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Annual Programme of Work 2009 - Ministry of Health

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3. KEY LESSONS AND CHALLENGES IN 2008<br />

Key challenges in implementing the 2008 POW include<br />

• Coordination and alignment <strong>of</strong> policies, implementation plans and programmes.<br />

o Changes in plans as a result <strong>of</strong> changes in levels <strong>of</strong> resource s mobilised for<br />

the sector were not reflected in agency plans as a result <strong>of</strong> weakness in<br />

communicating the changes in promptly.<br />

o Significant commitments were not originally captured in plans and budgets<br />

and made it difficult to have a clear idea <strong>of</strong> the full scope <strong>of</strong> resources<br />

available to the sector.<br />

o Difficulties in aligning the procurement cycle to the budget due to unplanned<br />

procurement and the huge budget cuts during the year. This negatively<br />

impacted on the efforts to meet procurements targets.<br />

• Major budgetary reallocation within the year to support the free maternal deliveries<br />

• Reimbursement <strong>of</strong> claims and the entire area <strong>of</strong> claims management by the NHIS.<br />

• Unpredictability <strong>of</strong> fund releases<br />

• Untimely information on earmarked funds<br />

• Nonalignment <strong>of</strong> finance and budget reporting systems<br />

• Delays in accessing funds from MOFEP<br />

• Inadequate capacity for monitoring <strong>of</strong> policy implementation at all levels<br />

• Difficulties in enforcing agency reporting requirements<br />

• Matching productivity with the wage bill<br />

• Inequitable distribution <strong>of</strong> human resource<br />

• Poor staff attitude within the sector<br />

• Uncoordinated referral system<br />

• Quality control <strong>of</strong> imported foods and drugs<br />

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