| How the Exemplars successfully engaged and coordinated stakeholders | Detailed strategies | Country examples and links to more detail |
|---|---|---|
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Establish national health priorities and plans led by MOH |
Establish national priorities to guide health sector planning |
Rwanda’s Vision 2020 Strategic Plan Peru’s Acuerdo Nacional (National Agreement) |
| Engage stakeholders and leverage technical expertise to inform development of national plans | Senegal's government setting up a working group of various donors (including representatives from USAID, WHO, and UNICEF) to guide planning for implementation of facility-based IMCI (FB-IMCI) (Senegal narrative) | |
| Develop accountability and governance structures aligned with national health priorities and plans |
Rwanda invoked Imihigo performance contracts between districts and the national government, including empowering health officials at all levels of government through provision of training, tools, and data for decision-making (Rwanda narrative) |
|
| Align partners and donors around government plans and priorities |
Establish criteria for donor and partner support of government plans and engagement |
In Rwanda, donors had to demonstrate high levels of financial support for the health sector to participate in the budget review process (Rwanda narrative) |
| Establish regular forum for donor coordination in support of national workplans and budgets |
In Rwanda, quarterly meeting between donors and government representatives led by the Ministry of Finance and Economic Planning (MINECOFIN) (Rwanda narrative) In Bangladesh, Sector Wide Approach (SWAp) required donors to channel funding to the broader health sector, not just favored programs (Bangladesh narrative) |
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| Establish regular cadence of meetings between MoH and all donors/partners | Establish health sector and initiative-specific annual operational plans and regular review cycles (e.g. twice annual, quarterly) | President's Malaria Initiative, Senegal, Malaria Operational Plan FY 2017 |
| Establish clear metrics against which progress will be assessed |
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| Consider mechanisms that directly factor performance assessment into budget allocation, so as to align incentives and foster accountability |
In Rwanda, performance-based financing to foster accountability (Rwanda narrative) In Peru, results-based budgeting (Peru) (Peru narrative) |
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To review progress and align on national policies & operational plans, engage key local and international stakeholders, including:
|
Senegal MOH’s Reproductive, Maternal, Newborn, and Child Health (RMNCH) cluster met monthly - developed an annual work plan to focus advocacy efforts and address emerging priorities (Senegal narrative) Ethiopia FMOH's "one plan, one budget, and one report" (Ethiopia narrative) In 2007, Nepal's National PMTCT Working Group (including the WHO, UNFPA, UNICEF, Joint United National Programme on HIV/AIDS, and USAID/Family Health International) performed an operational review of the PMTCT pilot programs (Nepal narrative) |
|
| Regular meetings with non-health governmental stakeholders (e.g. Ministry of Labor, Ministry of Women Affairs) to take a comprehensive approach to RMNCH issues |
In Senegal, the RMNCH cluster holds annual steering committee meeting including Ministry of Economy, Finance, and Planning; the Ministry of Education; the Ministry of Labor, and others (Senegal narrative) |
|
| Establish technical working groups around specific initiatives or interventions |
Create technical working groups (led by MOH) to decide appropriateness of new EBIs or adaptations of existing EBIs; plan introduction; support legal framework development, program planning, and monitoring design | In Bangladesh, the National technical working committee oversaw Saving Newborn Lives initiative (Bangladesh) (Bangladesh narrative) Senegal engaged key partners - USAID, WHO, UNICEF – to guide the planning for implementation of FB-IMCI (Senegal narrative) In Peru, the Neonatal Health Collective pooled resources and expertise which helped generate health standards, epidemiological-surveillance programs (Peru narrative) |
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Engage local and international stakeholders in technical working groups including:
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| Transition from vertical to horizontal funding |
Gain donor buy-in on broader health sector improvements, in addition to vertical programs (can use the quarterly meetings) |
Rwanda had a strong vision and national plan, with evidence-based explanations for their plans and clarity on how donors would fit in. This included the requirement that donor funding support & build upon a strong primary care platform. It also included a clear argument for sustainability, in that Rwanda would only take over programs and structures in the national plan (thus encouraging partners to follow national government policies). (Rwanda narrative) |
| Pool funding where possible , to harmonize planning, budgeting, accounting, and auditing |
In Bangladesh, Sector Wide Approach (SWAp) required donors to channel funding to the broader health sector, not just favored programs |
|
| Coordinate among different ministries in the national government |
Align on focus areas of national effort (education/awareness, prevention, and/or treatment) and key performance indicators (KPIs) to track progress towards this goal. Avoid duplication of efforts |
Rwanda established the Social Cluster, consisting of the Ministries of Health, Education, and Gender. The Social Cluster collaborates on high national priorities, e.g. gender-based violence and teenage pregnancies (Rwanda narrative) |
| Coordinate ministries to collaborate on implementation strategies to address a cause of death, including areas such as training, financing, education (including school-based initiatives), gender focus, and agriculture. Each ministry should develop the content most closely related to their area of expertise |
For an example of ministries collaborating on training, as part of Ethiopia's National Nutrition Strategy in 2008 and National Nutrition Plan in 2013, the Ministry of Agriculture conducted nutrition trainings in the agriculture sector, while the government promoted nutrition activities at schools (through the National School Health and Nutrition Strategy) (Ethiopia narrative) |
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| National government can partner with relevant industries, e.g. for nutrition-related programs |
Senegal's created the Cellule de Lutte Contre la Malnutrition (CLM), which helped launch the Programme de Renforcement de la Nutrition (PRN). This combined members from all nutrition-related industries, the Ministry of Finance, donors, and NGOs. (Senegal narrative) | |
| Collaborate across all levels of government, down to the local level |
In Bangladesh, Control of Diarrhea Diseases program was implemented with collaboration from the Ministry of Primary and Mass Education, Ministry of Information, and also local government. (Bangladesh narrative) |
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Ahsan KZ, Streatfield PK, Ijdi RE, Escudero GM, Khan AW, Reza MM. Fifteen years of sector-wide approach (SWAp) in Bangladesh health sector: an assessment of progress. Health Policy Plan. 2016;31(5):612–623. https://academic.oup.com/heapol/article/31/5/612/2355616. Accessed Apr 21, 2020.