OneHealth Tool Health Systems Financing Department
Planning cycles: Lack of synchronization between disease plans and national health plan http://www.nationalplanningcycles.org/
Findings from a review of national health plans ONE COUNTRY (25 LI countries) HRH: Human resources for health I&E: Infrastructure and equipment L&M: Logistics and medicine HIS: Health information systems L&G: Leadership and governance HFA: Health financing activities
Challenges that OneHealth aims to address Challenges: Too many tools for different vertical disease programmes De-linked planning cycles Little consideration of health systems in existing tools, and existing plans OneHealth Role: Bring tools into an integrated framework Enabling integrated health sector planning Bringing partners together Linking programme plans to a health systems planning platform "First planning then costing" Costing as part of the Planning process Cost analysis and budget considers financial projections and fiscal space Strategic Planning for Better Health Outcomes
The role of costing in the planning process Essential information for Effective Implementation and Accountability/Governance 5
OneHealth Tool: general overview
How was OneHealth developed? 2008: a meeting in Senegal reviewed 13 commonly used tools Agreement to develop a joint UN model. Inter-Agency Working Group on Costing (IAWG-COSTING) established in 2008 (WHO, UNICEF, WB, UNAIDS, UNFPA, UNDP). Partner support: The Global Fund to fight Aids, TB and Malaria, The Global Health Workforce Alliance, The Health Metrics Network, Bilateral agencies, IHP+, have provided funding and technical support. Other partners: UNIFEM and projects like USAID deliver, Optimize provide technical inputs. Health Planners in Country Reference Group provide technical and user related inputs into model development (Burkina Faso, Cap Verde, Ghana, Mali, Mauritania). 7
OneHealth Tool: Launched May 2012 WHAT? A software tool for medium term strategic health planning (3-10 yrs) FOR WHOM? Health Sector planners (MoH Department of planning) Donors, academe, NGOs and UN agencies Available in different languages PURPOSE? Facilitate strategic planning and costing at country level Integrated tool across diseases/programs and systems WEBSITE? http://www.internationalhealthpartnership.net/en/tools/one-health-tool/
What's new and different? Modular format adaptable to different country planning contexts User can choose the level of detail for planning Standardized approach used across programs Incorporates existing models for impact modelling of HIV/AIDS (GOALS, AIM), TB (TIME - TB impact model and estimates), Malaria (LiST) Direct links and checks built in between different components of the tool User-friendly interface 9
Pre-existing tools incorporated into OneHealth Tool MBB WHO (stop TB) WHO (ihtp) LiST (Lives Saves Tool) Resource Needs Model AIM, GOALS WHO ( Child Health Cost Estimation tool) FamPlan UNFPA RH costing tool Specific areas incorporated Bottleneck analysis, Fiscal space analysis; Budget mapping TB planning Detailed intervention planning for RMNCH (staff time minutes; drugs commodities) Impact for child and maternal health Costs for HIV/AIDS interventions Impact for HIV/AIDS interventions Intervention costing for child health; Overall Framework for Programme Activity Costing Impact for Family Planning interventions Costing reproductive health interventions 10
Model cost and impact with a health systems approach Community mobilization, demand generation, programme management National Hospital Health Centre Outreach Community Others Non communicable Child Health Nutrition Reproductive Health Water & Sanitation Immunization Malaria TB HIV Lives saved; healthier populations Infrastructure Health Information Human Resources Governance Supply chain Health Financing Increasing coverage of effective interventions Strengthening Health Systems Financial affordability
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Type of outputs (results) produced 1. Health impact: what will be my U5MR in 2020? Do I expect to reach my MDG targets by 2015? 2. Health Systems investments and service outputs: Required investments in the Supply Chain Total & additional bed days and outpatient visits; requirements for hospitals, facilities and community services 3. Costs: Costs by year, by programme, by inputs, etc. 4. Financial projections, fiscal space and expected shortfall 5. Scenarios: how is cost and impact different for alternative scenarios of packages, targets and activities? Note: Outputs can be configured to different reporting formats through budget mapping functionality. 13
Demonstrating health impact: OHT output examples
Accounting for impact of preventive interventions
What will be the demands on outpatient care? Predicted number of outpatient visits, by programme area 70,000,000 60,000,000 50,000,000 40,000,000 30,000,000 Nutrition HIV/AIDS Malaria Vaccination 20,000,000 10,000,000 - Child health Maternal/newborn and reproductive health 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Estimating health worker needs Comparing anticipated supply of health workers with the expected demand Other GAP HIV TB Estimated time needed for service delivery Available health workers
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Comparison of: Costed plans (planned expenditure) with Financial space available for health (multiple scenarios)
Soon to come: Fiscal space and supply chain review Malaria impact calculations for adults NCD impact module: mental health, CVD, cancer impacts DALY calculations Costing module for workers health 20
Examples of countries that have used / currently using the OneHealth Tool Botswana (sector wide) Burkina Faso (sector wide) Cabo Verde (sector wide) Democratic Republic of the Congo (sector wide) Ethiopia (RMNCH) Kenya (sector wide) Liberia (sector wide) Morocco (RMNCH) Mozambique (sector wide) Nigeria (malaria) Papua New Guinea (RMNCH) Paraguay (family planning) Rwanda (HIV/AIDS ) Senegal (health systems) Sierra Leone (sector wide) Sri Lanka (RMNCH) Sudan (sector wide) Turkmenistan (maternal) Zambia (child health, malaria) Viet Nam (RMNCH)
Freely downloadable from http://www.futuresinstitute.org/onehealth.aspx 22
OneHealth - launched May 2012 OneHealth available in English French Arabic and Spanish versions in pipeline Documents http://www.internationalhealthpartnership.net/en/tools/one-health-tool/ Help screen Life saver function response within 2 working days