Lao People's Democratic Republic. COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Situation Analysis

Transcription

1 COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment* Information updated: May 25, 2012 Policy Context Global strategy on women and children/ commitment National Health Sector Plan and M&E Plan Situation Analysis To provide free deliveries in order to ensure access to the most vulnerable; To produce 1500 new midwives by 2015 by upgrading existing staff and training and recruiting new staff; and To increase immunization from 67% to 90% by To increase the proportion of couples with access to modern contraception and; To increase the proportion of births attended by a skilled attendant. Country team present at the Philippines Accountability Workshop, March 19-20, 2012 GOVERNMENT Dr Somchit Akkhavong Deputy Director of Hygiene and Prevention Department Ministry of Health svilaynack@yahoo.com Mr Suphab Panyakeo Technical Officer Planning and Finance Department Ministry of Health panyakeo2011@hotmail.com Dr Khampiou Syhakhang Deputy Director Maternal and Child Health Centre Ministry of Health s_khamp@yahoo.com; khampious@yahoo.com Mr Somphanid Vongdeuan Technical Officer Division of Social Statistics Ministry of Planning and Investment Department of Statistics resaturday_lee@yahoo.com WHO COUNTRY OFFICE Dr Kunhee Park Office of the WHO Representative in Lao PDR parkku@who.int H4+ Ms Siriphone Sakulku MNCH Coordinator UNFPA, Lao PDR ssakulku@unfpa.org *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 1/16

2 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* KEY: 1 Not present, needs to be developed 2 Needs a lot of strengthening 3 Needs some strengthening 4 Already present/no action needed Civil registration & vital statistics systems Assessment & Plan 1 Coordinating Mechanism 2 Hospital reporting 1.5 Community reporting 2 Vital statistics 1 Local studies for mortality 1 Situation analysis (strengths, weaknesses/gaps) There is no comprehensive assessment on CRVS. However, a simple assessment is included in national HIS strategic plan (Goal 4 Objective 9). Rapid assessments are ongoing by the Lao Statistics Bureau. A Situation Assessment and Design of CRVS was proposed by UNICEF, UNFPA, WHO, UNESCAP and Plan International in There is no official interagency coordinating committee, but an interagency (MPI/NSB, MOHA, MOH, MOE, UNICEF, UNFPA, UNESCAP, ADB, WB, Plan International) task force is in place. National standardized forms for facility-based death reporting exist and computer-based system is being piloted in selected central hospitals. However, function needs to be improved. There is a form of community reporting in selected provinces in some aspects. Vital statistics rely on 2005 national census projection. There are no local studies for mortality. Priority Actions 1. Conduct Situaltion Assessment and Design of CRVS in Lao PDR (UNICEF, UNFPA, WHO have secured some seed fund/ To be discussed with concerned Ministries and partners). 2. Strengthen interagency coordination involving all key stakeholders. 3. Multi-stakeholder follow up event. 4. Improve hospital reporting of death, use electronic reporting system (start from central hospitals, TA/fund required). 5. Training of doctors in ICD 10 (Training in Thailand will be supported by WHO). 6. Review the progress in selected provinces and scale up to other provinces (additional fund required for scaling up). 7. Strengthen the analytical capacity of vital statistics office, including data quality assessment. 8. Prepare next national census 2015 (MPI). 9. Consult with University of Health Science and NIOPH to start HDSS in selected districts (TA/fund required). *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 2/16

3 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Monitoring of results M&E Plan 2.5 M&E Coordination 2 Health Surveys 2.5 Facility data (HMIS) 2 Analytical capacity 2 Equity 2 Data sharing 2 Situation analysis (strengths, weaknesses/gaps) The 7th National Health Sector Development Plan ( ) with specified indicators is available. However, there is no comprehensive M&E plan is included in NHSDP. There are M&E plans of Sector Working Group and sub-sectorial health plans. Two indicators among the 11 indicators, namely PNC<2days and PMTCT, are missing in the M&E of the national MNCH package. National Sector Working Group for Health and several technical working groups exist as coordination mechanisms. Discussion to improve national M&E components is ongoing (supported by SWG). Lao Social Indicator Survey (MICS+DHS) is ongoing and may produce the initial result in August Lao Expenditure and Consumption Survey (LECS) 5 will be available in 2013 (Data collection in 2012). 2nd STEP survey (noncommunicable diseases) will be conducted in The first annual national health statistics report 2009/2010 using HMIS was issued in The second annual report 2010/2011 will be issued in the middle of Vertical programs such as FP, EPI, HTM have conducted facility based survey on data verification and service readiness. Stock availability survey for essential medicine and FP commodities is undergoing annually. Effort to improve province and district capacity on HMIS is undergoing. The first annual national health statistics report contained little analysis. Disaggregated results are available in the national survey. However, there is a lack of disaggregated information in HMIS. Limited function of the MoH and national statistics center website. Priority Actions 1. Strengthen the M&E component of the NHS (during mid-term review of 7th NHSDP in 2013). 2. Strengthen national M&E actions into national Sector Working Group for Health (no extra budget required). 3. Strengthen the collaboration between national statistics center (MPI) and MoH (especially, questionnaire development, joint analysis). 4. Include 10 year health survey plan into NHSDP during mid-term evaluation in 2013 (no extra budget required). 5. Consider MNCH household survey (only MNCH coverage or socio-economic module survey) in selected areas in late 2013 (To be discussed, additional funds required) Possibly not a required priority action. 6. Prepare next LSIS Revise and harmonize the HMIS-MCH forms. 8. Conduct annual survey for data verification and service readiness (collaboration with GAVI, GF or additional fund required). 9. National health statistics report includes additional information such as NHA, stock availability survey. 10. Province/district level capacity building will be included and integrated into the MNCH package implementation (Funds partially secured by several partners). 11. Strengthen the analysis of data for more disaggregated data use. 12. Update MoH and national statistics center website for more access to health information (GF, JICA). 13. Wider dissemination of all relevant reports. *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 3/16

4 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Maternal death surveillance & response Notification 1 Capacity to review and act 2.5 Hospitals / facilities 2 Quality of care 1 Community reporting & feedback 1.8 Review of the system 2 Situation analysis (strengths, weaknesses/gaps) There is no national policy (However, routine reports could be a better option for Lao than 24 hour notification?). Routine report from village level has been implemented in selected provinces (Vientiane capital, Xiengkhuang, Salavan/ Future: Luangnamtha, Savannakhet, Houaphan out of 17 provinces). Maternal death review system has been implemented in two provinces and will be scaling up to other provinces. Only selected hospitals (4 central, 2 provincial, 14 district hospitals and around 100 health centers) are conducting facility based maternal death review. National focal point for maternal death review occuring in hospitals (person and department) has not yet been identified. EmOC assessment in 15 provinces and rapid EmOC assessment in other provinces. 10 MR (Minimum requirement) for district hospital and health center under implementation (simple checklist, nation wide). Community reporting and feedback present in selected provinces (Vientiane capital, Xiengkhuang, Salavan/ Future: Luangnamtha, Savannakhet, Houaphan out of 17 provinces). The first annual review of system meeting will be conducted in the middle of Priority Actions 1. MoH to discuss whether MoH includes maternal death into notifiable events rather than reporting separately (currently 19 events). If yes, disseminate above decision to provinces and districts (using surveillance budget). 2. Provincial level trainings to strengthen province and district capacity (fund secured by UNFPA and WHO/CO). 3. Develop hospital based reporting guideline and template (24 hours notification) (to be discussed). 4. Training in ICD certification and coding (links with CRVS) (fund secured by WPRO, in Thailand). 5. Dissemination of the reporting template (using OBGY society annual conference). 6. Strengthening 10 MR for HCs. 7. Continue province/district based implementation (fund partially secured). 8. First annual report and review meeting in the middle of 2012 (fund partially secured, TA required). *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 4/16

5 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Innovation and ehealth Policy 2 Infrastructure 2 Services 1.5 Standards 1 Governance 1 Protection 1 Situation analysis (strengths, weaknesses/gaps) A specific national ehealth strategy does not exist. However, an ehealth component is included in the national HIS strategic plan National ICT strategic plan (mainly infrastructure) is under finalization in the Ministry of Post and Telecommunication. Signal (3G) is available in most district hospital and health center levels. However, these devices are not available at the health center level. There are some onging pilot initiatives to improve information systems. There is currently no national ehealth standard or interoperability requirements. There is an absence of a separate governance mechanism responsible to coordinate with stakeholders to plan and implement ehealth. There is an absence of a data protection legislation and regulatory framework. Priority Actions 1. Build on a national ehealth strategy with country leadership (to be discussed) using eheatlh Strategy Development Toolkit. 2. Provide proper devices (such as mobile phone, tablet PC, 3G sim card, etc) and training to health centers in selected districts. 3. Advocate for better connectivity to rural areas. 4. Share the experiences from different pilot initiatives (Fund required). 5. Harmonize/Develop the application or a program at national level to replace current paper based data collection forms (TA needed). 6. Consider pilot project on Innovative ICT for MNCH in selected districts to get practical experience (fund required). 7. Develop interoperability requirements or standard at national level (TA needed ). 8. Develop a data dictionary. 9. Use existing health planning and financing TWG as the national coordination mechanism for ehealth. 10. Strengthen coordination between Ministry of Post and Telecommunication, MPI, MOLSW and MoH. 11. Draft a national policy on data protection (TA needed). *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 5/16

6 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Monitoring of resources National health accounts 2 Compact 2 Coordination 2 Production 1.3 Analysis 1.5 Data Use 1 Situation analysis (strengths, weaknesses/gaps) NHA report for FY was not endorsed. NHA report for FY is ongoing: it is under health planning and finance TWG as a coordination mechanism. Sub-account for RMNCH is not yet available. Formal agreements between government and partners exist but formal reporting is not submitted regularly to related department (MPI and MOH). However, International Cooperation Unit in DPF is trying to map fund and activities from all donors. General steering committee (HPF TWG) exist but does not focus on NHA. The first official NHA report is under finalization with limited stakeholders engagement (supported by WHO, JICA). There is very limited human resources for NHA work. Automatic NHA data conversion system does not exist. Only estimation is available publicly. Priority Actions 1. Finalize NHA report. 2. Develop NHA framework and action plan (TA/Funding required). 3. Organize a meeting to engage government and development partners and work towards "compact". 4. Consider MoH (or MPI) regulation towards compact. 5. Use NHA data as a part of existing steering committee (HPF TWG) role, with institutional support, and functioning using results-based management methods. 6. Ensure inclusion of all key stakeholders in resource tracking /NHA. 7. Establish/strengthen the NHA team at central and provincial level with capacity building (fund secured WHO/DFID). 8. Develop /strengthen database for production of NHA (TA from HS 2020?). 9. Strengthen analytical capacity in government and other institutions. 10. Disseminate report and analyses on government website (Lao statistics bureau website) and related government meetings. 11. Advocate for /promote use of NHA (including RMNCH ) data in policy making process (special session for NHA during HPF TWG). *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 6/16

7 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Review processes Reviews 2.7 Synthesis of information & policy context 2.5 From review to planning 2 Compacts or equivalent mechanisms 2.5 Situation analysis (strengths, weaknesses/gaps) National sector wide coordination mechanism: (1) Overall health: Sector Working Group (Policy and implementation levels), (2) MNCHN TWG (technical working group). Annual MNCH implementation review meeting will be continuously conducted. Ongoing work on HMIS. The first annual statistics book using HMIS data has been issued in 2011 and second book is under preparation. There is limited qualitative data available (Maternal death review result will be available in the mid of 2012). HiT (Health system in Transition) information will be available soon. There are limited mechanisms to translate results of the review meeting into planning, including resource allocation. The following mechanisms are in place: the Vientiane Declaration, a country action plan, a MDG compact and a sector wide coordination mechanism. The department of planning and finance has established a International Cooperation Unit to track partners' funding flows. However, it is still difficult to get the whole figure. Priority Actions 1. Hold annual reviews that are based on the goals, targets of the NHS. 2. Define at country level a calendar event to ensure better quality of the annual review process. 3. Ensure that the RMNCH appraisals are held and that findings feed into the health sector reviews. 4. Define annual targets and means of verification. 5. Develop mechanism to collect qualitative data. 6. Develop/implement mechanism to compile all quantitative and qualitative information to inform annual reviews. 7. Joint review of several donor funded programs. 8. Resource re-allocation as per review results if possible. 9. Strengthen resource mapping. 10. Harmonize the donor resource mapping format. 11. Strengthen the role of International cooperation unit in DPF. *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 7/16

8 COUNTRY ACCOUNTABILITY FRAMEWORK: Scorecard* Advocacy & outreach Parliament active on RMNCH issues 2.5 Civil Society Coalition 2.5 Media role 1.7 Countdown event for RMNCH 1.5 Situation analysis (strengths, weaknesses/gaps) Social Affair Commission in National Assembly (NA) is in charge of overall health including oversight to provinces. NA is keen to achieve health related MDGs which include RMNCH. NA decided to increase government health expenditure up to 9% of total government expenditure including free MCH services. There is NCMC (National Commission for Mother and Child) under Prime Minister Office. Joint UN supported SELNA program focuses on RMNCH also. INGO Group' has been established and assigned a chair person for health and nutrition. MNCHN TWG promotes NGOs' participation. There is fragmented contact to the media by different stakeholders. The Committees for MDGs in MFA and MoH are actively following up the progress of MDGs. Annual round table implementation review includes RMNCH progress. However, separate national Countdown event not yet planned. Priority Actions 1. Parliamentarians are mobilized to engage in RMNCH accountability, especially on financing (Political discussion). 2. Joint field visit between MoH and NA members to see RMNCH situation at local level (fund secured). 3. Strengthen communication between the Government and NGOs for further alignment. 4. Support capacity of civil society to synthesize evidence and disseminate messages. 5. Consider joint media briefing on RMNCH regularly (MNCHN TWG and CIEH coordinate). 6. Integrate the Countdown event into annual review meeting on MNCH package implementation (MNCHN TWG). 7. Prepare mid-term Countdown report / profile using all evidence in 2013 (MNCHN TWG). *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 8/16

9 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet CIVIL REGISTRATION AND VITAL STATISTICS SYSTEMS (CRVS) Conduct Situaltion Assessment and Design of CRVS in Lao PDR (UNICEF, UNFPA, WHO have secured some seed fund/ To be discussed with concerned Ministries and partners) 1 Rapid assessment MHA,MOH,MPI, MLSW,NA UNICEF, UNFPA, UNESCAP, WHO, Plan X $30,000 $30,000 $0 $0 Strengthen interagency coordination involving all key stakeholders 2 Meeting MHA,MOH,MPI, MLSW,NA Multi-stakeholder follow up event 2 Follow up MHA,MOH,MPI, MLSW,NA Improve hospital reporting of death, use electronic reporting system (start from central hospitals, TA/fund required) Training of doctors in ICD 10 (Training in Thailand will be supported by WHO) UNICEF, UNFPA, UNESCAP, WHO, Plan UNICEF, UNFPA, UNESCAP, WHO, Plan x x $0 $0 $0 $0 $0 $0 1 Development template, training DHC,DPF WHO x x x x $30,000 $30,000 $0 2 Training DHC,DPF WHO x x X X $100,000 $20,000 $20,000 $60,000 WHO, WB? *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 9/16

10 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet Review the progress in selected provinces and scale up to other provinces (additional fund required for scaling up) Strengthen the analytical capacity of vital statistics office, including data quality assessment 1 Review meeting, advocacy for scaling up, trainings at province and district levels MPI(NSC),DHP, MCHC,DPF UNICEF, UNFPA, WHO,WB,JICA,KOFIH, LUX x x x x $20,000 $20,000 $0 Govt and partners will fund 1 Training, Consultant NSC,DPF $0 $0 Prepare next national census 2015 (MPI) 3 Advocacy NSC,DPF x x x $0 $0 WB Consult with University of Health Science and NIOPH to 3 Contract with research group $1,000,000 $1,000,000? start HDSS in selected districts (TA/fund required) (university or NIOPH) *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 10/16

11 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet MONITORING OF RESULTS Strengthen the M&E component of the NHS (during mid-term review of 7th NHSDP in 2013) Strenthen national M&E actions into national Setor Working Group for Health (no extra budget required) Strengthen the collaboration between national statistics center (MPI) and MoH (especially, questionnaire development, joint analysis) Include 10 year health survey plan into NHSDP during mid-term evaluation in 2013 (no extra budget required) 2 Mid-term review meeting in 2013, Consultant MOH All x $30,000 $15,000 $15,000 Would have complementary funding from others 2 Regular TWG meeting MOH All x $0 $0 1 Regular communication MPI,MOH All x x x x $0 $0 3 During 2013 mid-term review MOH All x $0 Consider MNCH household survey (only MNCH coverage or socio-economic module survey) in selected areas in late 2013 (To be discussed, Additional fund required) Possibly not required 3 Under discussion $0 Prepare next LSIS Advocacy x x $0 $0 Revise and harmonize the HMIS-MCH forms 1 Printing and distribution DPF All x $20,000 $10,000 $10,000 $0 Conduct annual survey for data verification and service readiness (collaboration with GAVI, GF or additional fund required) Use more ICT to improve facility based data collection, recording and analysis National health statistics report includes additional information such as NHA, stock availability survey 2 Field visit, more discussion needed DPF All x x x x $0 1 Applications/program development, training DPF All x $20,000 $20,000 1 Consultant DPF All x x x x $0 Mobilize fund for below activity Improve analytical part of the national health statistics report and include more information into the report such as figure from NHA and meaternal death review (TA committed) Province/district level capacity building will be included integrated MNCH package implementation (Fund partially secured by several partners) Strengthen analysis of data for more disaggregared data use Update MoH and national statistics center website for more access to health information (GF, JICA) 1 Consultant, training DPF All x x $40,000 $20,000 $20,000 $0 WHO will fund 1 On the job coaching, supportive supervision DPF All x x x x $200,000 $170,000 $30,000 $0 Partners will fund for district level implemen-tation 1 Technical support DFP All x $0 $0 1 Update the website and hardware DPF,Cabinet, CIEH All x x x x $15,000 $15,000 $0 Others may also take on this work Wider dissemniate all relevant reports 3 $0 *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 11/16

12 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet MATERNAL DEATH SURVEILLANCE AND RESPONSE MoH's discussion whether MoH includes maternal death into notifiable events rather than reporting separately (currently 19 events)??? If yes, disseminate above decision to provinces and districts (using surveillance budget) 2 Meeting MOH (DPF,DHP) All x $0 $0 2 Meeting (under discussion) x $20,000 $20,000 Provincial level trainings to strengthen province and district capacity (fund secured by UNFPA and WHO/CO) 3 System strengthening through technical assistance DHC,DPF,DHP, DOP UNICEF,UNFP A,WHO x x x x $20,000 $0 $20,000 $0 Develop hospital based reporting guideline and template (24 hours notification) (to be discussed) Training in ICD certification and coding (links with CRVS) (fund secured by WPRO, in Thailand) 2 Under discussion $0 3 Training DHC WHO x $0 $0 $0 Dissemination of the reporting template (using OBGY society annual conferrence) 3 Meeting DHC,OBGY society WHO,UNFPA x $0 $0 to include with community report Strengthening 10 MR for HCs 1 To discuss DHC,DOP,DPF All x $35,000 $35,000 $0 Continue province/district based implementation (fund partially secured) First annual report and review meeting in the middle of 2012 (fund partially secured, TA required) 1 Review DHC,DPF,DHP,DO P 2 Meeting DHC,DPF,DHP, DOP UNICEF,UNFP A,WHO x x x x $30,000 $15,000 $15,000 $0 All x $0 *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 12/16

13 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet INNOVATION AND E-HEALTH Build on a national ehealth strategy with country leadership (to be discussed) using eheatlh Strategy Development Toolkit Provide proper devices (such as mobile phone, tablet PC, 3G sim card, etc) and trainings to health centers in selected districts 2 Consultant, meeting DPF x $0 2 Procurement DHC,DPF x x x x $0 Govt will fund Advocate better connectivity to rural areas 2 Advocacy MOH All x $0 Share the experiences from different pilot initiatives (Fund required) 2 Workshop MOH All x $0 $0 Harmonize/Develop the application or program at national level to replace current paper based data collection forms (TA needed) 1 Development of applications MOH? x $20,000 $20,000 Consider pilot project on Inovative ICT for MNCH in selected distrits to get practical experience (fund required) Develop interoperability requirements or standard at national level (TA needed ) 2 Pilot implementation MOH? x $100,000 $100,000 2 Consultant MOH? x $30,000 $30,000 Develop data dictionary $0 Use existed health planning and finanancing TWG as 2 Coordination MOH x $0 the national coordination mechanism for ehealth Strengthen coordination between Ministry of Post and Telecommunication, MPI, MOLSW and MoH 3 Coordination MOH,MPT x $0 Draft national policy on data protection (TA needed) 3 Consultation MOH x $0 *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 13/16

14 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet MONITORING OF RESOURCES Finalize NHA report 1 Report finalization, dissemination DPF WHO x $10,000 $10,000 $0 Govt and WHO will fund? Develop NHA framework and action plan (TA/Funding required) Organize a meeting to engage government and development partners and work towards "compact" 1 Consultant DPF WHO x $20,000 $20,000 $0 Govt and WHO will fund? 1 Advocacy Cabinet,DPF, All x $0 $0 MPI,MOF Consider MoH (or MPI) regulation towards compact 1 Advocacy Cabinet,DPF, All x $0 $0 MPI,MOF Use NHA data as a part of existing steering committee (HPF TWG) role, with institutional support, and functioning using results-based management methods 1 Discussion within MOH MOH x $0 $0 Ensure inclusion of all key stakeholders in resource tracking /NHA Establish/strengthen the NHA team at central and provincial level with capacity building (fund secured WHO/DFID) Develop /strengthen database for production of NHA (TA from HS 2020?) Strengthen analytical capacity in government and other institutions Disseminate report and analyses on government website (Lao statistics bureu website) and related government meetings Advocate for /promote use of NHA (including RMNCH ) data in policy making process (special session for NHA during HPF TWG) 1 Advocacy Cabinet,DPF, MPI,MOF All x $0 $0 1 Training DPF WHO x $25,000 $25,000 $0 WHO will fund? 1 Consultation DPF WHO x $10,000 $10,000 $0 2 Training DPF WHO x $0 2 Dissemination DPF WHO x $0 2 Advocacy DPF All x x x x $0 *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 14/16

15 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet REVIEW PROCESSES Hold annual reviews that are based on the goals, targets of the NHS Define at country level a calendar events to ensure better quality of the annual review process 1 Annual review within the sector wide MOH All x x x x $50,000 $20,000 $30,000 $0 coordination mechanism 1 Calendar MOH All x x x x $0 $0 Ensure that the RMNCH appraisals are held and that findings feed into the health sector reviews 1 Advocacy MOH All x x x x $0 $0 Define annual targets and means of verification 1 Annual review MOH All x x x x $0 $0 Develop mechanism to collect qualatative data 1 Annual review DPF,DHP All x $0 $0 Develop/implement mechanism to compile all quantatitive and qualitative information to inform annual reviews 2 Annual review DPF,DHP All x x x x $0 $0 Joint review of several donor funded programs 1 Annual review MOH All x x x x $0 Resource re-allocation as per review results if possible 1 Annual review MOH All x x x x $0 Strengthen resouces mapping 1 TWG meeting DPF All x x x x $0 Harmonize the donor resource mapping format 1 Format finalized by DPF DPF All x x x x $0 Strengthen the role of International cooperation unit in DPF 2 Advocacy DPF All x x x x $0 *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 15/16

16 COUNTRY ACCOUNTABILITY FRAMEWORK: Roadmap* Actions Priority (1=very high, 2=high, 3=medium 4=low) Suggested approach/methods Responsibility Lead government/ national institute Year of implementation Partners Total Estimated Cost per action Fund secured 2012/13 Catalytic funding Unfunded Potential sources for funding unmet ADVOCACY & OUTREACH Parliamentarians are mobilized to engage in RMNCH accountability, especially on financing (Political discussion) Joint field visit between MoH and NA members to see RMNCH situatioin at local level (fund secured) 2 Advocacy NA,MOH,Prov Governors 3 Field visit NA,MOH,Prov Governors All x x x x $0 $0 All x x x x Fund secured UNDP, UNFPA Strengthen communication between the Government and NGOs for further alignment Support capacity of civil society to synthesize evidence and disseminate messages Consider joint media briefing on RMNCH regularly (MNCHN TWG and CIEH coordinate) Integrate the Countdown event into annual review meeting on MNCH package implementation (MNCHN TWG) Prepare mid-term Countdown report / profile using all evidence in 2013 (MNCHN TWG) 2 TWG meeting Cabinet, DPF All x x x x $0 $0 2 Advocacy Cabinet, DPF All x x x x $0 $0 2 TWG meeting Cabinet, All x x x x $0 DPF,DHP 3 Annual review meeting MOH All x x x x $0 2 Consultation, report MOH All x Fund secured TOTAL CATALYTIC FUNDING (ESTIMATED NEED) $250,000 *This final version has been reviewed and validated through a broad consultation with the major stakeholders in-country. Page 16/16