Convergence Sites

Pangasinan

Nueva Vizcaya

Bulacan

Pasay City

Capiz

Negros Oriental

Misamis Occidental

South Cotabato

Summary of Health Reforms in the 8 Convergence Sites

Best Practices

Indigent Program

Hospital Autonomy

Pooled Procurement

Inter-Local Health Zones

Public Health Reform

Philippines Chalks Up Modest... continue..

Reasons that were cited by the review to explain the wide variance between accomplishments and set targets were: the change of government in 2001, ambitious targets, lack of budget support, and inadequate advocacy and push from top DOH management. The review concluded that although the reform program has been taken beyond the critical first steps, its momentum can grind to a halt if certain risk factors are not addressed, among which are: the proposed budget cuts for convergence sites development, high expectations generated in the expansion sites, and the lack of management capacity at the central and regional levels to implement the reforms. The meeting was attended by the Secretary of Health, the President of the Philippine Health Insurance Corporation (PhilHealth), senior officials of the Department of Health and PhilHealth, officials from the National Economic Development Authority and the Department of Budget and Management, and representatives from local government units, civil society, the academe, and the donor community.

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MSH-HSRTAP Contributed Substantially continue..

Demand driven project. The initial demand for MSH-HSRTAP support was from top DOH executives who were committed to health sector reforms. This demand was articulated in the HSRA and its implementation plan and the project was tailor fitted to meet such demand. Although the priorities of the current DOH top management have changed, the HSRA continues to be valid (and declared as such by the DOH) so that the project has remained relevant and useful. Furthermore, MSH-HSRTAP recognized that the HSRA served not just the DOH but multiple clients, particularly the LGUs, PHIC, and even legislators. This provided the opportunity for the project to continue its work by directing its support to these other clients.

Fixed targets, flexible benchmarks. A key feature of MSH-HSRTAP was that it adopted the very outcomes that the HSRA wanted to produce. This allowed the project to steer itself in the direction of HSRA objectives, even in a rapidly changing political environment. However, the project also built for itself some room for flexibility to adapt to such changes. The key feature here was the rolling annual plan with quarterly set and monitored benchmarks jointly determined with client agencies. This approach, which built on the experience with previous USAID projects like the Child Survival Project and the Health Finance Development Project, became more effective when coupled with close interaction between the project and its client.

Venue for reform minded health professionals. Beyond its staff and consultants, the project also effectively served as a venue for reform-minded health professionals in and outside the client agencies to discuss, debate and monitor the progress of HSRA implementation. In doing so, the project was able to sustain the constituency behind HSRA. Moreover, the project also could be seen as a facility to support health sector reform champions inside and outside government.

Project management committed to reforms. Finally, the drive behind the project could not have been sustained without managers that were committed to the HSRA. This commitment was consistently strong throughout the life of the project

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