Regional Health Management

Report on FY2012/13 and Plan 2013/2014

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R.D. Mutagwaba,Regional Health Services Coordinator, MOHSW

Presentation Layout

1. RHMT Performance FY2012/13 2. RHMT Annual Plans 2013/143. On-going efforts and way

forward

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1. RHMT Performance 1. RHMT Performance FY2012/13FY2012/13

Based on the Annual Report

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RHMT reports are assessed in order to;• review the RHMTs’ capacity to coordinate

health activities and RHMT performance• Check if Gov. set health policies and guidelines

are being followed• identify areas in which RHMTs need

backstopping in the process of implementation

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RHMT Progress in 2012/13

Source of Funds (actual)

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Basket Fund65%

Block Grant

8%

USAprgram

20%

TGPSH 2%

GLRA 3% Global Fund 1%

Others 1%

Funds by Region (actual)

6

0

100

200

300

400

500

600

700

800Ar

usha

DSM

Dod

oma

Iring

aKa

gera

Kigo

ma

Kilim

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roLi

ndi

Man

yara

Mar

aM

beya

Mor

ogor

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twar

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wan

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ani

Rukw

aRu

vum

aSh

inya

nga

Sing

ida

Tabo

raTa

nga

Mill

ion

Tsh

OthersGlobal FundGLRATGPSHUSA programBlock GrantBasket Fund

Recipients and Expenditures

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3,326

404

1,017

103 81 64

3,628

469849

100 118 550

5001,0001,5002,0002,5003,0003,5004,000

Bask

et F

und

Bloc

k G

rant

USA

pro

gram

TGPS

H

Glo

bal F

und

Oth

ers

Mill

ion

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Recipient Expenditure

Expenditure by function

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F10 Supportive Supervision

35%

F4 Service Coordination

17%F1 RHMT Plans and strategies

11%

F5 Human Resource

Management11%

F9 Network System

9%

F6 Health Service Quality

5%

F3 PPP3%

F8 Support RR Hospital

3%

F7 Emergency and Preparedness

3%

F2 Policy dissemination

2%

Others1%

Staffing• 13 regions are missing some RHMT cadres

(out of 8 cadres)• 5 regions do not have RMO• New regions are missing 3-4 cadres, out of 8

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Achievement (by Indicators)

RHMTs’ Annual PlanTimely Submission

Quality (over 70 % scored in assessment)

2011/12 2012/13 2013/14

9/21(43%) 18/21 (86%) 22/25 (88%)

2011/12 2012/13 2013/14

NA 19% 76%

RHMT Quarterly ReportTimely Submission

Q1 Q2 Q3 Q4

10/21 (48%)

21/21 (100%)

14/21 (67%)

21/21 (100%)

Achievement (…cont.)

% of RHMTs which supervised to all CHMTs (21 Regions)

Achievement (…cont.)

4338

43 43

7167

8681

0

10

20

30

40

50

60

70

80

90

100

SS Reports SS Reports SS Reports SS Reports

Q1 Q2 Q3 Q4

Good Practices by RegionDodoma: NHIF - Income Improvement by

Dodoma RHMT and RRHMTPwani: Increased User fee collection at Tumbi

Designated Regional Referral HospitalKagera: Improving commodity management in

region-wideRuvuma: Intervention to alleviate enrolled

nursing cadre shortage

Achievement (…cont.)

Findings

• RHMT members managed to Annual Plan on time.

• RHMTs support the CHMTs in preparation of annual CCHPs and CHOP (CHOP in some regions).

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RHMT Reports

Findings• RMSS-C tools:RHMT conducted Supportive Supervision, using Regional

Management Supportive Supervision (RMSS-C) tools after the training since Q4.

• Satisfaction of RMSS-C tool :• 96% of respondents (63) satisfied with RMSS-C tools. • The data shows using the RMSS-C tools really contributed the

improvements of support to CHMTs, intern of understanding (92%), communication (88%), intervention and supports (92%), relationship with CHMTs (93%).

(Based on RMSS-C User Feedback Survey in Sep. 2013) 15

RHMT Reports

Areas for Improvement and Challenges

Improvement of CHMT’s management through RHMT’s support

Support to the Regional Referral Hospitals Introduction and utilisation of RMSS-H tools

Support for capacity strengthening of RHMT to ensure their sustainable growth

Effective peer learning and inter-regional networks Trial on localized capacity-building approach

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RHMT Reports

2. Summary and Analysis 2. Summary and Analysis of RHMT of RHMT

Annual Plans 2013/14Annual Plans 2013/14

Based on the Annual Report

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IntroductionRHMT Annual Plans were made base on 10 Functions

1. Plan and Report for RHMT2. Promote dissemination of Policies, Regulations, Guidelines and

Circulars3. Promote an appropriate environment for private sector4. Coordinate Health and Social Welfare Services in the region5. Support Human Resources for Health and Social Welfare

Management6. Promote provision of quality services in all councils7. Facilitate emergency and disaster preparedness and response8. Enhance Regional Referral Hospital management capacity9. Develop inter-regional networking10. Conduct Supportive Supervision to CHMTs 18

Source of Funds (FY2013/14)

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Basket Fund 52%

Block Grant 16%

USA prgram

12%

GIZ 6%

UNICEF 3%

Global Fund 4%

Others 7%

Source of Funds by Region (FY2013/14)

20

0

100

200

300

400

500

600Ar

usha

Dar

es

Sala

amD

odom

aIri

nga

Njo

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Kage

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liman

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Lind

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anya

raM

ara

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orog

oro

Mtw

ara

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anza

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Ruvu

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Shin

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uSi

ngid

aTa

bora

Tang

a

Mill

ion

Tsh

Others

Global Fund

UNICEF

GIZ

USA prgram

Block Grant

Basket Fund

Findings

• 52% of budget rely on Basket Funds.• Amount of Basket Fund by Region was

decreased due to increased numbers of regions (21 to 25)

• There are huge gap of budgets by Region.

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Annual Plans

Assessment Results of RHMT Annual Plans 2013/14

Criteria Max Average Score 1. Timing of submission 5 76% 2. Structure /outlay of the plan 3 81% 3. Executive summary 4 80% 4. Budget Summary 3 87% 5. Regional Profile 2 92% 6. Current Status/Services & Admin 5 76% 7. Review of implementation 3 78% 8. Summary of issues to be considered 5 73% 9. Plan of Operation 10 74%10. Budgeting 10 81%

Total 50 Av. Score 78 %22

Score by RegionRegion Score (%) Region Score (%)1 Coast 96% 13 DSM 78%2 Kagera 92% 14 Morogoro 76%2 Ruvuma 92% 15 Rukwa 75%4 Manyara 88% 15 Katavi 75%5 Mtwara 86% 17 Arusha 74% 5 Shinyanga 86% 18 Dodoma 72% 5 Singida 86% 18 Kigoma 72%8 Lindi 84% 18 Njombe 72%8 Tanga 84% 21 Tabora 71%10 Mara 82% 22 Simiyu 70%10 Mbeya 82% 23 Iringa 64%12 Kilimanjaro 80% 23 Geita 64%

25 Mwanza 60%

Findings

• Average score of Annual Plans:- 80% for 21 regions- 78% for 25 regions

• Timing of submission improved i.e. 76% compared to previous year 40%.

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Annual Plans

Areas for Improvement

• More emphasis needed for linkage between situation analysis – problem identification, planning and how to support CHMTs and RRHMT.

• Presentation of the figures in situation analysis needs further scrutiny.

• RHMTs need more clarification on how to set priorities

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Annual Plans

On-going Effortsand

Way Forward

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On-going Efforts

•Revision of the Document on “Regional Health Management” (in 2008) •RMSS-H tool development for enhancement of the RRHMT’s managerial capacity•Closer relationship with PMORALG

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Thank you for your listening!!!

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