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2011-2016 HEALTH PROGRAM HEALTH SYSTEM STRENGTHENING COMPONENT: QUARTERLY REPORT JULY-SEPTEMBER 2014 November 2014 This report is a deliverable under contract # AID-685-A-11-00002, Health System Strengthening Component (HSS) of the USAID/Senegal Health Program, 2011-2016 The Health System Strengthening Component of the Health Program consists of technical assistance to the Government of Senegal implemented by Abt and financed by USAID under contract # AID-685-A-I I -00002 Submitted to: Babacar Lo USAID DAKAR Abt Associates 1 Immeuble Abdoulaye Seck 1 Rue de Fatick X Bd du Sud 1 Point E1 Dakar www.abtassociates.com HEALTH SYSTEM STRENGTHENING COMPONENT: QUARTERLY REPORT JULY-SEPTEMBER 2014 WARNING The authors' views expressed in this publication do not necessarily reflect the view of the United States Agency for International Development (USAID) or the United States Government. TABLE OF CONTENTS TABLE OF CONTENTS ............................................................................................................. iii ACRONYMS ................................................................................................................................... v 1 PROJECT OVERVIEW .......................................................................................................... 7 1.1 SUMMARY 7 1.2 PROJECT DESCRIPTION/INTRODUCTION ...............................................................................................7 1.3 KEY RESULTS OF THE QUARTER 8 1.4 KEY CHALLENGES 9 2 RESULTS OF THE QUARTER ........................................................................................... 10 2.1 EXECUTIVE SUMMARY 10 2.2 PROGRESS ON CHALLENGES IDENTIFIED DURING THE PREVIOUS QUARTER13 2.3 ACHIEVEMENTS OF THE QUARTER PER SUB-COMPONENT ....................................... 14 2.3.1 KEY RESULTS PER SUB-COMPONENT .......................................................................................... 14 2.3.2 REVIEW PER SUB-COMPONENT OF IMPLEMENTATION STATUS OF THE ANNUAL WORK PLAN 26 2.3.3 CHALLENGES, OPPORTUNITIES AND PERSPECTIVES PER SUB-COMPONENT28 3 CROSS-CUTTING ISSUES ................................................................................................. 29 3.1 GENDER MAINSTREAMING 29 3.2 ENVIRONMENTAL COMPLIANCE .................................................................................................... 29 3.3 COMPLIANCE WITH FAMILY PLANNING LEGISLATION AND POLICY REQUIREMENTS 29 4 STAKEHOLDER PARTICIPATION AND INVOLVEMENT ........................................... 30 5 LESSONS LEARNED ........................................................................................................... 32 6 KEY ACTIVITIES PLANNED FOR NEXT QUARTER PER SUB-COMPONENT INCLUDING UPCOMING EVENTS ................................................................................. 33 7 MANAGEMENT AND ADMINISTRATIVE ISSUES ........................................................ 34 ATTACHMENT 1: PROGRESS ON THE ACTION PLAN/INDICATORS .......................... 37 ATTACHMENT 2: FINANCIAL REPORT OF THE COMPONENT..................................... 42 LIST OF TABLES iii ACRONYMS AAP Annual Action Plan ACA Association Conseil pour l’Action AIDS Acquired Immuno-Deficiency Syndrome ARD Agence Régionale de Développement / Regional Development Agency AWP Annual Work Plan BAP Bureau d’Appui au Projet / Project Support Office BTC Belgian Technical Cooperation CACMU Cellule d’Appui à la Couverture Maladie Universelle / Support bureau for Universal Health Coverage CBO Community-Based Organization CDD Comité Départemental de Développement / Departmental Committee for Development CDS Comité départemental de suivi / Departmental Monitoring Committee CIM Comité d’Initiative Mutualiste / MHO action committee CONSAS National consultations on healthcare and social action COP Chief of Party CRDH Centre de Recherche pour le Développement Humain CRS Comité régional de suivi / Regional monitoring committee CTGP Comité Technique de Gestion du Projet / Project Management Technical Committee CTO Comité Technique Opérationnel du Comité Départemental de Suivi / Operational technical group of the Departmental Monitoring Commitee DAGE Department of General Administration and Equipment DF Direct financing FG Guarantee Fund DHMT District Health Management Team DLSI Division de la Lutte contre le SIDA / AIDS Control Division DMO Chief District Medical Officer DPPD Multi-year Expenditure Programming Document DPRS Department of Planning, Research and Statistics DSRSE Direction de la Santé de Reproduction et de la Santé de l’Enfant / Department of Reproductive Health and Child Health EIPS Equipe d’Initiative de Politiques de Santé / Health Policy Initiatives Group FHI Family Health International FNSS Fonds National de la Solidarité dans la Santé / National Solidarity Fund for Healthcare FY Fiscal Year H2S Health System Strengthening Component ICP Infirmier Chef de Poste / Chief nursing officer at health post ISSA Innovations et Systèmes de Santé en Afrique JPR Joint Portfolio Review MEF Ministry of Economy and Finance MHO Mutual Health Organization MIS Management Information System MNCH Maternal, Newborn and Child Health MOH Ministry of Health and Social Action MTEF Medium Term Expenditure Framework NGO Non-Governmental Organization ONAMS Office national de la mutualité sociale / National agency for social insurance v ORCAP Outil de Renforcement des Capacités par l’Auto-évaluation Participatives / Capacity development tool through self-assessment PBF Performance-based financing PLWHA Person Living With HIV/AIDS PNA Pharmacie Nationale d’Approvisionnement / National medical store PNDS Programme National de Développement Sanitaire / National Health Development Program PNFBR National Program on Performance-Based Financing RH Reproductive Health RHMT Regional Health Management Team RMO Chief Regional Medical Officer SDP Service Delivery Point SRAS Service régional de l’Action Sociale / Regional bureau for social action TFP Technical and Financial Partner UEMOA Union Economique et Monétaire Ouest Africaine / West African Economic and Monetary Union URMS Union Régionale des Mutuelles de Santé / Regional federation of mutual health organizations USAID United States Agency for International Development WHO World Health Organization vi 1 PROJECT OVERVIEW 1.1 SUMMARY Component name: Health System Strengthening (HSS) Project start date and end date: October 1, 2011 – September 30, 2016 Name of Implementing Partner: Abt Associates Inc. Cooperative Agreement number: AID-685-A-11-00002 Name of AOR: Babacar Lo Groupe Innovations et Systèmes de Santé en Afrique (Group ISSA) – Name of Subcontractors or Association Conseil pour l’Action (ACA) – Centre de Recherche Consortium members: pour le Développement Humain (CRDH) – Family Health International (FHI360) – PATH – Broad Branch Associates Geographic coverage (per region) Kolda - Sédhiou - Ziguinchor -Louga - Thiès - Diourbel - Kaolack - Kaffrine - Fatick - Dakar (Departments of Pikine and Rufisque only) Reporting period: July-September 2014 1.2 PROJECT DESCRIPTION/INTRODUCTION The Health System Strengthening (H2S) Component is one of five assistance instruments of USAID/Senegal’s 2011-2016 Health Program. The development objective of the Program is an “improved health status of the Senegalese population” and is to be reached through three intermediate results (IR): “Increased use of an integrated package of quality health services” (IR 1); “Improved health seeking and healthy behaviors” (IR 2); and “Improved performance of the health system” (IR 3). The Health System Strengthening Component contributes to achieving these intermediate results in collaboration with four other components of USAID/Senegal’s Health Program: (i) health services improvement, (ii) HIV/AIDS and Tuberculosis, (iii) community health, and (iv) health communication and promotion. The main objective of the H2S Component is to improve the performance of the decentralized (regional and district levels) public health system supported by effective and efficient policies, planning and budgeting at the central level of the Ministry of Health. The H2S Component will contribute specifically to the realization of Intermediate Result 3 through “an improved management of district and regional health teams” (IR 3.1) and an “improved health system performance through development and implementation of national level policies” (IR 3.2). The H2S Component is divided into four sub-components focusing on key areas for improving health system performance. The “Management and health systems at regional and district levels” sub-component will contribute to improving the effectiveness and quality of healthcare service delivery through improved health governance at the local level, enhanced capacities of regional and health district management teams, and motivation of staff working at health huts, posts and centers to extend the reach of priority healthcare services supported by performance-based financing (PBF) mechanisms. The “Social financing mechanisms” sub- component will focus on improving access to healthcare for populations in general and vulnerable groups in particular, by reducing financial barriers to healthcare and expanding health coverage through mutual health insurance schemes and the support of government authorities. Finally, sustainable improvements in health 7 system performance will be ensured with the creation of an enabling environment to support policy development, enhanced resource allocation for the sector, synergy and alignment of
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    Document of The World Bank FOR OFFICIAL USE ONLY Report No: PAD236 Public Disclosure Authorized INTERNATIONAL DEVELOPMENT ASSOCIATION PROJECT APPRAISAL DOCUMENT ON A PROPOSED CREDIT IN THE AMOUNT OF SDR 52.1 MILLION (US$80 MILLION EQUIVALENT) Public Disclosure Authorized AND A PROPOSED GRANT FROM THE GLOBAL ENVIRONMENT FACILITY TRUST FUND IN THE AMOUNT OF US$6 MILLION TO THE REPUBLIC OF SENEGAL Public Disclosure Authorized FOR THE SUSTAINABLE AND INCLUSIVE AGRIBUSINESS DEVELOPMENT PROJECT November 22, 2013 This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Public Disclosure Authorized Bank authorization. CURRENCY EQUIVALENTS (Exchange Rate Effective October 31, 2013 Currency Unit = CFA Francs CFA 482.71 = US$1 US$1 = SDR 0,65017815 FISCAL YEAR January 1 – December 31 ABBREVIATIONS AND ACRONYMS AAA Analytic and Advisory Activities AGS Accelerated Growth Strategy AFD French Development Agency AfDB African Development Bank AGEROUTE Works and Road Management Agency/Agence des Travaux et de Gestion des Routes AIDP Agriculture Insurance Development Project ANCAR National Agency for Agricultural and rural Advisory Services/Agence Nationale du Conseil Agricole et Rural ANGMV National Agency for the Great Green Wall/Agence Nationale de la Grande Muraille Verte APIX Private Investment Promotion Agency/Agence de promotion des Investissements et des Grands Travaux ARMP Public Procurement Regulatory Authority ASER Senegalese