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Summary

With support from the Bill & Melinda Gates Foundation, ThinkWell implements the Covid-19 Essential Health Services & Response Coordination project in Mozambique. We provide technical assistance to the Ministry of Health’s (MoH) Directorate for Planning and Coordination (DPC) to strengthen the MoH’s management of its Covid-19 response and the continuity of essential services during the pandemic. The DPC’s role is central to coordinating all health sector actors (public, private, donors, and implementing partners) to implement the National Strategic Health Plan (PESS) and the investment case of the Global Financing Facility (GFF). During this 12-month grant (October 2020-October 2021), ThinkWell will strengthen key functions of DPC in four areas:

  1. Sector leadership, including the alignment of donors’ health sector and production of sector strategies, plans, and monitoring documents
  2. Active data analysis to orient and facilitate the MoH’s use of data for planning and decision-making
  3. Streamlined management of Covid-19, including financial management
  4. Efficient management of essential service provision

Challenges

Mozambique has a high burden of disease, including an estimated 9 million cases of malaria, 2.2 million people living with HIV, and a TB incidence rate of 73/100,000. Given that, there is risk that, if not carefully monitored and managed, the strategy to contain and manage coronavirus may have the unintended consequence of increasing mortality from other causes. Prior to the pandemic, economic volatility, typhoons, and social unrest had already burdened the health sector. Donor coordination and pooled funding mechanisms has declined, even though international assistance contributes 50% of the country’s health financing. Stagnant public sector salaries limited the MoH’s ability to recruit and retain staff. Health sector actors are coalescing around the pandemic and the GFF investment case. This presents an opportunity to reinvigorate coordination, planning, delivery, and monitoring of essential health services.

Approach

The project’s approach to technical assistance is a progressive, multi-stage process to support the MoH towards transformational change. ThinkWell is moving away from embedding project staff in the MoH, since embedded staff often get pulled into completing daily tasks. Instead, we seek to transfer capacity to the MoH for their staff to lead and perform effectively.

Breaking New Ground

This grant is one of three country pilots for investment case implementation support that are part of a new partnership model for the Global Financing Facility and the Bill & Melinda Gates Foundation. One conclusion from the GFF strategy refresh was that countries need strong national leadership, including planning units, to lead multi-stakeholder engagement and implementation of the investment case. The strategy is to identify technical assistance gaps and build long-term institutional capacity. Mozambique and the other pilot countries will generate lessons for the other 36 GFF countries.

Results

The expected results include:

  • DPC will more actively lead coordination of health sector donors and adoption of a collective results framework (Quadro Unico)
  • DPC will lead the development and refinement of tools and platforms for planning and monitoring of the implementation of the National Strategic Health Plan (PESS) and the Global Financing Facility investment case
  • DPC will increase the MoH directorates’ ability for medical services, public health programs, and provinces to use data for monitoring and planning, and ultimately to improve access to quality services
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