Tipos

The National Health Policy and the Health Sector Strategic Plan are implemented through partnerships described under the broad framework of the Health Sector Wide Approach or SWAp. Under this framework, the Government of Uganda, through the Ministry of Health, has the lead role and responsibility for delivering the outputs of HSSP. Various other partners have defined roles to play and contributions to make. A series of memoranda of understanding or other formal arrangements such as government regulations, policy documents and contracts, are in place or are under development to govern these relationships.

2.3.1 Government of Uganda / Development Partners partnership

The Sector wide Approach (SWAp) was developed as a mechanism to “addresses the health sector as a whole in planning, management and in resource mobilization and allocation”. The SWAp supports Government in mobilizing and managing resources for the sector. Although support to the government’s budget (either general or sector specific) is the preferred financing mechanism, where partners cannot follow this approach, project support can be provided. The revised Memorandum of Understanding between the Government of Uganda and the health development partners (HDPs) spells out the obligations of the main parties and describes the structures and procedures established to facilitate the functioning of the partnership. The following are key structures and processes:

• The Health Policy Advisory Committee (HPAC) has proved beneficial in providing overall policy guidance to the sector. The HPAC Working Groups continue to carry out functions assigned by HPAC

• The annual GoU/DP Joint Review Missions enable the joint monitoring of the sector performance. The JRM receives the Annual Health Sector Performance Report and determines whether overall performance has been satisfactory. JRM also sets the priorities for the following year at the strategic level, through the identification of priority technical programmes, agreeing undertakings (or key process outputs) and determining broad allocations for the budget cycle. The HPAC Secretariat ensures that

the participants receive in a timely manner, electronic copies of the relevant documents for each Joint Review Mission.

• The Health Sector Working Group (SWG), established under the auspices of the Ministry of Finance, Planning and Economic Development, is the structure focused on the budget cycle and managing the approval and alignment of project inputs to the sector. New projects should follow GoU standards, guidelines and systems, be fully aligned with HSSP II priorities and minimize overheads as project resources are now counted as part of the total allocation to the sector and can displace budget resources. The budget process for FY 2005/06 – 2007/08 includes guidelines to SWGs on gender and equity budgeting.

• The National Health Assembly (NHA) was created to provide an annual forum for the broader health partnership (central and local governments, civil society, and development partners) to review sector policy, plans and performance. It provides an effective medium for wider consultation, political mobilization for health, and for consensus development among the stakeholders. The NHA first convened in 2003. As part of HSSP II the scope and mandate of the NHA will be clearly defined and its organization improved so as to derive maximum benefit from the effort. The Assembly is consultative and advisory. The NHA convenes once a year, with the MoH providing the secretariat.

• The health development partners (HDP) are responsible for their own co-ordination through the HDP group, which provides a forum for information sharing, consensus building and collating and coordinating responses to government. It is intended to reduce transaction costs for all parties, but especially government partners. The lead agency role is rotated on an annual basis.

The rapidly evolving nature of SWAps and the high turn-over rate of officers at all levels of the partnership demand that there is periodic information sharing and capacity building during the HSSP II period. The main purpose is to reorient and update on a periodic basis all major stakeholders, including the Local Authorities, on the principles and practice of SWAps in the health sector in Uganda.

2.3.2 Public Private Partnership for Health

The National Health Policy objective of making the private sector a major partner in national health development has to a large extent been achieved for the Private-Not-for-Profit sub- sector. A central PPPH coordinating office has been established within the MoH and a focal person for PPPH designated. The National Policy on Public Private Partnership in Health has been drafted and contains components addressing partnership with the PNFP and PHP. The component addressing partnership with the Traditional and Complementary Medicine Practitioners in not yet drafted. The related implementation guidelines for the PNFP and the PHP sub-sectors once approved, will be applied during HSSP II.

During HSSP II, effort will be directed to strengthening and broadening the partnership through more active engagement with other health related sectors, professional associations, private health care providers and TCMP, civil society and representatives of the principal consumers. In particular:

• Implementing the guidelines for the PNFP and PHP sub-sector to promote the partnership at Local Government level.

• Generation of evidence to promote and support the Public Private Partnership

• Strengthening the regulation of the private sector through the professional Councils and Associations

• Creating an enabling environment for investment in health

• Establishing appropriate institutional structures for implementing the PPPH; and

• mainstreaming PPPH in MoH activities, other line ministries and districts, including instituting a process for joint operational planning for a single District Work Plan. A similar policy framework will be developed for other private service providers such as private laboratories, pharmacies, drug shops and civil society non-facility-based service providers. The objective is to update and harmonize regulatory provisions governing the various components of the private health sector.

The important role of traditional and complementary medicine cannot be overstated. During HSSP II, the PPPH Office will expedite the process of facilitating the TCMP groups to come together and develop an appropriate policy and draft regulatory bill.