COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Sierra …€¦ · Developed during a national...

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 /16

1 2 3 4 5 Govt PartnerActivities

Adequacy (1–5) Situation analyses

(strengths, weaknesses, gaps)Actions



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








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








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








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








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








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








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








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.



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



2012 2013 2014 Total

Sierra Leone

Catalytic

funding

request


RemarkBudget from JPWF

Activity Area Activities Inputs


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



2012 2013 2014 Total

Sierra Leone

Catalytic

funding

request





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



2012 2013 2014 Total

Sierra Leone

Catalytic

funding

request





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



2012 2013 2014 Total

Sierra Leone

Catalytic

funding

request





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)



2012 2013 2014 Total

Sierra Leone

Catalytic

funding

request





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



2012 2013 2014 Total

Sierra Leone

Catalytic

funding

request





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



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