Vol.2, No.4 October - December 2019 E-NEWSLETTER Multi-Donor Trust Fund (MDTF) for Integrating Health Programs Summit steers Senior officials from the BARMM and central government unveil the emblem of the new Ministry of Health, BARMM at the health summit. health care course for the Philippines’ Bangsamoro autonomous region The Bangsamoro Autonomous Region in Muslim “These legislations (BOL and UHC) are vital in Mindanao (BARMM) held its first health summit strengthening the health system and in providing on July 23-24, 2019 and set directions for the new accessible good quality health services to the government to deliver quality health services and Bangsamoro people,” Dr Saffrullah Dipatuan, the Universal Health Care (UHC) to its population. first minister of the newly created Ministry of Health (MOH-BARMM), told some 200 participants The momentous health summit saw the participation at the summit in Cotabato City. of key ministers and high-level officials from the regional and national governments as well as international partners to discuss the transition INSIDE PAGES government’s plans to improve public health Activities schedule P. 2, 10 systems. It comes on the heels of the recently approved UHC law that entitles every Filipino to Brief news P. 2, 6, 7, 8, 10 healthy living and equitable access to affordable MDTF impacts in focus quality health services. BARMM was created with o WB study found gaps in Bangsamoro’s primary care P. 3 the ratification of the Bangsamoro Organic Law o Kiribati’s mobile TB clinic goes to community P. 4 o Future of health financing in Vietnam (BOL) in January 2019 following decades of P. 5-6 peace negotiations between Muslim separatist Technical support funding for Republic of Congo P. 6 groups and the Philippine Government. The BOL Developing a health financing strategy in Burundi P. 7 abolished the previous Autonomous Region of Muslim Mindanao (or ARMM) and created the Kiribati gets post-transition support P. 8 new BARMM. By virtue of its autonomous status, ASEAN tackles human capital development P. 9 BARMM will continue to maintain a different administrative structure from other regions in the Pacific health ministers come up with solutions P. 10 country. The UHC Law was signed by the President MDTF impacts on the ground P. 11 of the Philippines a month after the creation of BARMM. October - December 2019 Vol.2, No.4 page 2 MDTF ACTIVITIES SCHEDULE (October-December 2019) NEWS OCTOBER 14-21 National launch of “Using taxation to address NCDs: Lessons from Tonga” report in Tonga High level officials attending the two-day summit included Mr Eduardo Guerra, Minister OCTOBER 2nd WEEK World Bank mission to Jakarta and Yogyakarta, Indonesia, of Finance and Budget Management, BARMM; on the Health Security Financing Assessment Tool Mr Naguib Sinarimbo, Minister of Interior and Local Governance, BARMM; Dr Abdullah Dumama, Assistant OCTOBER 17 Secretary, Department of Health; and Ms Marjorie Consultation workshop in Tonga on the Health Facility Jalosjos, Assistant Secretary, Department of Interior Costing and Benchmarking Exercise and Local Governance. Development partners active in BARMM include the World Health Organization, OCTOBER 2nd - 3rd WEEK Health Public Expenditure Review as a part of the Overall United States Agency for International Development, Government Public Expenditure Review Dissemination in UNICEF, United Nations Population Fund, and Indonesia Australia’s Department of Foreign Affairs and Trade (DFAT). OCTOBER Consultation workshop on pharmaceutical and laboratory costs (as part of the broader Health Facility Costing Exercise) The World Bank supported the event at the during a World Bank health mission to Vanuatu from request of the Minister of Health BARMM. It September 29 to October 11 is part of the ongoing implementation of the Health Financing Systems Assessment (HFSA) OCTOBER 28 - NOVEMBER 5 that is supported by DFAT via the MDTF. World Bank to hold the Global Flagship Course on Health Systems Strengthening and Sustainable Financing at its This assessment centers around an analysis headquarters in Washington DC of health financing flows, but also examines institutional financial management capacity OCTOBER 29-31 and local level health service delivery. It also ASEAN Health Cluster 2 Meeting (health security) in includes a household survey on access to Nay Pyi Taw, Myanmar health services in BARMM, with a focus on immunization services and indices of nutrition NOVEMBER 1st WEEK Optimization of resource allocation for TB program – policy in the survey. These inputs have become even discussion on the results of the Optima modelling for more relevant during this transition period and Implementation Efficiency of the TB Program in Indonesia has also been feeding into the health sector’s medium-term strategic planning in BARMM NOVEMBER 6-8 which has just been completed. During the Health Financing GSG (Global Solution Group); a deep dive course on health financing and public financial management summit, the World Bank team reported on the at the World Bank headquarters in Washington DC progress of the HFSA and officially disseminated the Supply-Side Readiness Assessment of NOVEMBER 19 Primary Health Care in BARMM (story on page Planning and budgeting workshop for 2020 in the Solomon 3), completed as a part of the HFSA. Islands BRIEF NEWS World Bank to hold global flagship course in Washington DC The World Bank will hold a Global Flagship Course on Health Systems Strengthening and Sustainable Financing: The Challenge of Building Human Capital and Achieving Universal Health Coverage, at its headquarters in Washington DC from October 28 - November 5, 2019. The Health Financing GSG (Global Solution Group) is contributing to the development of this course, while also developing a deep dive on health financing and public financial management that will take place on November 6-8. The deep dive course will cover two focus areas and their interrelationships – (i) deep dive into health financing and its impact on health systems strengthening, and (ii) deep dive into overcoming public financial management challenges in the health sector. October - December 2019 Vol.2, No.4 page 3 MDTF MDTF impacts in focus NEWS WB study highlights need to invest in Bangsamoro’s primary health care A World Bank supply-side readiness assessment has found recent improvement in the delivery of primary care in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) but also the need for more investment to deliver health services in the autonomous region of the Philippines. The report, Supply-Side Readiness of Primary Health Care in the Muslim women who stand to benefit from better primary care in the BARMM BARMM, disseminated at the First Bangsamoro Health Summit on July 24, as those used to treat hypertension, diabetes and 2019 (story on page 1), provides the new regional asthma are available in less than 10% of the Rural government with baseline data it can use to carve Health Units (RHUs). BARMM has low vaccination out policies to deliver better primary health care rates and one-third of the facilities did not have services to its estimated 4 million population. measles or pentavalent vaccines in stock, and oral polio vaccine was available in only half of the facilities. Noncommunicable disease (NCD) services also lag significantly behind other regions due to limited availability of medicines and commodities for NCDs. The report, prepared by the World Bank’s Philippines Health, Nutrition, and Population team, said investments in supply-side readiness – the ability Study will help to shape BARMM health policies of the health system to deliver service – are essential if the Philippines is to address poor health The report provides an overview of the current outcomes in BARMM. It recommended increasing capacities and challenges facing the primary health health workforce density; addressing critical care system as the BARMM government enters shortcoming in logistics and supply chain, into its new role. By providing a detailed look at the particularly, timely delivery of medicines and availability of inputs needed to deliver priority supplies to RHUs; ensuring availability of basic services, it highlights current strengths, such as amenities such as power, emergency transportation, availability of basic equipment, and also indicates and communication channels; and using real-time areas that require strengthening if the national and information systems to manage service delivery. subnational health goals are to be realized. “We have to use these findings to tackle the Embroiled in a separatist struggle for many decades, bottlenecks. This analysis is very important to help BARMM is the poorest region of the Philippines with us decide future directions,” Assistant Secretary of health outcomes far worse than elsewhere in the Health Dr Abdullah Dumama said of the report. The country. While health outcomes are complex and study was supported by Australia’s Department of multi-dimensional, weaknesses in health governance Foreign Affairs and Trade through the Multi-donor have exacerbated the geographic and socio-cultural Trust Fund for Integrated Donor Financing for Health challenges associated with health care delivery. Programs, and the State and Peacebuilding Fund. The study found that essential first-line drugs such October - December 2019 Vol.2, No.4 page 4 MDTF MDTF impacts in focus NEWS Kiribati’s mobile TB clinic bringing treatment to community “We have seen great engagement with community leaders in promoting the mobile clinic and it provides us not only with an opportunity to test for TB, but also to educate everyone on how TB is transmitted and break down some of the stigma which still surrounds this disease,” said Dr Alfred Tonganibeia, Director of the National TB Program. TB education at a mobile TB clinic while waiting for the doctor Nurses providing health checks for the community South Tarawa, Kiribati may be a geographically in a village maneaba (community hall) small land mass compared to some of its neighbors in the Pacific, but limited transport options and “Often people won’t come to the hospital as continued concerns with associated stigma create they don’t realize they have TB, believing their barriers for people needing the tuberculosis (TB) symptoms to be just a passing cold. With the diagnostic services available at the Tungaru Central mobile clinic we can come to them and provide Hospital. As part of its efforts to provide more checks in their own community where they are efficient and targeted screening services, the more likely to attend. We also hold Saturday clinics Ministry of Health and Medical Services (MHMS) with the NCD team, which allows us to reach young is working on a new initiative, supported by the people when they are at home. This is particularly Australian Department of Foreign Affairs and important as we are seeing a peak in TB incidence Trade and the Global Fund, to address the barriers among young people in Kiribati.” people face in reaching the TB clinic by bringing the diagnostic services to the community. The NTP partnership with the NCD Program has developed in response to the growing number of The National TB Program (NTP) held the first mobile people affected by diabetes; a trend common across clinic in Betio, a key TB ‘hotspot’ in South Tarawa, the Pacific Islands. Previous research conducted by in May 2019. The clinic was set up in community the NTP has shown that diabetes increases the risk of maneabas (community halls) in partnership with contracting TB. This has been demonstrated with the the Noncommunicable Diseases (NCD) Program NTP continuing to detect patients with TB-diabetes and the local community. Ten additional cases co-morbidity during the community visits; reinforcing were identified through the mobile clinic with the importance of collaboration and coordinated treatment commencing soon after through the patient management with the NCD Program. Other Community Direct Observation Treatment (DOT) mobile clinics were also held for ten days through Program. The Community DOT Workers have September in other key ‘hotspot’ communities been instrumental in supporting the mobile clinic in South Tarawa. Kiribati has one of the highest through active case finding and using their rates of TB in the Western Pacific region with knowledge of their community and the families community transmission still occurring due in part affected by TB to direct screening efforts. to crowded housing, urban migration, high rates of smoke exposure, and poor nutrition. October - December 2019 Vol.2, No.4 page 5 MDTF NEWS MDTF impacts in focus The future of health financing in Vietnam Minister of Health of Vietnam Dr Nguyễn Thị Kim Tiến (pink jacket, left) listens intently as the World Bank team presents its study on health financing in Vietnam during their meeting in August 2019. How much does Vietnam spend on healthcare today, and how much could it spend in the future? The Future of Health Financing in Vietnam: Ensuring Sufficiency, Efficiency, and Sustainability, a report published in June 2019, answered these questions by analyzing healthcare spending in the context of rapid change and transition that Vietnam is going through. Vietnam now spends approximately US$ 129 per capita on healthcare, equivalent to 5.9 percent of GDP (based on the latest estimate from 2016). This is three times what it spent just 15 to 20 years Minister of Health of Vietnam Dr Nguyễn Thị Kim Tiến (pink jacket) expresses her appreciation for the report to Hui Sin Teo (left), ago. This pattern of spending has contributed one of the authors. to remarkable progress in improving the health outcomes and overall welfare of the Vietnamese health services and will continue to put upward people over the past few decades. pressure on health spending. The report thus looks at how Vietnam can maintain a sufficient level of But Vietnam is changing rapidly. While the economic public spending on health to sustain and further outlook remains strong, there are significant good health outcomes while responding to new economic headwinds and the government’s fiscal health challenges. Specifically, the paper analyzes position is tight. A rapidly aging population and an the prospects for increasing fiscal space for health increasing burden of noncommunicable diseases from various sources. and chronic conditions also pose new demands on the health sector. Significant policy shifts in health “Additional fiscal space for health is limited in the financing in recent years have also led to increases short to medium term … the largest source of in health service prices and user fees. effective fiscal space for health in Vietnam will be through improvements in health sector efficiency,” The combined effects of these transitions pose wrote authors Hui Sin Teo, Sarah Bales, Caryn some risks to the sustainability of essential public Bredenkamp, and Jewelwayne Salcedo Cain. October - December 2019 Vol.2, No.4 page 6 MDTF Hui Sin Teo (second from left), one of the authors of the report, speaks about its NEWS findings. Also pictured is WHO Representative to Vietnam Dr Kidong Park and his team. Improving health sector efficiency will require significant reforms to health financing arrangements and the service delivery system. Some key areas include changes to how providers are paid, integration of care, optimizing investment decisions, and improving performance measurement and Health Nguyễn Thị Kim Tiến expressed her gratitude accountability. to the World Bank for its support and congratulated the team on a “professional, well-structured, and This study was done in collaboration with the informative report”. The Ministry of Health plans Ministry of Health, the Ministry of Finance, and to disseminate this work to Vietnam’s National Vietnam Social Security. Vietnam is also a priority Assembly and relevant Ministries including Finance; country for support from Australia’s Department of Planning and Investment; and Labor, Invalids, and Foreign Affairs and Trade via the MDTF. Minister of Social Welfare. Technical Support Funding for Republic of Congo Gavi funding through the Multi-Donor Trust spending in 2016 going to health. Only a small share Fund is providing much needed resources in the of financing is allocated to primary health care, with Republic of Congo where there is limited funding almost half of the health budget (45.6%) going available for technical support. Congo is a lower- to tertiary care, even though the majority of the middle income country that is now considered disease burden in the country could be addressed a “blend” country which means access to through a strong primary health care system. concessional lending becomes more expensive, yet very little funding is allocated for analytical work The World Bank and the International Monetary and technical assistance. Given that the country Fund are collaborating to explore potential has now fallen back from a “post-transition” Gavi strategies that will protect financing for social sectors. country to a “preparatory transition” country, In addition, a new US$ 35 million Health Systems it is now eligible for support from Gavi and also Strengthening project under the International receives support from the World Bank through Development Association is in the pipeline. The Gavi’s Targeted Country Assistance mechanism. new operation will focus mainly on sustaining outcomes of the previous health project on Health outcomes in the Republic of Congo have performance-based financing and more stagnated and despite a lowering of debt/GDP importantly supporting the Ministry of Health to from 117.5% in 2017 to 87.8% in 2018 the country improve its use of public funds to the health sector. remains in a state of depressed economic growth and debt distress. Prioritization of health in the government budget is low, with just 4% of government BRIEF NEWS Policy paper on CSO financing in Indonesia is out The policy paper Engaging with Civil Society in the health sector in Indonesia, just published in September 2019, examines the existing public mechanisms to channel funds to Civil Society Organizations (CSOs), and the challenges to more widespread use. CSOs deliver key program interventions, and common barriers cited by stakeholders can be grouped around three main themes: (i) lack of information, (ii) limited capacity, and (iii) incomplete trust. The policy paper also provides recommendations to facilitate and create an enabling environment for improving engagement between the Government of Indonesia and non-state providers. October - December 2019 Vol.2, No.4 page 7 MDTF NEWS Developing a health financing strategy in Burundi Gavi’s Targeted Country Assistance (TCA) 2019 funds financing strategy. This is an excellent opportunity to the World Bank in Burundi are being used to conduct to lay the groundwork for increased domestic an analysis on fiscal space and an immunization funding and sustainable funding of key public financing assessment, both of which will inform health programs such as immunization to ensure the development of a health financing strategy. continuous access to quality health care services. Although work on a health financing strategy in Burundi is also one country that is moving to channel Burundi started four years ago, progress has been funds through government systems: under its third slow since the 2015 political crisis and the cessation Health System Strengthening grant, Gavi is channeling of most development partners’ support through $US 8 million for 2019-2020 as co-financing to the the government of Burundi. The TCA funds are World Bank KIRA (meaning wealth and good health re-invigorating momentum around the strategy in Kirundi) program – a health system support and a workshop will be organized later this year to project to strengthen the national Results-Based present and discuss results with the Government Financing program. and partners. The team expects a multi-year engagement to develop and implement the health BRIEF NEWS Flagship course to strengthen health systems HSFA rolls out in Indonesia with Presidential in the Pacific Instruction on health security preparedness A flagship course will be held in Fiji February 17-21, Indonesia’s Center for Health Determinant Analysis 2020 to help countries in the Pacific sub-region (PADK), Ministry of Health, conducted a three-day strengthen their health systems and achieve workshop on Health Security Financing Assessment sustainable financing as they progress towards (HSFA) from September 10-12, 2019 with technical support universal health coverage (UHC). The five-day from the World Bank and the World Health Organization course, a version of the World Bank Global (WHO). The workshop followed the issuance of Presidential Flagship Course, prioritizes issues relevant to Papua Instruction (Inpres) No 4/2019 on improving the country’s New Guinea and the Pacific. It will apply the pandemic preparedness, and capacity to deal with disease flagship analytical framework to enable structured outbreaks as well as health emergencies due to and strategic thinking about strong health systems nuclear, biological, and chemical agents. The development and sustainable financing which are critical for of the national action plan on health security, a follow up achieving UHC and managing changes in funding to the Joint External Evaluation mission in 2017, is also flows from some external sources. The course is being finalized. It would include an agreement on the intended for country teams of 5-10 people, complementarity of the World Bank’s Health Security comprising mid-level and high-level policy-makers Financing Assessment Tool, and the WHO’s REMAP from the Ministries of Health, Financing and tool. REMAP, recently developed by WHO, stands for Planning. Participation will be arranged by the “Resource Mapping and Impact Analysis on Health governments, World Bank and other supporting Security Investment”. partners. The venue for the flagship course is still to be finalized. October - December 2019 Vol.2, No.4 page 8 MDTF NEWS Kiribati gets post-transition support The World Bank program of support in Kiribati will continue to build on recent work assisting the Government and Development Partners to strengthen planning for, and monitoring of, health service outcomes. This includes providing technical assistance to institutionalize monitoring and reporting systems and processes that assist managers to make more informed decisions on the way resources are being allocated and used. A particular focus of the technical assistance and analytical work is on exploring options for improving efficiency, equity and quality of expenditure across the country. BRIEF NEWS A pharmacist checks drug stocks and supplies for distribution to public health clinics. Gavi has approved the request of the Ministry of Health and Medical Services (MHMS) for an additional US$ 100,000 post-transition support for work agreed Organizers and speakers pose for pictures at under their health PASA (programmatic advisory the PCIC international workshop in China. services and analytics). Kiribati will receive the fund through the MDTF for the Integration of Donor Financed International workshop in China on building Health Programs. Gavi commended the Government People-Centered Integrated Care system of Kiribati for working with UNICEF, the World Health Organization and the World Bank to identify the key China’s National Health Commission (NHC) and risks, opportunities and gaps related to the sustainability the World Bank jointly organized the International of Kiribati’s immunization program, and for developing Workshop on building People-Centered Integrated a set of relevant activities to address these priorities. Care (PCIC) system in Anji County, Zhejiang Province, China on September 18-20, 2019. Gavi’s post-transition engagement with Kiribati will The event, part of the World Bank China Health contribute to the sustainability of the Expanded Reform Program-for-Results (China Health PforR), Program on Immunization (EPI) through the provision brought together experts and government officials of technical EPI capacity building. It will also strengthen from China, Sri Lanka, Turkey, Poland, Kyrgyzstan, vaccine management and cold chain, assess the feasibility and the Philippines, to share Chinese and global of and country readiness for the introduction of the experiences in promoting the PCIC system. Human Papilloma Virus vaccine, and support capacity Participants also discussed various critical issues on building for budgeting and planning. In addition, Gavi building a PCIC system and identified potential solu- acknowledged the important commitments made by tions for strengthening it. The workshop consisted of the MHMS, along with partners WHO and UNICEF, under plenary sessions to disseminate global trends and the post-transition engagement request. These include reform experiences in building PCIC, and parallel revitalizing the immunization coordination committee, sessions to unpack key elements of PCIC. The latter financing implementation of the recommendations to focused on health financing, human resources in come from the next Effective Vaccine Management health, and information technology. There were also Assessment, and making staff available to engage with site visits to a village clinic, a township health center efforts to strengthen budgeting and planning processes. and a county-level hospital in Anji County for firsthand experience in the implementation of PCIC in rural China. October - December 2019 Vol.2, No.4 page 9 MDTF NEWS Achieving UHC, fighting malnutrition, and improving learning are key to human capital development in ASEAN High-level officials from ASEAN, including Thai Deputy Prime Minister Anutin Charnvirakul (4th from right) and Lao PDR Vice Minister of Health Phouthone Muongpak (3rd from left), pose for a group photo with development partners at the meeting. Key policy makers from the Association of Southeast Asian Nations (ASEAN) and experts from the World Bank and other development partners held a high-level meeting in Bangkok to work out how human capital development can be accelerated to prepare the region for the disruptive future. A panellist speaks during one of the sessions on About 120 participants attended the ASEAN High-Level human capital development. Meeting on Human Capital Development on September 9, 2019 and shared experiences on human capital education also widens inequality among its citizens, preparation. This has become of paramount importance especially in terms of income and wealth. amidst the unpredictable changes of the 4th Industrial Revolution that have brought fractious consequences At the meeting, Thai Deputy Prime Minister Anutin to issues of inequality, competitiveness, digital Charnvirakul shared Thailand’s experience in achieving transformation and disruptive technologies. Universal Health Care (UHC) despite economic constraints to inspire other ASEAN countries, while Lao PDR Vice Human capital development is an important component Minister of Health Phouthone Muongpak highlighted the for a knowledge-based economy and enhances the importance of nutrition in developing his country’s human competitiveness of a country while narrowing existing capital. The meeting ended with recommendations social and economic gaps. It requires investments in for accelerating human capital development in ASEAN. nutrition, healthcare, quality education, life-long learning, These include fighting malnutrition with nutritious and acquisition of new skills throughout one’s life. foods and quality healthcare, orienting the entire Human capital remains a challenge for ASEAN where education system around improved learning for the almost a third of its children are stunted, making them young and lifelong learning for adults, and achieving vulnerable to poor cognitive development. Unequal UHC to provide everyone with quality health services access to other basic services such as healthcare and and financial protection. October - December 2019 Vol.2, No.4 page 10 MDTF NEWS Health Ministers found Pacific solutions to regional challenges The 13th Pacific Health Ministers Meeting concluded Health security also featured as an important area with the ministers making commitments to strengthen of focus with issues such as microbial resistance, regional response to health and improve collaboration implementation of the International Health Regulations within the Pacific on a range of key health topics. These (2005), and the importance of the Pacific Public Health include universal health coverage and primary healthcare, Surveillance Network in tracking and responding to climate change and health, non-communicable diseases, outbreaks, all acknowledged. Health security is an issue health workforce, health information, health security, that challenges all countries, however, Pacific Island water, sanitation and hygiene, and immunization. nations face some uniquely Pacific challenges which require a regional approach. Cooperation and information Health ministers from almost all the Pacific Island countries, sharing were two themes which were echoed clearly and for the first time the New Zealand and Australia throughout the four-day meeting. The next annual Health Ministers, attended the meeting in Tahiti from meeting is scheduled to be held in Tuvalu in 2020. August 5-8, 2019. Some of the important commitments Dr Enis Baris, Practice Manager for Health, Nutrition which have come out of this annual meeting of Pacific and Population for the East Asia Region; and Aparnaa Health Ministers include the prioritizing of the human Somanathan, Program Leader for Human Development papillomavirus (HPV) vaccination program implementation. for the Pacific; represented the World Bank at the Tahiti This vaccine has shown impressive effectiveness in meeting. The World Bank also held useful discussions substantially reducing the incidence of cervical cancer. with the government delegations from Papua New This demonstrates a strong commitment by Pacific Guinea, Samoa, Solomon Islands and Tonga. Health Ministers to improving women’s health through effective primary care interventions. BRIEF NEWS World Bank public expenditure review training in Indonesia The World Bank held a two-day training workshop in Bekasi to help Indonesia strengthen its capacity in planning and budgeting to improve the quality of its public expenditure. The Sub-National Public Expenditure Review Training, held on August 20-21, 2019, came at the request of the Ministry of Health (MOH) because Indonesia’s health sector is facing significant challenges in ensuring quality planning and budgeting in the current decentralized setting. The training focused on utilizing various analytical tools, program budget and expenditure data, program outputs and other available data, that the sub-national program managers and planners have access to. Participants included 68 planners and program holders from 34 provinces, plus central planning and budgeting officials from the MOH. The response was very positive and there were requests to expand this type of training to all districts. The World Bank Health team collaborated with the World Bank Governance team, with support from the Macrofiscal, Trade, and Investment team, to prepare training material and curriculum for the workshop. ACTIVITIES SCHEDULE (October-December 2019) NOVEMBER 20 NOVEMBER / DECEMBER (TBC) Health Sectorwide Approach (SWAp) World Bank health mission to Kiribati timed to participate in the Development Partner Coordination Group Health Sector Coordination Committee meeting and to finalize World meeting in the Solomon Islands Bank program of work for 2020 NOVEMBER / DECEMBER (TBC) DECEMBER (TBC) World Bank mission to Tonga on quality of care and clinical governance World Bank health mission to Vanuatu to at Vaiola Hospital finalize annual program of work October - December 2019 Vol.2, No.4 page 11 MDTF NEWS MDTF impacts on the ground The Multi-Donor Trust Fund (MDTF) for Integrating Health Cote d’lvoire increases commitment to health Programs sets out to help lower-middle income countries (LMICs) attain Universal Health Care (UHC) Gavi’s support to the World Bank since 2017 to engage as they make the difficult transition from external to the Cote d’Ivoire in a health financing dialogue internal sources of funding. It strengthens countries’ focusing on mobilizing domestic resources has led health systems to accelerate and sustain key health to the Government committing 61.5% of its funding outputs and outcomes that contribute to UHC. MDTF to primary health care services between 2020 and impacts are wide-ranging and evident: 2023 – up from 20%. The World Bank Group, Global Financing Facility, Gavi and Global Fund partnership Gavi’s continuing support in the Pacific achieved this through joint analytics, joint advocacy, and agreed on commitments for health financing in The World Bank’s expanding partnership with Gavi was alignment with the Government of Cote d’Ivoire’s stated reported in the April 2019 newsletter. Since then, Gavi priorities. The dialogue also involved mobilizing funding to WB to support grant implementation activities domestic resources for health through the budget cycle, in this fiscal year have now been received and activities including the use of the medium-term expenditure are underway. These include efforts to shape stronger framework, and technical assistance on resource links between national and provincial annual plans and allocation. Analytical work and more evidence-based budgets in places such as the Solomon Islands, as well planning of development resources will also inform as new Post Transition Engagement support in Kiribati, the Gavi transition strategy when it is developed. as they build a more sustainable immunization program. New health sector design and governance reform PNG’s “Accelerated Transition” status extended projects in Cote d’Ivoire until 2025 Two projects are taking shape in the Cote d’Ivoire to The Gavi Alliance Board met in June 2019 and approved design the health sector and support governance the extension of Papua New Guinea’s “Accelerated reform. The first is the largest health sector reform Transition” status until 2025. PNG experienced many scheme to be financed through a World Bank operation difficulties throughout the year including measles and – the Strategic Purchasing and Alignment of Resources polio outbreaks, serious earthquakes, insecurity in the and Knowledge in Health (SPARK) project – worth highlands, and the hosting of the Asia-Pacific Economic US$ 200 million, approved in March 2019 and Cooperation meeting that diverted staff and led to a expected to close in 2025. The second is a US$ 100 two-month halt to immunization programs. This extension million project to use development resources to align means that PNG will remain eligible to apply for up to and leverage domestic financing. It is to be done by US$ 60 million of Gavi’s funding and it will continue reimbursing on performance under the responsibility of to access Gavi pricing for new vaccines. The Board the Governance Global Practice (Enhancing Government established two criteria for PNG’s extension: (i) the Effectiveness for Improved Public Services). agreement on a policy matrix that outlines PNG’s commitment to immunization and health system strengthening, and (ii) PNG’s compliance with Gavi’s To receive the MDTF e-newsletter please contact: Sutayut Osornprasop, World Bank Thailand, vaccine co-financing requirements. The World Bank will sosornprasop@worldbank.org, +1 202 3783383 continue to work alongside Gavi partners to support Chadin Tephaval, World Bank Thailand, the Government as it strengthens financing and delivery chadint@gmail.com, +66 86 600 0715 of primary health care services, including immunization. For more information find us on WB Facebook, WB Twitter and WB Health Twitter