I. Introduction:
MEDiCAM with some support from the Global Fund for Health System Strengthening and in collaboration with the Department of Planning and Health Information, Ministry of Health, organized a Community based NGO planning forum for all MEDiCAM’s member and the planning team from the Municipality Health Department and the Kandal and Kampong Chhnaing Provincial Health Departments. This is a summary report of the forum that was held on July 09, 2007 at Cambodiana Hotel, Phnom Penh.
Objectives of this forum were:
1- To make NGOs aware of the planning process and the timeframe of AOP.
2- To discuss the current challenges, issues, difficulties, and seek practical solutions for this integration of the AOP.
The event was opened by H.E. Prof. Eng Hout, secretary of state, MOH. In his opening speech, he highlighted some achievements made by the MOH, health partners and NGOs such as the decrease of the HIV prevalence among women age 15-49 years old that stay at home, and reduction of child mortality rate to achieve the millennium development goal and MOH plan. He stated that the immunization coverage and the universal use of breast feeding are increased. He also thanked all stakeholders for their efforts in contributing to this success. Lastly, he strongly encouraged all development partners (NGOs) and PHD to discuss the integration of NGO’s plan into AOP (Annual Operational Plan).
Dr. Benjamin Lane, WHO, emphasized that we need to strengthen the capacity of civil society and health partners. He explained why the AOP plays an important role in the achievement of the MOH goals. The values of AOPs are practicality in operational levels of the heath system, ensuring best possible use of human resource and to make sure that there is no conflict between health providers and management level. He also recommended that all NGOs and health partners should find solutions, on how to work together and the challenges of the issues related to the integration of the AOP.
Dr. Sin Somuny, executive director of MEDiCAM, then provided welcoming remarks. In his speech, he emphasized the importance of working together with the government to ensure ownership, alignment, harmonization, managing of resources and mutual accountability. He said expected that all participants would actively participate in the discussion on the AOP and would receive the actual knowledge and understanding about AOP. He hoped that at the end of the forum we will have the practical solutions which will contribute to a better implementation of AOP in future.
II. Process:
The objectives and the program of the forum were drafted with consultation from key stakeholders such as the representative of Health Planning and Information Department, MOH.
Dr. Chengli Bunty, PNCB Coordinator, presented the objectives of the forum and summarized the process of the forum. Dr. Lun Monil, Vice chief of the Planning Bureau gave the overview of the Annual Operational Plan (Step1 to step 6 of planning cycle). The Issues of Integration from MoH’s perspective and why integration is very important for MOH were presented by Dr. Lo Veasnakiry, Director of Department of Planning and Health Information, and many question were asked.
In the afternoon, Dr. Chengli Bunty summarized the issues that had been raised at the annual sharing event in Pursat, Kratie and Siem Reap. All the issues had been discussed in plenary discussion which was moderated by Dr. Sin Somuny, Executive Director of MEDiCAM.
The participants discussed how to integrate NGOs plans in to an AOP. Objectives of the discussion were (1) to make NGOs aware of the planning process and the timeframe of AOP. d(2) to discuss the current challenges, issues, difficulties, and seek practical solutions for this integration of the AOP.
III. Summary of key issues and recommendations
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Issues |
Recommendations |
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1- Difference of fiscal year of planning and budgeting |
- Developing plan this year is for implementing next year - NGOs can join readjustment at step 5 in December when they have more confirmation from their donors. Likewise, for the Gov, after approval from the National Assembly. |
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2- Most NGOs staff working at the provincial level do not know the budget and planning of their own organization and have no authority to integrate their budget into AOP |
- PHDs should develop format of what information needed and bring to NGOs’ attention at Pro-TWGH - NGO managers should bring this to consult with their leaders in order to bring the information for integration |
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3- Different formats and different ways of budgeting and planning process |
- Integrate activities that NGOs commit to support in their focus areas - It is not required to include NGO Administration costs - Use MoH format of AOP |
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4. Misunderstanding that when NGOs integrated their support to AOP, the budget will be used under the control of PHDs |
- Integration does not mean that PHDs will control NGOs budget. It only indicates NGOs commitment in the areas that they will support but the whole administrative financial management procedures will lie with NGOs, and not PHD. - NGOs even if not directly support PHD, OD or HCs should also integrate what they support so that the MoH knows what overall investment made in the HS |
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5. Not all NGOs have been invited to participate in the AOP process |
- PHDs should invite all NGOs to attend - NGOs should work closely with PHDs - PHDs should have NGO mapping - Contact MEDiCAM for list of NGOs |
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6. When and at what step of planning process can NGOs participate |
6. All steps of planning Cycle |
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7. Step 5: Never hold meetings with Stakeholders after approved budget and readjustment |
PHDs should use ProTWGH forum for informing the readjustment after approval and all partners should be invited to attend |
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8. Limited capacity of NGOs staff attending the AOP, and sometimes too rushed with other commitments |
-NGOs should ensure sending higher capacity of NGO representatives to attend AOP development and they should commit fully to the process. |
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9. Misunderstanding concept of NGOs toward AOP |
- Integration does not mean that PHDs will control NGOs budget. It only indicates NGOs commitment in the areas that they will support but the whole administrative financial management procedures will lie with NGOs, and not PHD. - NGOs even if not directly support PHD, OD or HCs should also integrate what they support so that the MoH knows what overall investment made in the HS. |
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10. HC staffs have limited capacity in planning |
-GAVI will support 10 ODs for building capacity of 130 HCs -Appeal for NGOs’ support to build HCs capacity (on hand coaching or funding support to provide training) -PHDs must develop the training plan and mobilize resources at ProTWGH |
IV. Conclusion
In conclusion, the CBO/NGO planning forum was able to resolve a number of issues with NGO involvement in the AOP. NGOs now have a greater understanding of the process and their involvement with it. Concerns from NGOs on time frames and ownership of activities have been addressed and the importance of the involvement of the appropriate NGO staff has been emphasized by the PHDs. Training requirements have been identified and further training is to be conducted with HC staff. The AOP integrated planning activity helps to prevent overlap of activities within a province and the PHDs are able to mobilize resources from one area to support another activity if required.