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PERFORMANCE ASSESSMENT & PLANNING MEETING GHS/NTD COUNTRY PROGRAM: FINANCIAL MANAGEMENT INFORMATION SYSTEM STRENGTHENING
This report was made possible by the generous support of the American People with funding from the United States Agency for International Development (USAID) and the END in Africa Control of Neglected Tropical Diseases Program, led by FHI 360, under Cooperative Agreement No. AID-OAA-A-10-00050. It was prepared by Deloitte Consulting LLP. The views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government.
PERFORMANCE ASSESSMENT & PLANNING MEETING GHANA HEALTH SERVICES NTD COUNTRY PROGRAM: FINANCIAL MANAGEMENT INFORMATION SYSTEM STRENGTHENING
JULY 2012
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CONTENTS 1 EXECUTIVE SUMMARY ....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
2 BACKGROUND ....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
3 DELOITTE’S CAPACITY BUILDING METHODOLOGY AND PROCESS ....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
4 STRENGTHENING THE FINANCIAL MANAGEMENT SYSTEM OF GHS: EXPERIENCE USING THE CAPACITY BUILDING METHODOLOGY WITH GHS/NTDCP....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
4.1 Capacity building workshop .....................................................................................................6 4.1.1 Analyze current capabilities .....................................................................................................7 4.1.2 Set performance goals.............................................................................................................8 4.1.3 Design solutions ......................................................................................................................9
5 LOOKING FORWARD: NEXT STEPS AND CONTINUED SUPPORT TO NTDCP ON FINANCIAL MANAGEMENT ....... . . . . . . . . . . . . . . . . . . . . 11
6 BEST PRACTICES AND LESSONS LEARNED....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
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1 EXECUTIVE SUMMARY The END in Africa project supports national neglected tropical disease country programs in implementing and scaling-up integrated activities to control NTDs. It also provides technical assistance to build sustainable capacity in host countries to implement such programs.
Strengthening the health ministries’ capabilities in financial management, budgeting, work planning, and monitoring and evaluation is fundamental to the success of NTD programs.. Without strong financial management systems, budgets will not align to program needs, drugs will not be purchased based on demand, staff will not be paid on time, fiduciary integrity will be lost, and program targets will not be achieved. Strong financial management enables the scaling-up of integrated mass drug administration, promotes country ownership of NTD programs, improves resource utilization and facilitates resource mobilization.
In Ghana, FHI360 and Deloitte Consulting, LLP have established a partnership with Ghana Health Services (GHS) to strengthen organizational capacity and promote local ownership of the country’s NTD program. In June 2012, Deloitte piloted a capacity building workshop to help program managers and ministry officials analyze their financial management processes and systems, define gaps in performance, and identify areas for improvement. Workshop participants—primarily GHS/NTDCP managers and staff--utilized a customized maturity model to undertake a process of self-reflection, diagnostics and planning.
This process helped the participants identify desired growth areas by:
1. Defining desired performance targets
2. Measuring current performance in financial management against those targets
3. Identifying gaps between the two.
4. Articulating and prioritizing specific action items to close those gaps.
5. Establishing indicators to measure progress over time.
6. Developing a work plan for addressing the gaps. 7. Establishing a mechanism and schedule for ongoing monitoring, with the flexibility to
adapt to unforeseen circumstances, incorporate newly identified priorities, and support ongoing improvements.
By the conclusion of the workshop, GHS/NTDCP managers and staff had set performance targets in areas to define the direction in which the organization would like to go. The performance targets included: • Stakeholder satisfaction exists with the financial management processes
• Roles and responsibilities of financial management unit staff are clear to everyone
• Capacity and skills of staff are improved in proposal writing and fundraising for more effective resource mobilization
• Risk management for NTDCP is established and improved
• Financial reporting systems are in place for timely reporting to NTDCP on program financial performance
• Financial allocation and expenditure tracking processes are made more efficient
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In addition, action items were identified that align to the performance targets and will help the GHS improve their performance:
• Develop a finance strategy for NTDCP
• Develop an NTDCP-specific framework to accelerate and streamline compliance with new and updated policies
• Design a Program Financial Analysis Tool
• Strengthen resource mobilization and public-private partnerships (PPP)
• Design a risk management strategy
There is a unique opportunity for the END in Africa to build on the momentum created during this capacity building workshop and ensure that the GHS/NTDCP program is able to see to fruition the action items that were defined, as well as achievement of the performance targets. To do this, the END in Africa project has been requested by the GHS to support the NTDCP. The specific areas of support are discussed in Section 5.
Continued support in the financial management system, and building on the energy that was been created during the capacity building event, will enhance sustainability of the NTDCP and institutionalize a process of continuous improvement that facilitates country ownership and achievement of results.
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2 BACKGROUND Strong financial management systems are critical to the sustainability, effectiveness and efficiency of NTD program delivery. Without strong financial management systems, budgets will not align to program needs, drugs will not be purchased based on demand, staff will not be paid on time, fiduciary integrity will be lost, and program targets will not be achieved. Further, strong financial management allows for the scaling-up of integrated mass drug administration and promotes country ownership, as countries are empowered to ensure compliance with US Government standards to support the transition of direct funding to governments to manage and support NTD programs.
USAID’s END in Africa project aims to strengthen national response to NTDs in five West African countries. The project addresses different components of the NTD Country Programs, including increasing coverage of NTD interventions, and more importantly, building capacity of the NTDCPs in the area of managerial, monitoring & evaluation, drug forecasting & procurement and financial management to better manage integrated NTD programs. Deloitte Consulting is responsible for the last point, and has three main interrelated objectives:
• Conducting financial training of the US Government rules and regulations for the NTD country programs (NTDCPs) and sub-grantees;
• Performing financial sampling of GHS/NTDCP expenditures to ensure the integrity; and
• Supporting the sustainability of national NTD service delivery by strengthening the capacity of GHS/NTDCP’s financial management processes and systems.
To kick-off the third objective above, Deloitte was asked to pilot a capacity building event, which would more broadly strengthen the financial management system to more effectively respond to the needs of the NTDCP. Ghana was selected as the pilot country and therefore, the END in Africa team worked with the Ghana Health Services (GHS) to tailor Deloitte’s Capacity building approach to their specific needs.
Deloitte’s Capacity Building Framework helps organizations through a continuous process of self-reflection, diagnostics and planning to establish:
1. A shared future vision for the organization and performance targets the organization will aim to achieve within the next 6 months.
2. A baseline measure of the organization’s current capacity across elements of sustainability and performance targets
3. A roadmap to meet the performance targets.
Combined, these steps engender stakeholder buy-in, collective thinking on the strengths and weaknesses of the financial management system, and a shared vision for how the organization will overcome the weaknesses to achieve agreed-upon performance targets.
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3 DELOITTE’S CAPACITY BUILDING METHODOLOGY AND PROCESS
Deloitte’s capacity building framework has distinct steps that help stakeholders walk through a process of vision, self-reflection and action. It moves beyond “yes/no” type questions and gauges an organization’s ability to have impact, as measured by its self-defined performance targets.
Through an interactive stakeholder workshop, Deloitte works with stakeholders collaboratively to move through the following steps of the framework:
Step 1: The discussion and development of a shared future vision for the financial management system based on the organizational mandate and/or the strategic plan, with related performance targets the organization will aim to achieve within the next 6-12 months.
Step 2: A baseline measure of the organization’s current financial management capacity. This is done through the use of a tailored maturity model (see below), which helps the organization self-assess its capabilities across defined domains and parameters. This assessment is fundamental in defining gaps in performance and related areas for improvement.
Each maturity model is tailored to the specific reality of the organization that will be using it. Deloitte collaborates with the stakeholders in advance of the capacity
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building event to define the relevant parameters and create a customized maturity model that reflects the applicable stages of capacity for the organization.
Workshop participants use the maturity model to define the appropriate “stage of capacity” reflecting the organization’s current capabilities along each parameter. This is followed by a discussion around: the stage at which the organization would like to be, the gaps and challenges that inhibit the organization from progressing to the next stage, and what needs to be done to overcome the challenges and progress to the desired stage.
Step 3: A work plan is established to achieve the desired improvements, meet performance targets, and overcome the defined gaps. This step requires staff to define resources necessary for achieving the improvements including time, finances, leadership support, training and technical assistance. Participants also prioritize which activities they will pursue, based on what is most realistic in the next 6 months.
Step 4: Based on the work plan that is defined among the group, efforts are begun to address the gaps and perform the activities defined in the maturity model, helping the organization advance its capacity in each of the prioritized parameters.
Step 5: Throughout all of the steps, leadership and staff will meet regularly to monitor and manage performance per the agreed-upon goals. As part of this process, leadership will plan a follow-up workshop to revisit the maturity model to see if the organization has progressed closer to the desired stage within the parameters, identify additional challenges and update the action plan.
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4 STRENGTHENING THE FINANCIAL MANAGEMENT SYSTEM OF GHS: EXPERIENCE USING THE CAPACITY BUILDING METHODOLOGY WITH GHS/NTDCP
The END in Africa project engaged the GHS to work through the capacity building methodology, focusing on the financial management system that supports the NTDCP. To prepare for the event, a process mapping exercise was conducted to better understand how the GHS is organized and how funds flow through the organization.
The GHS is an autonomous government agency within Ghana’s executive branch. Charged with implementing national health policies mandated by the country’s Ministry of Health, including administering the NTDCP, the GHS is organized administratively along three levels (National, Regional and District) and functionally, along five levels (National, Regional, and District, Sub-district and Community). Funding from the Government of Ghana and its development partners is administered via GHS’ Budget and Management Centers (BMCs) or Cost Centers.. The GHS/NTDCP program operates across these different divisions, which requires complex financial management processes and heightens the need for integrity in the management of funds.
To improve financial management efficiencies, the GHS/NTDCP leadership asked the END in Africa project to customize a capacity building approach for the NTD program. Through discussions with GHS leadership, key financial management focus areas were identified:
• Strategy & Execution
• Leadership & Team Dynamics
• Finance Governance
• Policy & Processes
• Talent & People
• Transaction Processing
• Performance & Decisions
• Financial Control & Documentation
These priority categories were used to define the maturity model domains. With these categories, or domains, the project worked with GHS leadership to tailor a maturity model with specific parameters and performance measurement indicators for GHS/NTDCP. Please see Annex I for the maturity model developed for GHS. .
4.1 CAPACITY BUILDING WORKSHOP Having the right mix of participants is vital to the success of this type of capacity building workshop. In Ghana, participants included finance and accounting professionals as well as NTD project personnel from GHS, Catholic Relief Services (the END in Africa project partner that manages program operations in Ghana). Equally important is to include both managers
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(particularly the GHS Finance Manager, in this case) and staff in the participant mix, so that buy-in is achieved among decision-makers as well as among the operational staff. This helps to ensure the sustainability of the work plan by engaging both the personnel that are empowered to allocate resources as well as the staff that will carry out the work on the ground.
The following participants took part in the capacity building workshop: two facilitators from END in Africa, 6 technical officers from the GHS/NTDCP, 4 staff from Catholic Relief Services (CRS/Ghana), 2 regional accountants, and 3 national finance managers.
The full agenda of the workshop is attached in Annex II. However, a summary of the findings from the three main sections of the workshop follows.
4.1.1 ANALYZE CURRENT CAPABILITIES1 As discussed above, the maturity model is a tool that can be used to define an organization’s “stage of maturity” along a continuum. The tailored maturity model is built to reflect domains and parameters that are consistent with the organization’s goals and targets. In the case of the GHS, they were gathered to discuss the financial management system; as such, the maturity model was built to reflect issues related to financial management.
The GHS assessed its current capabilities against the maturity model developed according to its unique financial management system. To encourage maximum participation among everyone present, the facilitators separated the participants into two multidisciplinary sub-groups. Each group:
• Discussed the capacity domain and parameters, and identified the current level of maturity of the GHS/NTDCP financial management system based on the model;
• Scored the stages of “capacity” against each parameter: Stage 1 (Lagging) – Stage 4 (Leading);
• Documented their discussion and reasoning why they collectively marked each parameter at a given stage; and
• Discussed and documented the steps that need to be taken to improve the stage of capacity for each parameter, focusing on defining specific actions and changes necessary for improving the ranking.
Once the sub-groups completed the parameter reviews for each domain , each group presented its assessment and the entire team came to a consensus on the ratings and finalized the baseline assessment.
This process was followed by a session where the GHS/NTDCP participants prioritized capacity gaps to address challenges identified in the participatory assessment. In prioritizing the gaps, participants considered factors such as:
• Relevance: Which parameters are most closely connected to the NTDCP objectives?
1 After initial discussion with the GHS Finance Manager, the group urged the facilitators to go through the maturity model first, before step 1 of the framework, which is to set the performance targets. Therefore, the sequence of the framework is out of order. More is explained in the “lessons learned” section.
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• Impact: What positive impacts will the Program or Budget and Management Centre experience if the capacity gaps in this parameter are addressed? What negative impacts will it experience they are not addressed?
• Time: How much time is required to make a change in this parameter? Is it something that can be addressed in the next 6 months? Do other changes need to happen before these capacity gaps can be addressed?
• Stakeholder involvement and support: Who are the main stakeholders that will be involved in addressing the capacity gaps in this parameter? What level of support is required to make a change? Does that support exist?
Top parameters and capacity gaps that the GHS/NTDCP team identified are:
Parameter Prioritized Capacity Gap of GHS/NTDCP
Finance Governance: Alignment (P1)
Financial objectives are defined within the GHS systems but seem not to be inculcated in NTDCP strategy. The NTDCP technical master plan exists, but does not correspond to a financial management strategy.
Finance Governance: Program Planning (P4)
No periodic planning meetings occur currently. Regular meetings should be held between finance and NTD programs at all levels.
Policy & Processes: P5-‐ Renewal
No framework has been established for the update/renewal and introduction of new policies. A framework should be developed to ensure the seamless incorporation of new and revised policies into the NTDCP.
Performance & Decisions: P1-‐Program Financial Analysis
Absence of standard format for program financial analysis
Strategy & Execution: P4-‐Resource requirements
Strategies for operations exist but proposal writing capacity is weak for finance and program staff.
Financial Control & Documentation: P2 Risk Management
Absence of risk register/matrix.
Additional detail can be found in Annex 3.
4.1.2 SET PERFORMANCE GOALS Normally this step is completed first. However, it was important to the GHS that this step be completed after the maturity model, so the group would have some context on where it needed to go.
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After a brief discussion of the GHS/NTDCP Strategic Agenda, which focused on the 5-year strategic plan, the participants utilized the following questions to frame appropriate performance targets:
1. What is the role of financial management vis-à-vis the NTDCP?
2. What are the expectations for the financial management system in regard to ensuring that the NTDCP functions effectively?
3. If the financial management system did not exist, what would happen to the NTDCP?
4. What financial management targets must the program meet in order to be sustainable and achieve the overall objectives?
These questions helped the participants discuss and better understand the overall purpose of the financial management system in the context of NTDCP, as well as envision what the performance targets might look like. As a group, participants also began to develop a clear definition of “success”, and to identify specific indicators to measure the NTDCP’s progress on the path to achieving the targets.
The participants used this process to set the following performance targets:
1. Stakeholder satisfaction exists with the financial management processes
2. Roles and responsibilities of financial management unit staff are clear to everyone
3. Capacity and skills of staff are improved in proposal writing and fundraising for more effective resource mobilization
4. Risk management for NTDCP is established and improved
5. Financial reporting systems are in place for timely reporting to NTDCP on program financial performance
6. Financial allocation and expenditure tracking processes are made more efficient
4.1.3 DESIGN SOLUTIONS Based on the identified priorities, participants determined the most effective allocation of time and resources to maximize the potential for progress, keeping in mind the limited supply of both. They identified appropriate actions and events to address existing performance gaps, and determined the requirements for resources and support, as well as a suitable timeframe for completion. This became their Performance Achievement Action Plan (i.e. work plan), which will change and evolve as the program moves through the maturity model continuum and/or new gaps emerge. The participants used this process to identify the following key action items:
1. Develop a finance strategy for NTDCP: GHS/NTDCP identified that financial objectives are defined within the GHS financial management system but are not defined in NTDCP strategy.
2. Develop an NTDCP-specific framework to accelerate and streamline compliance with new and updated NTD operational policies: A significant amount of the NTD program budget is allocated to cover per diems, fuel cost re-imbursement, etc. Disputes relating to operational policies, such as per diems,
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affect program implementation. The GHS/NTDCP needs an institutional framework to ensure that changes in NTD operational policies and processes are built into the financial management system.
3. Design a Program Financial Analysis Tools: Having identified the absence of standard formats for program financial analysis as a weakness, GHS/NTDCP needs to design a financial analysis tool and train the finance team in its use.
4. Strengthen resource mobilization and public-private partnerships (PPP): Develop and implement a training program in proposal writing & fundraising techniques for the NTDCP and finance teams to establish PPPs and mobilize resources for the program.
5. Design a risk management strategy: Develop a risk matrix for analyzing and improving GHS/NTDCP operational management.
See the full Performance Action Plan in Annex III.
To oversee the achievement of these actions, the GHS/NTDCP is establishing sub-committees for each of the key areas identified during the workshop. The subcommittees will be responsible for ensuring progress is made, actions are completed, and the Finance Director is informed.
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5 LOOKING FORWARD: NEXT STEPS AND CONTINUED SUPPORT TO NTDCP ON FINANCIAL MANAGEMENT
One of the key structural contributors to a program’s success is the strength of the financial management system. Transparency in information, maintenance of expenditure records, standardization of procedures & processes, close monitoring of program documentation and proper controls will enable GHS/NTDCPs to operate more effectively, achieving greater financial integrity and improved impact of the NTD program.
The capacity building workshop highlighted key areas of improvement to strengthen the financial management capacity of the GHS/NTDCP and ensure improved operational systems, and long-term sustainability of the NTDCP. To ensure that the GHS/NTDCP is able to build on this momentum, they are moving forward on a series of actions identified in their Performance Action Plan. Some items on the Plan can be completed by the NTDCP alone. But the participants requested specific technical support from the END in Africa team to help them address some of their action items, and help them get closer to their performance targets. To ensure that momentum is not lost, we propose continuing to work with the GHS/NTDCP to help them complete the action items. Together, the GHS and the END in Africa team have identified specific areas for technical support, which are described below, and are aligned to the action items.
Activity and proposed support from END in
Africa Time frame Expected Outputs Results
Action area 1: Develop a finance strategy for NTDCP that is aligned to the 5-year strategic plan
Assist GHS/NTDCP subcommittee to develop finance strategy to support the 5-year strategic plan Provide guidance on how to develop the strategy, so it clearly aligns to the 5-year strategic plan
07/12 – 10/12 Finance strategy to support the NTDCP 5-year strategic plan developed and linked to strategic objectives of NTDCP
Strategy launched and disseminated to all stakeholders
Full awareness and operationalization of NTDCP strategies (both technical & finance) Improved capacity of GHS/NTDCP to understand the importance of a finance strategy and how to ensure the strategy is linked to the strategic objectives. Improved dialogue between the GHS/NTDCP finance
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staff and the technical/service delivery staff Improved stakeholder satisfaction regarding financial processes
Action area 2: Develop an NTDCP-specific framework to accelerate and streamline compliance with new and updated NTD operational policies
Provide guidance on how to develop a framework through a targeted working group, helping them define what the framework might look like, the actions needed to finalize it, and how to operationalize it. Provide examples of models/frameworks that have worked previously for cross-program operations Facilitate dialogue between the GHS, the NTDCP and the finance team, to ensure communication about new policies
07/12-11/12 Identification of model frameworks/processes from other programs and countries
Creation of NTDCP-specific operational model so that new operational policies are communicated to those affected
The existence of a framework for the update/renewal and introduction of new operational policies that is built into the NTDCP/BMCs governance model.
Improved and more efficient processes for financial allocation and expenditure tracking
More compliance with NTD Operational policies
Fewer delays in payment because of improved compliance and fewer disputes on operational/finance issues.
Action area 3: Design a Program Financial Analysis Tool
Assist sub-committee to define the financial analysis needs and specifications to support more timely NTDCP financial reporting (through all the program stages, including planning, implementation, monitoring, etc.) Support the design of the Financial Analysis Tool through mentoring and guidance in tool development
08/12-12/12 Development of the program financial analysis tools
Training of 10 regional BMCs and 170 BMCs of finance team on developed tools for program financial analysis (Training reports)
Improved decision-making process based on available data Improved strategic planning capabilities of GHS/NTDCP staff to plan and implement programs based on financial data Consistent and timely reporting of NTDCP financial performance at unit and BMC levels through integrated
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Support the GHS/NTDCP in the use of excel or other applications that may be used as the platform for the Program Financial Analysis tool.
financial systems, automated reports and external sources.
Action area 4: Strengthen resource mobilization and public-private partnerships
Help the GHS/NTDCP understand their financial needs for expanding and sustaining their programs through the TIPAC. Support the GHS/NTDCP in identifying possible sources of funds to fill the financing gap (as defined by the TIPAC) Support GHS/NTDCP in designing and implementing a training program in proposal writing & fundraising techniques for the NTD program and finance teams
08/12-1/13 Knowledge of the funding gap Defined sources of potential funding to fill the resource gap
Developed training curriculum on proposal writing & fundraising techniques
Trained program and finance teams (12 BMCs) on proposal writing/fund raising (training report)
Submission of one or two bids/proposal(s) to potential resource providers
Improved decision-making process based on current and projected financial data
Improved network of GHS/NTDCP for potential funding, which can increase the sustainability of NTDCP
Increased resource mobilization for NTDCP and fewer funding gaps
Strategic partnerships with the private sector for resource mobilization and continued support
Action area 5: Design a risk management strategy
Support GHS/NTDCP in defining potential risks to the sustainability of NTDCP Provide technical support to the GHS/NTDCP in developing a risk mitigation plan, as well as tools to analyze and improve GHS/NTDCP financial and operational management
09/12-11/12 Team developed risk matrix for NTDCP
Orientation of staff (11 regional BMCs and 170 district BMCs) on risk management matrix
Better management of NTDCP financial risks Staff familiar with their role in mitigating financial risks, which can enhance the sustainability of the NTDCP
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The use of the maturity model in and of itself is very useful in helping organizations see where they are along a capacity continuum. The maturity model should be revisited every 6 months or so to continue the momentum and process improvements, until the organization has “graduated” and is operating at maximum efficiency. As depicted in the figure below, the GHS/NTDCP can get closer to their performance targets, continue to realign their operations with potentially new performance targets, and continue the process of business process optimization for stronger, more sustainable NTDCPs.
Therefore, the END in Africa project proposes that the maturity model be revisited with the GHS/NTDCP in the next 6 months to continue helping them improve their ability to achieve their performance targets, and help USAID enhance the success of the NTDCP through improved integration, collaboration, transparency, and accountability.
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6 BEST PRACTICES AND LESSONS LEARNED
This capacity building workshop was a pilot for the END in Africa project. Therefore, careful attention was paid to the process by which the workshop was organized and implemented. Many lessons were learned that will inform future capacity building workshops using the performance-improvement methodology described above.
• Key to the success of the workshop was the early involvement of the GHS/NTDCP Acting Deputy Director of Finance. Future workshops should continue to seek management involvement at similar levels, and securing this involvement should be adopted as a best practice of future END program capacity building workshops. Securing high-level managerial involvement in the workshop contributed to the workshop’s success in several regards:
o Mobilizing the appropriate staff to attend the workshop. o Motivating staff to actively participate and contribute ideas during the
workshop. o Increasing the level of managerial buy-in for the newly created Performance
Achievement Action Plan (PAAP), which is essential for the assignment of appropriate resources to carry out the plan.
o Obtaining managerial commitment for the PAAP increases the likelihood that the GHS/NTDCP will continue to implement and follow through on the work plan in the coming months, improving the prospect for the creation of sustainable program efficiencies.
• Overwhelmingly, the feedback from the workshop was very positive. In particular,
participants valued the open dialogue, and team-building focus of the approach and methodology. The capacity building methodology brought people together and started the relationship-building process between people in a number of different areas within GHS, many of whom did not necessarily work together much previously, but who need to do so in the future. Collaborating to make lasting change is critical. Collaboration cannot happen unless people have a common vision, and understanding of how to get there. The capacity building approach facilitated this and enabled willingness of participants to instigate change.
• Ensuring that the participants understand the methodology and are able to conceptualize how using it would help improve the financial management system were essential to the workshop’s success, from both a motivational and enabling perspective. Explaining the methodology and its benefits motivated the participants to spend time and effort to create the best possible Performance Achievement Action Plan for the NTDCP, and to commit to implementing it in the subsequent months. Future workshops should continue to devote sufficient time for this purpose.
• As mentioned above, once the workshop got underway, the group decided that Step 1, setting performance targets, should occur after Step 2, conducting the analysis with a maturity model. While this was not recommended, it ended up working out well. Explaining the maturity model early on in the workshop gave the participants a clearer understanding of the methodology and process, which was cemented by using the model right away to analyze the current state of the NTDCP. Once the team went through the maturity model, they appeared to have a much stronger
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vested interest in defining the performance targets, and they were eager to think about defining “success” of the GHS/NTDCP financial management system. Future capacity building workshops may also benefit from reversing the order of steps 1 and 2, at least for the initial workshop.
• Encouraging the team to think in advance about the capacity building approach and capacity issues may help in making the workshop more efficient. It would also ensure participants are familiar with the topics which are going to be discussed, and help them feel comfortable sharing their opinions. Distributing a set of questions to the participants in advance of the meeting, and asking participants to bring their ideas/responses with them to the event could prompt discussion and enable the group to think more deeply about current processes and areas for improvement.
• Financial sampling had not yet occurred in Ghana, which would have validated
some of the analyses and assessments made by the GHS/NTDCP. While this did not deter any of the discussions, the financial sampling findings may have provoked additional discussion and helped define priority areas for financial management strengthening. As it was, the Ghana financial sampling work occurred shortly after the capacity building event, so the findings can be compared, and further enhance how the performance action plan is implemented. Ideally, future capacity building events should be held shortly after financial sampling is done, in order to inform the activities and discussion during the workshop.
The capacity building workshop produced lessons learned for future activities, a baseline to measure future improvements of the GHS/NTDCP, and an actionable work plan. With continued support to from the END in Africa program GHS/NTDCP will be able to achieve its objectives and ultimately independently implement the national NTD program.
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ATTACHMENTS
Annex I: GHS/NTDCP Maturity Model
Annex II: Participants Guide & Program Agenda
Annex III: Performance Achievement & Action Plan
Annex IV: Capacity Building Event- Evaluation by participants
Annex V: Participants List
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