verification and sample

service readiness.

1 Plan sample survey of facility (100-

150 sites) prior to review using WHO

standard instrument.

MOH WHO,

Development

partners

x x x $120,000 $20,000 $100,000

Training on advance data analysis,

modelling methods (MME,CME),

GIS, Equity analyses. Develop

analytical report for the National

reviews by involving key

institutions; review contents,

undertake analyses, data quality

assessment, presentation and

report writing.

1 WHO analysis and data quality tools.

TA and training on analyses and

development of annual statistical

report .

MOH WHO, UN

agencies, Donors,

Development

partners

x x x $105,000 $15,000 $90,000

Develop national health repository

to share relevant data and reports

using Regional Health observatory

platform.

2 Technical assistance for national

observatory/portal. Build upon

current national and regional

observatory approaches.

MOH WHO x x x $60,000 $0 $60,000



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance



Formulate policy on notification of

all maternal deaths (including

private sectors).

To form functioning maternal and

perinatal deaths review committees

at all levels.

To hold central annual review

meetings and biannual review

meetings at state and regional

levels and to disseminate the

findings/ results for corrective

actions and share the experience

1 Advocacy to central level decision

makers for policy formulation.

Formation of functioning maternal

and neonatal deaths review

committees at all levels.

Resources mobilization and training

to expand to other townships to

cover the whole country.

17500 X X $70,000 $20,000 $50,000

Advocate and expand to other

townships to cover the whole

country.

1 Advocacy workshop in expanded

townships.

X X X $440,000 $0 $440,000

Create mechanism for raising

Awareness and to increase

responsiveness.

Advocacy and training workshops. X X X $0

Strengthen capacity for maternal

and perinatal death review at all

levels.

2 National capacity building

workshops

X X $0

To ensure adequate allocation of

financial resources from MOH and

other agencies

District capacity building workshops X X $110,000 $0 $110,000

Capacity building (skills/ medicine

and equipment) in existing

townships as well as expanding

townships.

X X $2,640,000 $0 $2,640,000

Improve reporting by hospitals;

Training in identification of

maternal death and ICD certification

and coding (links with CRVS),

2 Training of hospital staff in ICD and

coding (link with CRVS)

X X $0 $0

Strengthen hospital capacity and

practices, including private sector

2 Routine reviews/audits X X $264,000 $0 $264,000

Expand the reporting system to

other remaining townships.

2 X X $10,000 $10,000 $0

MATERNAL DEATH SURVEILLANCE AND RESPONSE



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)To develop the standard operation

procedures and conduct trainings.

Establish a regular system of QoC

assessments, with dissemination of

results for future planning and

policy. Need adequate financial

resource allocation for data

collection and regular death review

in all hospitals as well as for

corrective actions (supports) in

phase wise manner.

3 Technical assistance and training for

facility assessment

X X $700,000 $0 $700,000

Quality assessment in health

facilities

X X $700,000 $0 $700,000

To conduct community based

research on Quality of care and

client's satisfaction

$0

Develop community system of

maternal death reporting and

response, using ICT in the phase

wise manner

2 Develop plan for strengthening

MDSR in community, using ICT.

Conduct pilot in 2013 followed by

scale-up in 2014-15

X X $620,000 $20,000 $600,000

Utilization of mobile phones up to

sub rural health centre levels

3 Introduce/train on community

reporting using ICT

X X $500,000 $500,000

To strengthen VA for maternal

deaths in communities in 120

Townships and to extend to cover

the whole country

3 Training on VA at community level X X $0

To strengthen the community

involvement in VA in maternal

death review and feedback system

3 Develop system for review process

and feedback/ interpretation of

data

X X $0

Expand/Support and strengthen

review system including

dissemination and utilization of the

report

3 X X $0



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance



Establish a National eHealth

Steering Committee (to include

MOH, MCIT, MNPED, MOEP, MST

and other primary stakeholders &

development partners).

1 Ensure leadership commitment and

manage the process leading to

development of a national eHealth

strategy.

MOH MCIT, MNPED,

MST, WHO, UN

Agencies, donor

partners

x x x $15,000 $4,000 $11,000

Develop Myanmar's eHealth

Strategy (with country's leadership

and broad buy-in).

1 MOH 3MDG, MCIT,

MNPED, MST,

WHO, UNFPA

x x $70,000 $10,000 $60,000

Conduct full assessment of all

health facilities in selected states

and regions (up to sub-centre).

1 Through e-survey, 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.

MOH MCIT, Donor

Partners, WHO

x x $350,000 $5,000 $345,000

Initial implementation of ICT-

resources to facilitate electronic

data management in selected

health facilities within one region

[region name] and one state [state

name] (up to the level of sub-

centre) and subsequent roll-out of

the successful implementation

throughout the country by 2015.

x x $500,000 $0 $500,000

Design Myanmar's eHealth

Architecture and document all

components of the architecture

toward establishing a Common Data

Management Platform

2 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.

MOH MCIT, Donors,

WHO,

x x $30,000 $22,000 $8,000

INNOVATION AND E-HEALTH



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Design, develop, test, and

implement a Common Data

Management Platform in one state

and one region (up to the sub-

centre).

MOH MCIT, Donors,

WHO, INGO,

Private Sector

x $300,000 $300,000

Conduct "needs assessment" for

eHealth standards and

interoperability components

required to support eHealth

services, applications and

infrastructure, as well as to facilitate

health information flows.

1 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.

MOH WHO, MCIT,

Donor, MST

x x $60,000 $10,000 $50,000

Implement eHealth standards in

selected states/regions as part of

the Common Data Management

Platform

MOH WHO, MCIT,

Donor, MST

x x $50,000 $50,000

National eHealth Steering

Committee (already referred in Item

1) will serve as the governance

mechanism.

2 $0

Policy related to health data

privacy, security, and confidentiality

will be developed by 2014.

[Incorporate the existing draft/law

as necessary].

2 x $0



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance



Update NHA framework sub

account for RMNCH & others

programme should be introduced.

1 Apply/validate one national health

accounts framework

$0

Review of existing NHA Framework;

Modify the framework through due

process. Strengthen the institutional

arrangements and team.

2 Stakeholder workshop to establish

governance and TOR

$0

Provision will be in place to make

RMNCH as a focal topic.

$0

Organize a meeting to engage

government and development

partners and work towards

establishing a formal "compact."

2 Propose the need for formal

"compact" to next CCM. Working

group on HHS might take this task to

establish the "compact."

MOH Development

Partners (UN

Agencies, INGOs,

NGOs,CBOs, Donor

Agencies)

x x x $150,000 $10,000 $140,000 JICA, DFID, AusAID,

USAID, GF, ADB

Strengthen the technical capacity of

the steering committee. Form

working committees with specific

tasks assigned.

1 Regular meetings of technical

steering committee

MOH Development

Partners (UN

Agencies, INGOs,

NGOs,CBOs, Donor

Agencies)

x x $0

Expand representation to include

key stakeholder including

International Agencies, INGOs, Civil

Society including NGOs and private

sector.

1 x x $0

Human capacity need to be

developed at the sub national

levels.

2 (1) Capacity building of existing staff

through specialized training; (2)

recruit (technical assistant/s

consultants) to providing training for

existing staff*(subject to

confirmation); (3) additional 1

person be recruited for a longer

term.

MOH/DHP WHO, 3MDG x x x $130,000 $10,000 $120,000 *(subject to

confirmation;

World Bank would

provide $50,000;

specifically for

category 2)

MONITORING OF RESOURCES



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Automated systems need to be

developed for government

expenditure data conversion.

3 Refer to the activity immediately

below.

$0

A common information platform for

NHA be developed and

implemented, and its connectivity

to other information systems. The

NHA systems must be able to

independently operate, yet, be able

to connect with other health

information systems so that

appropriate/required reporting

functions can be met.

3 Conduct exhaustive assessment for

establishing an eHealth Architecture

for NHA; and to develop a costed

plan to design, test, and deploy NHA

Common Information Platform at

the MOH Headquarters.. Catalytic

funding under e-health architecture.

MOH 3MDG, Bilateral

Partners

x $100,000 $0 $100,000

Strengthen analytical capacity

based on SHA 2011.;

2 national consultative workshop to

develop SHA-related analytical

templates; TA to be provided to

facilitate the workshop ($15,000)

MOH x x $25,000 $25,000

Establish central website for

dissemination of results (links with

national observatory)

$0

Strengthen and increase the use of

NHA data in policy making process.

2 (1) Develop "NHA Policy Brief"

(40,000)* and (2) engage policy

makers to draw upon the NHA data

and resulting implications in the

planning process (15,000).

MOH Development

Partners (UN

Agencies, INGOs,

NGOs,CBOs, Donor

Agencies)

x x $55,000 $55,000



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance



Advocate for all partners and

stakeholders to align review

mechanisms based on the goals and

targets of the NHP. Ensure multi-

stakeholder participation.

1 Advocacy meeting for all partners

and stakeholders (private sector,

NGO/INGOs)

MoH WHO, UNICEF,

UNFPA

$20,000 $5,000 $15,000 additional funding

from other

partners

Establish a system to conduct

reviews that can include all sectors

(private, NGO/INGOs) together with

national data. Conduct the review

of RMNCH involving all sectors and

all stakeholders.

1 Establish continuous review system

including all stakeholders.

MoH WHO, UNICEF,

UNFPA

$100,000 $5,000 $95,000

The results of the comprehensive

review involving all sectors and all

stakeholders should be used for

planning process.

3 Disseminate review results for

planning

MoH WHO, UNICEF,

UNFPA

$20,000 $0 $20,000

Organize a meeting to engage

government and development

partners including NGO/INGOs,

donors and work towards

"compact".

2 IHP+ approach to develop compact.

Combine with similar meeting under

Resource tracking, funded from

catalytic funding.

MoH, CCM WHO, UNICEF,

UNFPA

$15,000 $0 $15,000

REVIEW PROCESSES



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance



Parliamentarians should sit on the

national committee with other

stakeholders on a regular basis

(quarterly).

2 X X X $135,000 $0 $135,000

Organizing public forums for

information sharing by

parliamentarians at central and

state/ regional levels.

3 X X X $0

Establish coalition with participation

of all stakeholders by formation of

electronic linkages/ networks

Development of websites (RMNCH

Myanmar)

2 X X X $15,000 $4,000 $11,000

Support capacity of civil society

organizations to utilize the RMNCH

website to disseminate messages

1 X X X $0

Work with the media to strengthen

their capacity to report on RMNCH

related issues.

To conduct workshops for media

communication to health

personnels and assign media focal

persons in each technical areas

1 X X X $5,000 $0 $5,000

Work with the media to strengthen

the capacity of media personnels

reporting towards implementation

of national commitment towards

Global Strategy.

1 X X X $15,000 $8,000 $7,000

Improve information flows to media

by conducting press conferences

biannually and encouraging the

utilization of MOH website

Wide dissemination of publications

of MOH (Health in Myanmar,

Newsletters)

1 X X X $20,000 $0 $20,000

ADVOCACY & OUTREACH



(1-2=high,

2=medium,

3=low)


institute

Partners 2012 2013 2014 2015 Total

Estimated

Cost per

action

2012/13

Catalytic

funding

Unfunded

balance

Potential

sources for

funding unmet

balance


CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS)Along with the national COIA

workshop, a national Countdown

event on RMNCH (COIA) should be

held.

To designate and commerate

RMNCH day on 4th July and start

countdown annually on RMNCH,

COIA till 31st December, 2015

1 X X X $50,000 $0 $50,000

Prepare National Countdown

Report by using all evidences, and

disseminate and publish National

Countdown report on National

Countdown Event (RMNCH day) by

MOH and all stakeholders

2 X X X $10,000 $0 $10,000

TOTALS 11,354,000 250,000 11,104,000 -

Needs Catalytic request Unfunded balance

CRVS $2,200,000 $46,000 $2,154,000

Monitoring of results $860,000 $61,000 $799,000

MDSR $6,054,000 $50,000 $6,004,000

eHealth & Innovation $1,375,000 $51,000 $1,324,000

Monitoring of resources $460,000 $20,000 $440,000

Reviews $155,000 $10,000 $145,000

Advocacy $250,000 $12,000 $238,000

TOTAL $11,354,000 $250,000 $11,104,000


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