2012 Holistic Assessment of Health Sector POW - Ministry of Health

and municipal assembly levels because the health sector has still not been fully devolved. Secondly there
were no clear guidelines on how the district health directorates were to participate in the development of
the composite plans and budgets. In most districts they were not invited to participate in the exercise.
With regards to implementation of programme budgeting, budgets have already been categorised based
on programmes and there is the need to provide guidance to BMCs on how to access funds based on the
programs.
4.2.2 Strengthen the regulatory framework
Although a lot of bills have been passed into law, efforts aimed at operationalising the law through legal
instruments seem slow. The Ministry of Health should lead the process of ensuring that the appropriate
stakeholders are brought together to facilitate the development of the various legal instruments on time.
4.2.3 Strengthen inter-sectoral collaboration and public-private partnership
A framework (cross-sectoral planning group on health) exists at the national level and is led by the National
Development Planning Commission (NDPC). Similarly, structures exist at the regional and district levels for
cross-sectoral activities. The challenge is that of participation. Most district directors of health services do
not participate in District Assembly activities neither do the assemblies take responsibility nor initiate a
process to get cross-sectoral activities on health going. The process of devolving the health sector to the
district assemblies is gathering momentum. This will address some of these challenges.
The private sector policy provides for cross-sectoral activities in the mobilsation of resources for health and
health care. The delay in printing and disseminating the policy does not augur well for the development and
promotion of private sector participation in health. There is an increased interest of the private sector to
engage the public sector in improving access and quality of health care, lack of clear guidelines for these
engagements is affecting progress in this area.
4.2.4 Strengthen systems for improving the evidence base for policy and operations research
The plan to introduce a structured in-service training for the senior personnel of the MOH and Agencies in
evidence-based policy making and programme monitoring has been on the drawing board for the second
year running. It looks like the implementation of this priority activity has challenges. A re-evaluation of the
need for this activity should be carried out and resources allocated to ensure that the necessary
arrangements are made to bring the plan to fruition if it is still deemed necessary.
4.3 Health objective 3: Improve access to quality maternal, neonatal,
child and adolescent services
4.3.1 Reduce the major causes contributing to maternal and neonatal deaths
The implementation of the MAF action plan has delayed. Delay in release of funds has been blamed for the
slow process in implementing the MAF. The content and processes of MAF are not new. Indeed part of the
MAF plan is being implemented at all levels. Whiles waiting for disbursement of the MAF money, the
Ministry of Health should provide guidance and supervision to ensure there is synergy with on-going
activities. Meanwhile, efforts aimed at minimising the delays should be made.
The target of providing appropriate equipment to at least 25% of hospital blood banks nationwide to make
them functional could not be met. However 34 health facilities were provided with cold chain equipment
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