Report onHarmonization and Alignment of

TA support in Vietnam(Statement of Intent Milestone 2)

Ron van KonkelenbergLe Duc Chung

Phung Van Quan

SOI Milestone 2 Project

• Statement of Intent Milestone 2:– A study is carried out to assess the degree to which

technical assistance in the health sector is harmonised and aligned

• Project funded by GTZ and JICA• Project Objectives:– Assess the degree to which technical assistance in the

health sector is harmonised and aligned;– Recommend options to overcome identified

constraints and propose a methodology for ongoing monitoring of developments in the sector in terms of alignment and harmonisation.

Methodology

• The project involved 3 steps: – Document review, – Consultations and – Reporting.

• A fourth step, presentation and discussion in with stakeholders, was deferred and will be considered at a later stage.

Document Review: Aid Effectiveness

• The literature on harmonization and alignment of technical assistance is a component of the body of literature that deals with the more general question of aid effectiveness .

• Key International Agreements:– Paris Declaration 2005– Accra Agenda for Action 2008– Hanoi Core Statement 2005 Localized Paris

Declaration– Health Partnership Group Statement of Intent 2009

Document Review: Harmonisation and Alignment Issues

• In 2003 JICA and the Central Institute of Economic Management study made comprehensive assessment of issues in Vietnam on Government and Donor Side

• In 2006 Bijlmakers et al identified similar issues• In the intervening period many reports have

made similar findings• In the Health Sector most, if not all the issues

remain unresolved

Document Review: National Capacity Building

• Ministry of Investment and Planning and Development Partners have been working together particularly at the Central Level to:– Build capacity, – reduce the transaction costs, – improve the quality of aid delivery and – increase the overall ODA effectiveness and efficiency,

• 3 areas targeted for action – legal capacity to create a transparent ODA regulatory environment; – organizational capacity to create an efficient ODA management

mechanism; and – capacity of human resources to manage ODA in a professional manner

(including a range of common reporting management tools). • Line Ministries such as Agriculture, Transportation and Education

were early to align with these activities and, with the SOI, the Ministry of Health has more recently formalized its involvement.

Document Review: Capacity Development Activity Issues

• There have been Significant developments in Public Financial Management and Planning, however

• Activities Biased to strengthening of Project Management Units (PMUs). – Emphasis inhibits mainstream management capacity building – Conflicts with the principles of alignment and harmonisation in

the Paris Declaration and the Hanoi Core Statement. • Emphasis on PMU management detracts from two more

important capacity building requirements: – Capacity to deliver services (to achieve better outcomes) and – Capacity to manage services (to support delivery of more

equitable, effective and efficient services). – Conflicts with the Paris Declaration and the Hanoi Core

Statement principle of managing for results.

Consultations (1)• Confirm the general conclusions reported in the

literature • General Examples of issues: – excessive reliance on TA for activity design and conduct

(lack of MOH ownership); – long delays in implementation (complex and/or

duplicated systems on both sides and lack of counterpart funds);

– poor quality implementation (poor TA and TA support quality);

– lack of consistency in direction (alignment issues); – and uncoordinated duplications (harmonization issues).

Consultations (2)

• Both sides agree TA and TC in the health sector are fragmented and should to be better coordinated

• Both sides acknowledge the issues stem from both sides.

• Development Partners clearly target their support to MOH and/or Provincial priorities.

Consultations (3)• Specific Examples of Issues:

– concurrent or sequential planning support to provinces using different documentation, methods, definitions, inputs, outputs and/or processes without formal linkages to central planning and/or budgeting requirements;

– Funding of planning and/or development activities as discrete project activities without consideration of the intrinsic linkage requirements.

– Supporting delivery of the same type of services in different areas with different service protocols, monitoring and/or evaluation mechanisms;

– Differential support for funding of National Targeted programs each with different funding eligibility criteria and/or scope of coverage within the program;

– Lack of counterpart funding to enable use of equipment supplied;

Systemic Harmonisation and Alignment Weaknesses

• Lack of shared understanding of the health sector’s development needs and/or priorities to which TA support can be aligned. – This weakness is currently being resolved through development of a

comprehensive health sector management plan (SOI Milestone 8).• Lack of shared definition of harmonisation.

– Harmonisation of TA is not simply sharing information about different activities. For practical purposes harmonisation is standardization of technical design of the TA.

– Two different forms of technical standardization are required:• Where TA supports development requires a standard approach over all

elements of TA design to ensure uniformity of results and to facilitate ongoing expansion and enhancement of the health sector.

• Where TA supports evaluation of different methodologies common technical standards are required over shared components of the design so different methods can be objectively analysed (to determine which is the most cost-effective or, alternatively, if different methodologies are required in different settings).

• Lack of formal TA Alignment and Harmonization and Monitoring Mechanisms

Proposals for the Alignment and Harmonisation of TA (1)

• Convene a Technical Working Group for TA Alignment and Harmonisation with the following Terms of Reference:

– Review the TA database (SOI Milestone 1) with respect to TA alignment with the MOH 5 year plan (SOI Milestone 8).

– Review the TA database with respect to technical content to determine:• The number of TA projects with similar objectives, roles and functions;• The extent to which similar TA projects are technically harmonized

– Data and definitions; terminology; methodologies; forms; technical, managerial and/or administrative processes and procedures, timelines, computational methods, and addressing reporting needs and quality standards of the Provincial and Central Authorities.

– Consult with relevant stakeholders to modify designs where TA is not currently harmonized

– Prepare a TA Alignment and Harmonisation plan to support implementation requirements of the MOH 5 year plan.

– Recommend an appropriate body for ongoing monitoring and management of the TA Alignment and Harmonisation Plan and associated TA/TC coordination activities in the Health Sector.

Proposals for the Alignment and Harmonisation of TA (2)

• Adopt a procedural checklist to be completed by the funding agency for all new proposals for TA

• Initial registration of the proposal in the MOH TA Data base • Identify the MOH planning objectives (from 5 year plan) and

activities the TA proposes to support • Identify similar TA activities active and/or proposed in the

health sector or other sectors• List of technical design issues where the proposed TA differs

from existing TA designs (see previous slide)• Endorsement by the Technical Working Party on TA

Alignment and Harmonisation or subsequent entity assigned responsibility for TA planning, monitoring and support.

Monitoring

• Monitor and report on all new TA activities initiated in a calendar year, scoring each project on a 5 point score as follows: – No item of the checklist achieved (0)– First item of the checklist achieved (1)– First and the second or third achieved (2) – First, second and third items on the checklist achieved (3)– All items on the checklist achieved (4)

• Reports can be generated by planning objective/activity and by DP showing numbers of new TA activities initiated by score.

Resources• The Technical Working Party on TA Alignment and

Harmonisation and any subsequent entity assigned responsibility for TA planning, monitoring and support will require

• Routine participation from the MOH DPF and other Departments with a direct interest in the TA under review;

• Technical support (not representation) from Development Partners

• Secretariat support for meeting preparations, collation and dissemination of data, agenda item follow-up activities. – If this activity is combined with management of the TA database

(Milestone 1) the volume of work would be equivalent to up to 1 full time administrative officer.

• The TA database administrator should be a research officer, not an IT specialist.

End of Presentation

Cam Ơn