PAHO/WHO report finds...Health sector’s budgetary plans not “in sync” with strategic plan

PAHO/WHO report finds…Health sector’s budgetary plans not “in sync” with strategic plan

May 17, 2016 News

By Jeanna Pearson

Budgetary requests and allocations made by the Ministry of Public Health (MoPH) may not have been in sync with the true health needs of the population and its strategic plan, since there is a scarcity of research and operational planning in the sector, a Pan American Health Organization (PAHO) report has revealed.
The report Health @50 in Guyana: Progress Health Report 1966-2016, which was released last Saturday, disclosed that a lack of operational research and planning might have caused budgetary allocations to not be in line with the requirements of the population and programmes, and thus could lead to unnecessary expenditure of financial resources.
It indicated that this shortcoming could also lead to a deficit of coordination of activities while negatively impacting the continuum of comprehensive care.
When the findings of this report were placed before Public Health Minister Dr. George Norton, he stated that while there is no sufficient research being conducted, there is no evidence of overspending and irrelevant budgetary requests made by the ministry.
Norton asserted that a shortage of epidemiology staff in the public health sector is the chief cause for little to no research being carried out.
“Our system has been inefficient for years but we are fixing it and we are making progress,” he said.
He emphasized further that the ministry could not have been “overly” requesting funds when it is barely taking 10% of the National Budget.
“We don’t have the money, and the little that we have we have been stretching it, and that is what is creating a strain across the sector…we don’t have an overspending problem, we have a human resource problem,” he added.
Earlier this year, the coalition government injected $28 billion into the health sector, which is an increase from the 2015 budget of $22.1 billion. Finance Minister Winston Jordan had announced the 10.9% allocation, citing an interest in developing human resource productivity.
Norton promised that the ministry is focused on increased remuneration and improved staff satisfaction. Currently, he stated, it is working at increasing the epidemiology staff in the sector.
The health report stated that while the focus of the Planning Unit has been on the budgeting aspect of programmes, there is hardly any monitoring and evaluation conducted, with operational research to determine cost effectiveness or cost efficiencies of various initiatives and programmes.
“One of the core functions of the MoPH is the development of strategic plans, which is evidenced by National Health Plans (NHP) as well as National Strategic Plans (NSP) for specific diseases. On many occasions, the development of these plans was driven by donor requirement to access funding,” the report stated, explaining that these plans are documents that outline the broad strategies to assist the MoPH to achieve its goals.
However, it stated that the operationalization of these strategies necessitate short (1-3 years), focused and target-driven Operational Plans (OP) also called Implementation Plans and so where OPs were not developed, the annual budgets for the various departments of the Ministry were sometimes “not aligned with the programme” due to the lack of costed execution plans.
It noted that while the ministry has data collection systems in place, detailed analyses are not always conducted at all the various levels across the system.
“Evidence-based and informed decision making will allow for improved programme planning, monitoring and evaluation and programme refinement,” it said, citing a deficit of human resources, skills and competencies in many programmes to analyze and interpret data.
This, in turn, results in information not often being utilized in real time, especially at the regional levels, to influence changes to programme implementation.
The report mentioned that human resource has been a challenge for the ministry, with the sector having a lack of adequately trained and skilled staff, and also the retention of skilled human resources like doctors, nurses and other ancillary medical staff.
It opined that this deficiency could be the result of the country’s brain drain, including difficult working conditions, inadequate remuneration, and a “perceived lack of interest on the part of government about the welfare of workers.”
“A Human Resource Strategy that includes the attraction, retention, capacity building and succession planning of human resources is critical, but even more important, are the implementation and sustainability of this strategy,” the report stated.
Since the early 1970s, there has been a gap in terms of doctors (both general practitioners and specialists) and the shortage has always been supplemented by bilateral agreements with the Cuban and Chinese governments to have their nationals strengthen Guyana’s health system.