Summary Governance and Supervision of the Health System

21 Intermediate Outcome: Improving strategic planning In this reporting period the following activities are being implemented that contribute to improved strategic planning:  Implementation of the Executive Development Program EDP for strategic management of human resources.  Analysis of provincial and district health systems as inputs for regional strategic health plans and regional five year development plans. Intermediate Outcome: Improved ability to identify health system needs The following activities implemented in this reporting period are contributing to the development of information on health system needs:  Capacity building for the human resource projections and analysis. This will result in a 10 year projection of human resource needs in Indonesia.  Case Based Groups CBG 16 review involving a baseline and capacity assessment conducted by an international expert used to develop a nine month capacity development plan.  The commencement of a Road Map for HTA to identify institutional roles, responsibilities and governance arrangements for HTA.  The analysis of province and district level health systems to provide inputs for regional government plans. Intermediate Outcome: Improving communication and coordination Communication and coordination with government counterparts is a key strength and an intensive on- going process. It occurs at all levels from the micro planning and implementation of activities to mid- level management, strategic planning and policy dialogues. The TD meets regularly with the Secretary General to address issues of coordination with implementing units across the MoH as well as other ministries. Specific activities undertaken in the reporting period were:  Quarterly technical coordination meetings: These are chaired by the Secretary General and supported by the AIPHSS TD. The meeting reviews progress and technical coordination required across all IUs. Other technical review meetings took place specifically on accreditation, human resources planning, and health centre information systems.  Policy Dialogues: In this reporting period the first policy dialogue using the analysis from the HSR took place in May 2015. The topic area was selected by the Secretary General focusing on pharmaceutical policy under national health insurance. Multiple stakeholders across public and private stakeholders attended agreeing to participate in further multi sectoral collaboration.  The Health Policy Unit HPU: This unit was a recommendation in the IPR in 2014. It was finally established in this reporting period and is currently in the process of developing a work plan and list of priority areas. The HPU is considered an important mechanism in the knowledge management strategy to channel different knowledge products emerging from the AIPHSS activities. It has direct access to the special advisers to the Minister.  Health Systems Strengthening Coordination Unit HSSCU: This was a direct request from the Secretary General. The Unit was established in this reporting period and intends to coordinate all donor funding related to health systems across the MoH.

3.5.1 Summary

Capturing the contributions to good governance requires compiling and assessing the outputs and outcomes of different activities across all building blocks to understand how they are being taken up by partners and used in a sustainable manner. Alongside this it is necessary to acknowledge the intensive coordination and communication that is undertaken on a day to day basis to implement and monitor activities undertaken across human resources, health financing, and service delivery. All 16 Case Based Groups CBGs are the basis for the hospital provider payment system for JKN. They are used as a unit of costing and fundamental to the payment system to manage undertake cost control 22 AIPHSS activities require collaboration, negotiation and communication by partners within MoH and sub national levels and across other ministries and external stakeholders. These types of actions can contribute to improved governance at the various levels of government. Larger activities such as the HSR, NHA, CBG, and HTA are all fundamentally contributing to the governance of health systems and policy development. On another level the interaction required by the national and sub national levels to roll out the linkages between the RJPMN and RJPMD facilitate improved collaboration and linkages in the context of decentralisation. Adequacy of Inputs: The range of activities that are implemented are adequate to influence good governance. Progress against Schedule: Most of the activities above are reported under other EOPOs. The HSSCU was delayed by two months but is now established. Sustainability: All activities are highly sustainable as reported above. However, the HSSCU and HPU are at risk of not being continued after the end of AIPHSS as they are not structural units within the MoH and externally funded by AIPHSS. AIPHSS will work with MoH to explore ways to institutionalise these structures using amendments to MoH regulations, including ensuring adequate funding through APBN . This will be part of the AIPHSS’s exit strategy. The performance of both units will be monitored during the remaining period to demonstrate their value. Next Steps: Next steps for many activities are reported above. Specific to this EOPO are:  The HSSCU implement coordination amongst donors and development partners.  HPU to commence the delivery of policy advice using policy briefs and policy dialogues.  TD to continue technical coordination meetings. Gender, Social Inclusion and Disability: No direct activities.

3.6 Summary of Investment against EOPOs and Building Blocks