United Nations

Support to Health Sector Plan (NDP4)

MOHSS Review & Planning Meeting

Mr. Lesley Charles Usurua

Ministry of Health & Social Services - Namibia

Outline of Presentation Background

UN Support to Health Sector

Utilization of Budget

Major Challenges

Recommendations

DELIVERING AS ONE

The four pillars of Delivering as One are: 1. One UN Leader and One UN Team 2. One UN Program with 3. One UN Budgetary Framework 4. One UN House

Effective coordination leads to a more strategic and efficient UN system in support of international and national development Goals and priorities as

DELIVERING AS ONE

DELIVERING AS ONE…and ONE UN VOICE Advocating and Communicating as One UN enhance effectiveness from common efforts

Aligning to National Priorities

Vision 2030 The NDP4 The MOHSS Strategic plan The Health Policy Framework 2010-2020 Global & Regional Strategic Directions Various country documents (The WHO CCS 2010-2015) UNICEF CPD, UNFPA CPD UNAIDS Strategic Framework, and 2011 Political Declaration The United Nations Partnership Agreement Framework

(UNPAF) 2014-2018

VISION 2030 “ A PROSPEROUS AND INDUSTRIALIZED NAMIBIA

Challenges, Implications thereof and Strategies

Challenge Implication s/Risks Strategy to address the Challenge

Health Financing

• Reduction of Donor Support

• Efficient use of resources

The gains made i.t.o addressing health challenges may be reversed

Innovative Financing Methods to Increase the size, allocation and use of funding

Availability of Health Professionals • miss-match of the S&D for skills• difficulty in attracting & retaining

Reduced quality and quantity of health services

• Retain and Attract Skilled Health Professionals

• Training on strategic priorities

Governance Framework• Inadequate co-ordination andpartnership b/t main stakeholders

Poor co-ordination and lack of information sharing and appropriate surveillance

• Revise and implement appropriate legal and regulatory framework

• Improve Accountability and Coordination

Access to Health Facilities• sparsely distributed population• Poor Infrastructure • cultural factors

Universal health provision will not be achieved and there will be in-equality in services

• Improve service delivery, • Ensure affordability• Improve acceptance of

health services

Morbidity and Mortality• Both communicable and non-communicable diseases are at unacceptably high levels (HIV/AIDS; TB)

Life-expectancy, maternal mortality, rates of TB and other health outcomes will continue at unacceptable high levels

Focus on Communicable and Non-Communicable Diseases; Lifestyle Diseases; HIV/AIDS & TB

WHO Country Cooperation Strategy 2010-2015

Improved Health Outcomes

Combating Priority Diseases

Improving Maternal, New-born, Child & Adolescent Health

Promoting a Safer and Healthier Environment

Strengthening the Health System

Key areas of UNICEF support 2014-2018

Maternal and Newborn Care Child Survival

Interventions

PMTCT, Pediatric AIDS and ALHIV

Water, Sanitation and Hygiene

(WASH)

Nutrition

UNFPA Mandate Strategic Plan

UNAIDS Strategy 2011-2015

1. Reduce Sexual Transmission by 50% by 2015 2.Reduce HIV among Drug users by 50% by 2015 3.Eliminate new HIV infections among children

4. 15 Million People Accessing ARV 5. Reduce TB Deaths in PLHIV by 2015 6. Closing the global AIDS Resource Gap by 2015 7. Eliminate Gender Inequality

8. Eliminate Stigma and Discrimination against PLHIV throu legislations 9. Eliminate HIV Travel Restrictions 10. Strengthen HIV Integration by eliminating parallel Syst .

3 Zeros

National Strategic Framework Support

UN Joint Support Programme

UN Support to HSP/NDP4

SI 1: Increase the size, allocation and use of funding The UN Mobilized 10 million Euro from EU for accelerating the reduction of MM & Child Mortality in Namibia, Thematic fund for RHCS, EU- SRH/HIV integration, Japan 1.5m US$ to mitigate effect of flood/drought in 7 regions Advocacy for allocating more resources to health priorities of the country especially to Maternal & Child Health Advocate for decentralization of resources and efficiency for optimum utilization of funds Support to evidence based programming > 12 million USD

UN Support to HSP/NDP4

SI 2: Retain, attract and train staff

Supported capacity building of staff in various health services delivery and health management

– National, regional and International training, meetings, study tours (Malaria, TB, HIV/AIDS/SRH, EPI, NCDs etc…)

– LSS/EmONC training – Other training (ENBC, FP, AFHS, etc..) WHO 520,000 USD Support for the development of HRH policy and strategic

plan TA support for bottleneck analysis towards decentralized E-

MTCT roll out (UNICEF 50,000 USD)

UN Support to HSP/NDP4

SI 2: Retain, attract and train staff

TA support for cold chain assessment, development of phased replacement plan and installation (UNICEF 75,000 USD)

Support Curriculum development & review for staff training (UNFPA 40,000 USD)

Support recruitment of technical staff in operational areas (UNFPA 380,000 USD)

Technical Assistance

TOTAL = 1,065,000 USD

UN Support to HSP/NDP4

SI 3: Good Governance- Revised Regulatory Framework

Development of policies and strategies for health; Support Assessments, Reviews and Researches (MTR,

Evaluations etc…) Support the enactment of the Tobacco control Act of 2010 Advocate for the finalization of the Environmental and

Public Health Bill Support Heath Extension program strategy and SOP for

implementation and national roll out

UN Support to HSP/NDP4

SI 3: Good Governance- Revised Regulatory Framework

Communication strategy for sanitation and Global Hand Washing week celebration

Support sensitization and implementation of revised scope of practice - task shifting

HIV/SRH integration policy/guideline development TOTAL Budget (Technical Assistance) – ( 70,000.00 UNFPA, UNICEF 75,000 USD, WHO 120,000 USD) TOTAL 265,000.00 USD

UN Support to HSP/NDP4

SI 4: Improved Stakeholders Coordination

Development of UNPAF with NPC for harmonizing UN support

Joint Planning, Implementation and Supportive Supervision

Support health partners’ coordination forum for Health

Support country coordination mechanisms (CCM, ICC, MNCH Committee, Cervical Cancer Task Force etc...)

TOTAL Budget= 140,000.00 USD

UN Support to HSP/NDP4

SI 5: Access to Health Services Support the upgrading of six district hospitals, procurement of

equipment, supplies in pipeline, (consultation with MOHSS ongoing) (WHO 1,211,600.00 USD)

Support construction of two Maternity Waiting Homes in 2013 (Outapi and Okongo consultation underway) (WHO 540,000.00 USD)

Procurement of medical and anthropometric equipment for hospitals and PHC centers (discussions underway) (WHO 650,000.00 USD, UNICEF 150,000 USD )

Procurement of cold chain equipment (WHO 182,000.00 USD, UNICEF 270,000 USD

UN Support to HSP/NDP4

SI 5: Access to Health Services

Support procurement of ambulances and vehicles for outreach services (WHO 1,196,000.00 USD)

Development of medical inventory system for tracking equipment, supplies etc…

Support the development of standards and guidelines

Strengthen FANC, Immunization and RED, disease prevention and control, training and capacity building for staff (MLM, IYCF, Surveillance) (UNICEF 65,000 USD)

UN Support to HSP/NDP4

SI 5: Access to Health Services Support Procurement of obstetric equipment &selected RH

commodities, contraceptives, emergency RH KITS & Female condoms Support AFHS & integrated SRH and HIV service delivery especially for

young people VIA and Cryotherapy Strengthen comprehensive GBV prevention & response Support youth participation in program design and implementation Support the HIV prevention response Support capacity of national statistical system to produce, disseminate

& utilize quality data on population dynamics(UNFPA: 1,245, 000.00 USD)

GRAND TOTAL= 5,509,600.00

MATERNITY WAITING HOMES

Transportation (Ambulances)

UN Support to HSP/NDP4

SI 6: Reduction of Diseases Adaptation of the new WHO guidelines for ART/PMTCT

and decentralized bottleneck analysis to define and target E-MTCT interventions

TA and financial support for capacity building to high impact interventions to prevent and control priority diseases

Support to evidence based programming – MPNDR (UNFPA 115,000.00 USD) (WHO 140,000.00 USD,

UNICEF 55,000 USD) TOTAL = 310,000.00 USD

CHALLENGES

Lack of adequate trained human resources for health (EmONC, IMNCI, PMTCT, AFHS etc…)

Low absorption/utilization of available budget for intended interventions

Limited community mobilization

Inadequate coordination and communication mechanisms among health partners;

Emergence of NCDs including Mental Health, HPT, Diabetes and Cancer (double burden)

RECOMMENDATIONS

Expedite recruitment, retention and motivation mechanisms for health work force (HRH Strategy);

Decentralize training to regions and districts and integration into pre-service training institutions

Strengthen Integration of services and coordination mechanisms between different stakeholders

Implement innovative strategies that will bring a difference on access and quality of health services (Integration, MWH for keeping women and newborns for 72 hours, VIA/Cryotherapy, on job training etc…)

Need for a paradigm shift to tie high coverage and improving quality of services

I THANK YOU