7. Ms. Rukayya Mansab WHO 8 Dr. Yahya Ipuge CHAI

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1 Agenda Attendance: 1.1 Present: TC SWAp MEETING 18 th March Ms. Blandina Nyoni PS MoHSW, Chairperson bnyoni@simbanet.net 2. Dr. Deo M. Mtasiwa CMO, MoHSW cmo@moh.go.tz 3. Mr. E. Maswi DPS, PMORALG dps@pmoralg.go.tz 4. Mr. Jacques Mader Swiss Cooperation jacquesmader@sdc.net 5. Dr. Rufaro Chatora WHO chatorar@tz.afro.who.int 6. Ms. R. L. Kikuli MoHSW rlkikuli@yahoo.com 7. Ms. Rukayya Mansab WHO mansabr@tz.afro.who.int 8 Dr. Yahya Ipuge CHAI yipuge@clintonfoundation.org 9. Ms. Kessy Mgonela MoHSW mgonela2001@yahoo.com 10. Dr. Marcel L. Madili CSSC mmadili@cssc.or.tz 11. Ms. Tusa Mwakosya MoHSW tmwakosya@yahoo.com 12. Ms. Columba O Dowd Dev. Specialist columba.odowd@dfa.ie 13. Ms. Peggy Thorpe CIDA peggy.thorpe@ccotz.org 14. Dr. Ellen M. Senkoro, Mkapa Foundation, emsenkoro@mkapahivfoundation.org 15. Ms. E. Mwakalukwa MoHSW ellymwakalukwa@yahoo.com 16. Dr. Bjarne O. Jensen MoHSW bjensen@hspstz.org 17. Dr. Anna Nswilla CDHS answilla@yahoo.co.uk 18. Dr. Faustine Njau MoHSW faustinnjau@hotmail.com 19. Ms. Mariam Ally MoHSW mariammwakobe@yahoo.com 1

2 20. Mr. Bernard Konga MoHSW 21. Dr. Makamla Mnungu MoHSW 22. Mr. Joseph Kelya MoHSW 23. Mr. R. D. Mutagwaba MoHSW 24. Ms. Prisca Lwangili MoHSW 25. Mande Limbu CARE 26. Mehjabeen Alarakhia CARE 27. Dr. Emmanuel Malangalila World Bank 28. Ms. Janeth Kibambo MoHSW 29. Mr. Winna Shango MoHSW 30. Mr. Lusajo E. Ndagile MoHSW 31. Ms. Mary Swai MoHSW 32. Ms. Kirstine Nojgaard DANIDA 33. Dr. Rik Peeperkorn EKN 34. Mr. N. Mwamwaja MoHSW 35. Dr. J. K. Chuwa MoHSW 36. Dr. G. D. Ndossi TFNC 37. Mr. J. J. Rubona MoHSW 38. Dr. S. M. Egwaga MoHSW 39. Ms. Erika Fukushi MoHSW 40. Ms. Mayumi Sugihara MoHSW 41. Ms. N. Mnzava MoHSW 42. Dr. Mary Kitambi MoHSW 43. Dr. Samwel Ogillo APHFTA 2

3 44. Mr. Maximillian Mapunda WHO 45.. Dr. Hiltruda Temba MoHSW 46. Mr. Irenei Kiria Sikika 47. Dr. Charles G. Massambu MoHSW 48. Ms. Susan Monaghan USAID 49. Mr. Andrew Rebold USAID 50. Dr. Angela Ramadhani MoHSW 51. Dr. Rita Noronha UNFPA 52. Dr. Theopista John WHO 53. Dr. Saidi Mpendu BAKWATA 54. Mr. Andrew N. M. Sayile PMO-RALG 55. Dr. Peer Sieben MoHSW 56 Mr. Raynold John MoHSW 57. Ms. Jeanne K. Ndyetabura MoHSW 1.2 Absent with apology: 1. Dr Adeline I. Kimambo CSSC 2. Mr. Severine Kahitwa PMORALG 3. Ms. Winfrida Nshangeki PMORALG 4. Mr. Needpeace Wambuya MoFEA. 2.0 Agenda for the meeting endorsed: 1. Introduction, 2. Agenda for the meeting, 3. Minutes of the Last meeting, 4. Matters arising, 3

4 5. Status of the Technical working groups, 6. Specific Up Dates and Presentations, 7. Schedule of future WG, TC-SWAp, SWAp and BFC meetings, 8. Any Other Business. 3.0 Discussion and Agreements: 3.1 Agenda item number1: Introduction: The chairperson opened the meeting at am. She commended for well organized TC-SWAp meeting. The chair recognized the presence of the WHO Representative and was followed by self introduction Agenda item number 2: Adoption of the agenda: Agenda were adopted and agreed. 3.3 Agenda item number3. Minutes for the last meeting: Minutes of the last meeting were passed. However, the name of Ms Kirstine Nojgaard, Counselor (Health) RDE to be added in the list of those attended. 3.4 Agenda item number 4: Matters Arising: a) Final 2009/10 Milestones: Members were informed that the 2009/10 Milestones were finalized and availed to all members. b) Updates on the final Health Sector Performance Profile Report, PAF Indicators and TPA: Update on Final Performance Profile Report 2008/09, was presented by Head, M&E. He explained that the work is ongoing. He also highlighted on the status of PAF indicators and TPA Comments given by members: GTZ Health Coordinator said that, he is aware of the four PAF Indicators. However, the EU has added one indicator to be from the Region and this is in the contract signed by EU and MoFEA. This means that the MoHSW and PMORALG 4

5 should abide to this condition, otherwise non compliance would lead to reduction of funds from the DPs. First Secretary, Royal Netherlands Embassy, proposed that there is a need to harmonise the targets in HSSP III and that in MKUKUTA and that the targets set should be realistic and achievable.. Chair DPGH TROIKA, raised a concern that there are some inconsistence of target figures in the PAF Indicators. He requested Head HSRS/Coordinator of Health Sector MKUKUTA to verify the target figures and that the corrected PAF Indicators will be discussed in the next Monitoring and Evaluation Working Group Meeting. WHO Programme Officer, asked if there is a room for flexibility on EU regarding the increase of indicators? Chairperson, responded that, there is a flexibility, so long that the indicators are not many and are achievable in the given time period. CMO informed the meeting that, Head HSRS will set a clear vision on regional indicators that is achievable and answered the concern of the EU. c) Review of the Joint Annual Process after a decision of conducting comprehensive JAHSRs Bi-annually:. The review was presented by the Head of the HSRS. He pointed out that a Task force (see list) was formed and had a meeting on 17 th February The Task Force came out with the proposal that was presented to the meeting. The list and proposal were endorsed by TC SWAp. GTZ-,Health Sector Coordinator, informed the members that he has accepted the list, however, he will be in the Task force till May d) TOR for the 12 Working Groups: These would be discussed as an agenda. 3.5 Agenda item number 5: Status of Technical working Groups: The chairperson informed the members that all chairs and deputy chairs of the 12 WG have been officially appointed and are coordinating the implementation of their Working Group activities in accordance to their Terms of Reference. This was followed by updates given by the chairs of working groups. Eight groups presented the status of implementation with the exception of four groups including Multi-Sectoral Nutrition, 5

6 Disease Specific Programs, Emergency Preparedness and Pharmaceuticals, Commodities, Infrastructure and Food Safety. These groups that did not do so, were requested to prepare and circulate to all TC SWAP members in a week s time. 1) Region and District working group: The Chair of the Group, reported that she is on track as far as the milestones of reviewing of the CCHP Guidelines is concerned. a) Who are the stakeholders of this group? Response: Everybody involved in the health related activities. Interested parties however, may be invited to the working group discussions/meetings following the need to prevailing topics of discussions. b) Milestones 2. Regional Hospitals: Is this milestone included in this technical working group? Response: Yes, although some of its activities could be discussed in other W/G. c) Health Services Boards for hospitals: Are they legally established? Response: Yes, the Draft guideline is in place and the process for its approval is on process. d) Financing of District Health Services. Under new system, there should be three accounts in the district that is, Personal Emolument (PE), Other Charges (OC) and Development. Basket fund will be channeled through Development account. Issues raised: Will this new system increase bureaucracy? Won t the consolidation of these funds involve more days before the release? Response: Since the consolidation of the accounts was done by MoFEA, then the Health Care Financing Working Group will discuss on how to address the 6

7 issues raised. The recommendations from the HCFWG will be discussed by MoHSW, PMO-RALG and Ministry of Finance and Economic Affairs. 2) Human Resource for Health Working Group: The chair of this WG reported that the implementation of the milestones set is on track. Comments. a) Other Ministries like MoFEA, POPSM, PMORALG, PO, Civil Services Commission should be members in this working group. b) Are funds for carrying these activities available? Response: Yes, they are from Government, Development Partners and other stakeholders. c) Following the good effort made by the government of constructing new health facilities, is there a plan to match these efforts with a production, retention and distribution of workers? The MoHSW is advised to design strategies for solving this earmarked gap. Capacity of Training Institution is also supposed to be increased to suite the current need. d) Are we on track to achieving the milestones as per set deadline? Response: Yes, the achievement is 50%. e) In the Next TC SWAp in May 2010, the presentation should relate the ratio of increasing number of personnel in relation to increase in facilities and population. 3. Health Care Financing Working Group: Up date on this Group was presented by the Group chair. Public Expenditure Review; there was a discussion to have a specific work study on Human Resource group. What is the progress so far? 7

8 National Health Accounts should include RCH Sub Accounts. This is because there were limitations in accessing the data. The PER as designed cannot accommodate the MCH/RCH Sub Accounts. It s important to distinguish the Public Expenditure and National Health Accounts. NHA is not done regularly. Is it realistic to do it on yearly basis? Response: NHA will be done yearly. Since there is information on HRH, let s start slowly by including it in the Public Expenditure under review and enlarge gradually. Its better to capture both for Public and Private. Thus, PPP Technical W/G and Health Care Financing Working Group should discuss on how best to accommodate the HRH data in the PER under review.. 4. Monitoring and Evaluation Working Group:. Chairperson for M& E explained that the project is almost reaching the implementation stage. He informed the meeting that Ifakara Health Research Institute has been given a contract to do the job. Data should be completed immediately on the Health Sector Performance Profile Report. Another meeting should be held to conclude on the Health Sector Performance Profile Report.. Regarding on the Strategy to be supported by RNE, Norway, Ifakara and Global Funders; there is a need to put a clear management structure that depicts who reports to who? The strategy has been presented at the global fund and approved.. M and E W/G should come out with the final Work Plan to achieve the strategic outputs and this work plan needs to be in line with HSSP III. The Work plan should be endorsed by all the Potential Funders. It s better to consolidate on what we have, before looking for other studies. 5. Public Private Partnership (PPP): 8

9 The chairperson for this W/G presented the status. The chair, reported that the PPP policy guidelines will be ready in this financial year and will be distributed to all TC SWAp members. What is the status of the PPP Strategy and when will it endorsed by the TC SWAp? What is the status of the PPP independent desk? Has it moved to DPP or is it still on the agenda?. Has the PMO-RALG established the budget line item in the LGAs for Service Agreements What is the status? To be financed through the normal MTEF procedure. Responses: The PPP strategy will be finalized and be distributed to all the members. The management will sort out the issue of the PPP independent desk office. In the LGAs there will be three accounts (for PE, OC and Development) and that there will be a budget line item to pay for service rendered in line with service agreements between the LGAs and the Private Sector. Another explanation was given that Big Hospitals like Ndanda and other DDH Regional Hospitals will be supported by the Govt. Process is underway. 6. Maternal and New Born Child Health W/G: It was reported that the work of harmonizing and developing the TOR for this group was on process. Where are we in terms of Development Funds that focus on MNCH? The response was that there was no problem. 6.5 mills additional resources is present. Utilization of those funds is undergoing the normal government tendering procedures. Participants had comments that there is a need of spearheading the procurement process. There are so many studies in such a way that there is no need of further research. Available information should be utilized to enable smooth implementation of MNCH activities, what is important is Advocacy. 9

10 What has the Group (MNCH) done relating the inclusion of MNHC activities to RHMT and CCHPs. Response: Many interventions/activities in RHMT and CCHP are among the priority areas that get funds. During the assessment of these plans, this area is one of the criteria for approval. There are number of sub-working groups within this W/G. Can they be limited and become few? Response: Yes, it is possible. In the process of forming the group, all members are supposed to be invited; however members of this WG should have representation from the sub groups and other technicians could be invited to the meeting depending on the specific technical subject matter for discussion at that particular time. The Chair informed the members that smooth management of the WGs, the HSRS should propose the realistic number of each working group and that the WGs should meet once or more than once in every month and that the TC-SWAp should meet once after every two months. Most funds come from Development. Partners. Will it be sustainable? Answer: Funds for MNCH in the CCHP is allocated from various sources including block grants, cost sharing and LGDG. Under the MMAM also procurement of MNCH equipment is allowed. Which method will be used to make sure important equipment is being procured? Response: MNCH is producing a proto-type of equipment that is required and will be distributed to regions and districts. There was a concern that representation of Civil Society is limited. Response: It is not limited. For W/G group it is possible to increase the number of members but to TC SWAp it is difficult as limit number of members is stipulated in the MOU. 7. Social Welfare/ Social Welfare Protection Working Group: It was reported by the chairperson of this WG that the first meeting was held on 5 th January Draft ToR for this group are being prepared and the Cabinet Paper to table the Social Welfare Policy at the Cabinent is been finalised. It is expected that they will be presented at the next TC SWAp meeting in May and at the National Steering Committee. There is a need to increase the membership in the SWWG from the Development Partners including USAID. Response: There is no problem. 8. Health Promotion Working Group: 10

11 The status of this WG was reported that this is a new T/W group. The first meeting for this group was held on 11 th January Draft ToR were presented. Conclusion: How is the WG addressing the participation of the communities? Response: There is a participatory approach for the community to be involved in the preparation of the Plans. The issue of health promotion is complex. HEU has been strengthened to deal with health promotion and health centre and dispensary will have a unit to deal with health promotion. In addition, the Health Scheme of Service to be effected from July 2010 allows recruitment of Social Welfare Officers and Nutritionists to deal with health promotion at the community level. The TC SWAP meeting endorsed the TOR for the eight Technical Working groups. The remaining four groups were requested to meet immediately to finalize their ToRs and circulate them to TC SWAP members for comments in a week s time. HSRS should remind the chairs of the TWGs to meet as scheduled. Agenda no.6: Specific Up-dates and Presentations: a) CCHP Guideline: Presented by Coordinator, DHS. She pointed out areas that have been amended and those which have been added in the new guideline. It should be circulated to members for comments. Zero draft should also be distribution to BFC meeting. Is it a guideline for this year or next year? Members had different opinion regarding this. Others said should be for this year, others said there is no need of rushing. b) Health Workforce Initiative: This was presented by Assistant Director, Human Resources - Planning. Presentation should include SW interventions 11

12 Target should be set and indicate the time-frame. Should indicate the gap between the required workforce and the available one. There are different data that can be used. Working Group should sit and decide on the time frame. They can use the MKUKUTA and other information available instead of waiting to get the actual data. c) Budget and MTEF process: This was presented by the Director of Policy and Planning. She pointed out that MTEF guideline for the next financial year has been given. There is a lower ceiling than that of last year. She also pointed out the areas of focus as follow; Strengthen District Health Services and SW: Enhance quality and access to Maternal, Newborn and Child Health at Public and Private. Improving Human Resources capacity at all levels. Construction, rehabilitations and equipment. Strengthen Control of Communicable, non-communicable and reflected tropical disease. Is the lowering of the ceiling going to support increase of ceiling at LGAs. PMO-RALG is requested to look into the mechanism of controlling the funds. In the coming TC SWAp meeting there should be time to discuss the Draft of MTEF budget. A meeting could be called to share the MTEF breakdown. Basket Finances need to be reflected and discussed at the BFC meeting. It was advised that the Health Care Financing should look on the value for money for the interventions. PS MOHSW informed the participants that she has directed Ministry officials to use Health Facility, Health Institutes conferences as venues instead of Hotels. Chairperson promised to organize an Ad-Hoc meeting to discuss on MTEF. 12

13 d) Cost sharing: Coordinator for Health Financing explained that the cost sharing guideline has been reviewed and is undergoing the process of being approved. The cabinet paper on cost sharing has been prepared and will be presented. Members advised that the details should be discussed in the Health Financing Working Group. e) MKUKUTA: Presented by Head, HSRS. Information was given that MKUKUTA II has been completed and that MKUKUTA III has started. MoFEA did not allow active participation from other stakeholders. Some indicators have not been included. It is important to catch up. MKUKUTA is given emphasis from the higher level so the management for MoHSW should give it importance. Through MKUKUTA SWAp should ensure that Health gets a place. Discuss with Parliamentary people, push on budget allocation to health before budget. TROIKA requested to support. f) General Updates on the Establishment of the Health Sector Resource Secretariat: The process was explained by the Head HSRS. He indicated the components that fall directly under the resource secretariat and those that are under other departments. Global Fund Coordinator, Dr Temba also explained how Global Funds are being requested and utilized. HSS should cut across all sections instead of focusing on HIV/AIDS alone. HRH working group should also synchronize its activities to this working group. Each Regional Hospital should have a master plan for rehabilitation. Electronic copy should be produced and circulated to members for comments. HIV/AIDs sector requested to take attention and use the format. Secretariat to provide address. 13

14 Agenda no 7: Schedule of future W/G, TC SWAP, SWAP and BFC meetings: The schedule had been distributed before. Members advised that there should be a column that will indicate the implementation status. It was advised that if there are comments and additions they should be communicated to the secretariat. The schedule was approved by the TC SWAP. It was agreed that Meetings should be held on working days. Agenda no 8: Any other Business: 1. Revised ToR for TC SWAp Time will be given. The Task Force should look into them. 2. Rick outgoing up to June. Who is the incoming? TROIKA PS to take care of this. 3. PS will be chairperson for TC SWAp instead of CMO Closing: The meeting was closed at 5:00 p.m. Signed Chairperson (PS) Secretary.(DPP) 14