Sustainability AIPHSS Progress Report December 2013

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7.2 Partnership

During this reporting period the partnership has seen further tensions developing between RorenCPMU and DFAT. This appears to be due differing perceptions on performance, efficiencies and role. These perceptions have led to a sense of mistrust which is a high risk for the program. The ISP has been able to mediate on several occasions but there is clearly a need for further partnership building between partners. In light of the mutually recognised need for partnership improvement, the ISP project manager, CPMU coordinator and two representatives from DFAT attended a two day training session on “Partnership Training: making partnerships work”. The workshop highlighted the benefits of working through a true partnership and at completion of the training all participants agreed that there was much scope for improvement in the partnership approach for AIPHSS. As a result, management representatives from the three partners confirmed a commitment to working toward establishing a Partnership Agreement in 2014. This will be most relevant after the AIPHSS Review in early 2014 to include any recommended changes the program may receive.

7.3 Sustainability

The sustainability of AIPHSS has several dimensions. These are:  the degree of ownership and participation by the SRs, senior policy makers at the national and sub national levels;  alignment with government priorities;  the technical quality and relevance of outputs from activities. It is also essential that outputs are produced at a rate of practical absorption;  the quality of technical management that guides outputs towards policy process and uptake;  quality of evidence produced by AIPHSS that can provide the government with evidenced based solutions for improving the equity in health financing;  improved strategic planning in human resources and availability of human resources for the poor and improved primary health care services. A key element to all dimensions is working within the government systems to ensure relevance and appropriate change. All aspects required to achieve sustainability are in place but need to be continually assessed and improved. 8 Risk Management The ISP monitors risks on a daily basis and has been proactive in minimising risks to DFAT and GoI partners. In the last six months, the ISP has been tasked to undertake large and more complex activities for example: PJJ, ADINKES, Health Sector Review HSR, and negotiations of the United Nations University contract. For all activities, the ISP reviews and scrutinises ToRs and activity budgets in detail to ensure there are no errors or over calculation in budgets. In addition, the ISPs working relationship with the CPMU has been clarified and the CPMU Procurement and Finance Officer is now taking a more proactive role in reviewing ToRs and budgets. However, in the absence of the Grant Agreement, the ISP has been required to take on a larger role in review and monitoring of activity implementation, which is very resource intensive task. 32 During this reporting period the CPMU has shown increasing leadership particularly since the appointment of permanent staff to the CPMU and establishment of the Provincial and District offices. Since the Grant Agreement is no longer continuing there is now a lack of clarity on the processes of how workplan activities will be funded at the national level. Tasking Notes are the only channel remaining for the partnership to fund SR activities. This risks creating a bottleneck as each activity will require a tasking note to release funds. The ISP, CPMU and DFAT will review the process for 2014 to identify a more efficient system of operation in light of the anticipated escalation of activity implementation. The ISP also committed a significant effort to ensure the provincial staff were trained on risk process for all elements of the program implementation financial, ME as well as overall management. During the AIPHSS Orientation week a comprehensive session in fraud management was presented which included discussions with the DFAT Risk and Fraud Management specialist. The full risk matrix for the AIPHSS is presented in Annex 4. 9 Summary of Lessons Learned and Recommendations for the Next Reporting Period

9.1 Governance