Joint Assessments of Moldova National Strategic Plan for HIV

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Joint Assessments of Moldova National Strategic
Plan for HIV
Overview Peter Godwin, Team Leader Chisinau, 27
June
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Joint Assessment what is it?

• Joint assessment
• A process whereby country stakeholders and
  international partners come together
• to carry out an independent assessment of a
  national strategy and its accompanying
  documentation
• that is seen as valuable and is accepted by
  multiple stakeholders (including within the
  country)
• Purpose of joint assessment
• To provide country with constructive feedback on
  the national strategy that could be used to
  further strengthen it
• To inform decisions on funding or technical
  support by the government and international
  agencies

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Joint Assessment why?
Developmental feedback
Government budget allocations to disease program
National disease strategy documentation from
countries
Jointly assessed national disease
strategy documentation
International agencies financial and/or
technical support
National disease strategy documentation
national disease strategy complementary
documents (e.g., operational plan, ME framework)
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Joint Assessment benefits?

• Focus on development, financing and
  implementation of robust national strategies
  aimed at improving health outcomes and
• supports Paris aid effectiveness principles and
  Accra Agenda for Action
• Specific anticipated benefits
• Improved quality and credibility of national
  strategic frameworks
• Renewed focus on national strategies as a basis
  for alignment and harmonization
• Improved harmonization among funders that have
  agreed to use the same approach to assess the
  soundness of national strategies
• Opportunity to improve strategy
  development/implementation process, including
  breadth of stakeholder involvement

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Joint Assessment Process

• Takes place in country, over an 8-12 calendar day
  period
• Conducted by an independent, multi-disciplinary
  joint assessment team of national and
  international experts (selected by country
  stakeholders and international partners), with
  the support of national facilitators
• Based on the set of attributes for sound national
  strategies contained in the Joint Assessment of
  National Strategies (JANS) Tool

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Organized by a multi-stakeholder, country-based
Joint Assessment Organizing Body Involves the
joint assessment team conducting documentation
review, discussions with key stakeholders, and
some site visits Output of the
assessment Debriefing to present and discuss
findings with country stakeholders A report
highlighting the identified strengths and
weaknesses of the countrys national disease
strategy documentation
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What a joint assessment is (and isnt)
It is It is not
a multi-partner process a single-agency (e.g. Global Fund) process
a forward looking assessment focusing on strategic direction and feasibility of implementation a review of previous and ongoing program implementation
conducted by a multi-disciplinary team of experts conducted only by disease experts
aiming to assess strengths and weaknesses of national strategy documentation leading to a funding decision or funding recommendation
part of a learning process (at this stage) going to be perfect!
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Joint Assessment team who?
legend
external

• Joint assessment team
• members must all be independent
• members can be either external or local
• team leader however must be external
• assessment team members conduct assessment and
  contribute to and sign off on final assessment
  report

• National facilitators
• local (or from locally-based international
  agencies)
• can be non-independent
• can participate in assessment to observe or
  provide information, but not contribute to
  deliberations or report

local
Team leader
Other experts (to cover all attributes)
S t a k e h o l d e r s i n t e r v i e w e d
b y j o i n t a s s e s s m e n t t e a m
National disease authority
e.g., from government, civil society, private
sector, technical partner and donor agencies
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Roles and responsibilities
Joint Assessment Organizing Body

• Works with team leader to prepare and organize
  joint assessment
• Coordinates and facilitates the involvement of
  relevant country stakeholders throughout the
  process, including their involvement in
  discussing / commenting on joint assessment
  findings

Provide feedback on joint assessment process as
part of effort to capture lessons learned
Assessment team

• Conducts assessment of national strategy using
  the JANS Tool, via document review, stakeholder
  interviews and some site visits
• Debriefs stakeholders
• Develops assessment report

National facilitators

• Participate in joint assessment alongside
  assessment team to provide context,
  clarifications, and other relevant information
• However, do not contribute to writing the joint
  assessment report
• Their participation in some interviews may not be
  appropriate

Other in-country stakeholders

• Provide information as potential interviewees
  and/or comment on draft joint assessment report
  (with a focus on factual accuracy)
• Use joint assessment report to inform internal
  decision making on financial and technical
  support as appropriate

• Supports the preparations of joint assessments,
  offers guidance, facilitates country-level
  support, and examines lessons learned to inform
  future design of joint assessments
• Representative(s) to accompany joint assessments
  to provide support as needed and gather lessons

Joint Assessment Support Group
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JANS Tool
The Joint Assessment of National Strategies
(JANS) Tool and the Information Note on the Use
of the JANS Tool to Assess National Disease
Strategies are used as the basis of the
assessment.
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Joint assessment team
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Assessment team expertise

• The joint assessment team possesses expert
  knowledge of international best practice and
  standards in
• disease control
• national strategy formulation and implementation
  
• relevant health system considerations
• budgeting and financial management systems
• procurement
• monitoring and evaluation and
• multi-stakeholder involvement.

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Assessment team for Moldova
Peter Godwin Team Leader, Strategic Planning,
MSI Alexander Turdzeladze Finance and
audit Boris Sergeyev HIV disease expert Roger
Drew ME, MSI Ulrich Laukamm-Josten Programme
management Mihai Ciocanu Procurement and supply
management GF observer Cindy Carlson UNAIDS
observer Anja Nitzsche-Bell
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Independence and conflict of interest
The joint assessment team leader lives outside
the country and has no ongoing or previous
engagements with the country that could create
the perception that he/she cannot fulfill his/her
role as team leader in an independent and
impartial manner.
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Independence and conflict of interest

• All joint assessment team members must be
  independent and impartial
• each team member must have had no material
  involvement in the development of the national
  strategy and
• each team member and his/her employer must not
  be a potential financial beneficiary of a funding
  decision that is based on the jointly assessed
  strategy.

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A few experts proposed and paid for by some of
the donors participating in the joint assessment
may be included in the joint assessment team.
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National facilitators
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National facilitators responsibilities

• National facilitators selected by the JAOB, with
  inputs from the team leader, to participate
  alongside the joint assessment team in
  interviews, fact-finding activities and
  assessment team discussions (as requested). They
  will provide context, clarifications, and other
  relevant information
• Can take part in team discussions about findings
  and provide further context as needed
• Will not contribute to writing the joint
  assessment report, but will be able to comment on
  draft versions of the report along with other
  country stakeholders.

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JANS Tool
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JANS Tool Background

• Developed by multi-partner working group, under
  International Health Partnership (IHP),
  2008-2009
• Defined a set of principles to underpin joint
  assessment
• Developed for different types of national
  strategy (health sector or sub-sector/disease)
• Piloted by IHP for various health sector joint
  assessments 5 countries in 2010/11
• Piloted in Global Fund NSA First Learning Wave
  (for disease strategies

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JANS Tool Structure

• Based on the attributes of a sound strategy
• 5 categories of attributes
• The situation analysis, and coherence of
  strategies and plans with this analysis
  ('programming)
• The process through which national plans and
  strategies have been developed
• Financing and auditing arrangements
• Implementation and management arrangements
• Results, monitoring, review mechanisms
• Attributes describe ideal elements contained in
  a sound national strategy
• Characteristics describe further the ideal
  elements in the attributes

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JANS Tool Guidelines on use

• Tool provides overall framework for joint
  assessment
• Not a yes/no approach
• Attributes may be most useful level of reference
  can serve as guide to joint assessment agenda
  setting and team composition
• Joint assessment report sets out strengths and
  weaknesses according to each attribute
•  National strategy/plan  in Tool refers to a
  portfolio of documents (national strategy
  document plus operational plan, ME plan, budget,
  etc.)
• Guidance document entitled Information Note on
  the Use of the JANS Tool to Assess National
  Disease Strategies references technical
  documents for HIV/AIDS, tuberculosis, and
  malaria, that are recommended for use alongside
  the JANS Tool for certain attributes
• More detailed information and interpretation of
  the JANS Tool is provided in the Joint
  assessment guidelines document on the IHP
  website

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JANS Tool Five categories of attributes
Category Focus of attributes
1. Situation Analysis and Programming Sound situational and response analysis Clearly defined priority areas, objectives and interventions, contributing to improved health outcomes Planned interventions, cost effectiveness, sustainability Risk assesment and mitigation strategies
2. Process Multi-stakeholder involvement in development and endorsement of national strategy documentation Consistency with higher and lower level strategies
3. Finance and Auditing Comprehensive budget/costing, financial gap analysis Specification of allocation of funds Financial management system
4. Implementation and Management Operational plans, resource deployment Procurement policy Governance, management and coordination framework
5. Results, Monitoring and Review Monitoring and evaluation Joint periodic performance reviews
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1. SITUATIONAL ANALYSIS PROGRAMMING -
ATTRIBUTES

1. National strategy is based on a sound situational
   and response analysis of the context (including
   political, social, cultural, gender,
   epidemiological, legal, and institutional
   determinants).
2. Clearly-defined priority areas, goals,
   objectives, interventions, and expected
   outcomes/products that contribute to improving
   health outcomes and meeting national and global
   commitments (such as the Millennium Development
   Goals and WHA resolution on PHC)
3. Planned interventions are feasible, locally
   appropriate, equitable and based on evidence and
   good practice, including consideration of cost
   effectiveness and sustainability (both financial
   and programmatic)
4. Both assessment of risks (analyzing feasibility
   of and potential obstacles to implementation) and
   proposed mitigation strategies (including
   specifying technical assistance needs) are
   present and credible.

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2. PROCESS - ATTRIBUTES

1. Multi-stakeholder (including government)
   involvement in development of national strategy
   and operational plans (led by government, with a
   transparent participative process) and
   multi-stakeholder final endorsement of national
   strategy.
2. High level of political commitment (at the
   highest level) to national strategy
3. National strategy consistent with relevant
   higher- and/or lower-level strategies, financing
   frameworks and underlying operational plans

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3. FINANCE AUDITING - ATTRIBUTES

1. Expenditure framework with comprehensive
   budget/costing of the program areas covered by
   the national strategy.
2. Expenditure framework includes financial gap
   analysis including a specification of known
   financial pledges against the budget from key
   domestic and international funding sources
   (specification of sources of domestic funds
   desirable).
3. Description of financial management system
   (including financial reporting against budgeted
   costs, and accounting policies and processes) and
   evidence that it is adequate, accountable, and
   transparent
4. Description of audit procedures and evidence of
   appropriate scope of audit work, as well as
   independence and capacity of auditors
5. In the context of national development policies
   (where applicable) Explanation of how external
   resources will be channeled, managed and reported
   on.

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4. IMPLEMENTATION MANAGEMENT - ATTRIBUTES

• Operational plans are regularly developed through
  a participatory process and detail how strategic
  plan objectives will be achieved.
• Description of how resources will be deployed to
  achieve clearly defined outcomes (with attention
  to staffing, procurement, logistics and
  distribution. Plan describes transfer of
  resources human, commodities to sub-national
  level and non-state actors).
• Procurement policy that complies with
  international guidelines and evidence of
  adequate, accountable, and transparent
  procurement and supply management systems with
  capacity to reach target populations.
• Specification of governance, management and
  coordination mechanisms/framework for
  implementation (describing roles,
  responsibilities and decision-making of all
  stakeholders)

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5. RESULTS, MONITORING REVIEW - ATTRIBUTES

1. Plan for monitoring and evaluation that includes
   clearly-described output and outcome/impact
   indicators, with related multi-year targets that
   can be used to measure progress and make
   performance based decisions.
2. Plan for monitoring and evaluation includes
   sources of information for indicators and
   description of information flows.
3. Plan for monitoring and evaluation that includes
   descriptions of data collection/data management
   methods, tools and analytical processes
   (including quality assurance).
4. There is a plan for joint periodic performance
   reviews (reporting of results against specified
   objectives and respective targets explaining any
   deviations) and processes for the development of
   related corrective measures.
5. Monitoring and evaluation plan describes
   processes by which monitoring results can
   influence decision making (including financial
   disbursement).

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Agenda 27 June 8 July
Agenda for the joint assessment developed by JAOB
in consultation with the team leader. The joint
assessment agenda includes the opportunity for
the joint assessment team to interview relevant
stakeholders, including civil society and private
sector organizations, and visit facilities to
obtain and verify further information as needed.