The Bougainville Plan for Health 2012 to 2030


Appendix 10: Draft timetable of significant events



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Appendix 10: Draft timetable of significant events

Plan timetable and financial impact (Draft 20/04/12)





Event

Begin

Complete

Comments/

Impact

Capital

Recurrent

Health goals
















Measles elimination*

2012

2015?

95% measles vaccine coverage in all regions for 2 years. Other WHO criteria to apply before elimination can be declared.


See DHFF

See DHFF

MDG 5 compliance*

2012

2014?

Meet criteria set by Maternal Health Taskforce.








MDG 4 compliance*


2012

2018?










Universal health coverage*

2012

2019?

Free, accessible primary health care for 99% of ARB population.


DHFF




Malaria elimination




?

WHO criteria for elimination.








Health services

















Essential obstetric care in all health centres and community health posts


2012

2014?




RHSD funding

Nil

Maternity/ midwife training program for all existing staff involved in deliveries




2014?

All deliveries conducted by trained NO/CHW.


RHSD funding

0.2

Training needs assessment and training program developed and implemented for all existing staff


2012

2013

Maximise the potential of existing staff.

RHSD funding




ABG tobacco free policy and practice


2013?

2020?










ABG home brew and alcohol PH program


2014?

2018?










Develop and implement nutrition strategy to address first 1000 days and NCDs



2014?

2020?







1m

Medical supplies move to Pull system

2013?

2014?

Improved medical supplies


GoPNG funded




Decision on medicines purchasing options for ABG.

2014?




Assess impact of current approaches and move to Improved medical supplies.


Neutral




Buka Hospital re- accreditation





2013?










Diagnostics – Digital Xray established in 2 district hospitals





2020?




1m




Integration of BHCP into health services and coverage of all villages


2013

2014?







1m

Introduction of pneumococcal vaccine

2014?




Reduced child admissions for pneumonia








Medical supplies, and equipment electronic inventory and ordering system





2015?










Integrated Information system linking all levels and facilities


2012

2019?










DHFF facility level funding and removal of user fees.


2011

2013

Increased utilisation, increased performance at facilities.





3.3M

Drs deployed to districts and major facilities – increasing skills in facilities.


2013?

2025?










Buildings

















STI clinics (2)

2012

2012

At Buin and Arawa. AusAID project currently underway.



Already committed




Rural Health Service Delivery rural health infrastructure upgrade

2012

2016?

Rural Health Service delivery project currently covers South and Central and is underway. Additional support required for North region’s rural facilities.


Already committed




CHW training school establishment


?2012

2018

Increased availability of CHWs. Cost approx K10m.


K10m

K2m

Arawa District Hospital Development

?2015

2020

Cost of new District Hospital $25m.


K25

K5m

Rural Hospital development Tanamalo, Moratona


?2020

2022

Cost $5 -10m per site.

K10m

K2m

Buin Hospital development

?2016

2021

Cost K10m

K10m

K2,2

Development of Buka Hospital as provincial hospital

2022

2029

Cost K100- 120m if new site required.


K120m

K20m

Nursing school development


2023?

2030










Children’s hospital development





Post 2030










Governance and management

















Establish Health Plan Independent advisory group

2012

2012

Advises Minister on progress of this plan.








Establish Bougainville Health Board

2012

2012

Coordinating mechanism for health sector organisations (church, hospital, rural, NGO).








Establish Bougainville Health Authority

2012

2014

Merger Rural Health and hospital services.









Appendix 11: Prioritisation and sequencing


Evidence based business cases should be prepared for all projects exceeding PNG K1 million. Business cases should respond to the criteria below.

PRIORITIZATION

In determining priorities, the health sector will assess various options, by applying and considering the following principles.



  1. Equity

  2. Impact

  3. Disability adjusted life years (DALYs) gained

  4. Technical feasibility

  5. Effectiveness

  6. Efficiency

  7. Cost

  8. Opportunity cost

  9. Sustainability

  10. Consistency with health sector values

  11. Cultural acceptability


TIMEFRAME FOR IMPLEMENTATION

In determining when various strategies should be implemented, the health sector will consider the following principles.



  1. Time to benefit

  2. Pre- requisites in order for strategy to be viable/beneficial. (personnel, finances)

  3. Benefit of small scale introduction before expansion and roll-out

  4. Recurrent cost of maintaining strategy and how this affects ongoing annual expenditure


Appendix 12: Technical advisory group for this plan.


This plan was prepared following direction given by the Vice President & Minister for Health of ARB, The Honourable Patrick Nisira and from four days of discussion with a technical advisory group from the ARB health sector and consultation with a wide range of stakeholders.
Plenary sessions were attended by:
Laurence Disin, ABG Chief Administrator

Raymond Masono, ABG Deputy Administrator


Members of the technical group:

  1. Dr Pumpara, CEO, ARB Health Division

  2. Dr Imako, CEO, Buka General Hospital

  3. Simon Disin, Director of Policy, Planning and Administration ARB Health Division

  4. Alois Pukienei, Director of Public Health, ARB Health Division

  5. Matthew Monei, Director of Corporate Services, Buka GH

  6. Vincent Momei, Environmental Health, ARB Health Division

  7. Michaelyn Pau, Catholic Church Health Secretary

  8. Rev Abi Enoh, United Church Health Secretary

  9. Hona Nolan, Women’s Representative,

  10. Puara Kamariki, CEO for Human Resource, ARB

  11. Maria Cartwright, NGO Health Rep, MSF

  12. Ruby Mirinka, Bougainville Healthy Communities Program

  13. Aileen Pilau, Health Information Officer

  14. Peter Awin , Health Centre

  15. Ms. Agnes Titus, UNDP

  16. Ross Naylor, Health Economist

  17. Dr Isaac Ake, Health Sector Expert and NDoH Representative

  18. Dr Joan Macfarlane, Public Health Specialist

  19. Prof Don Matheson, Health Planning Specialist and Lead Adviser


Stakeholders Consulted:
Vice President & Minister for Health ARB: The Honourable Patrick Nisira

Secretary of Health Pascoe Kase

NDoH Strategic Policy Division:

Technical Adviser, Health Economics, Navy Molou

Senior Planner (Strategic) Roselyn Melua,

Facilities branch Mr Ambrose Kwaramb.

Asian Development Bank: Rob Akers

WHO Representative: Dr William Adu-Krow

Dr Paulinus Sikosana

Dr Mohammed Salim Reza

PNG Finance Consultant : Gima Ruba

ARB CEO Finance, Graham Kakaroutz

CEO Planning and Aid Coordination  Lesley Tseraha

GoPNG Secretary of Treasury Simon Tosali

AusAID Dr Geoff Clark

UNICEF, Chief, Child Protection, Elaine Bainard

Dr. Grace Kariwiga

NZAID New Zealand Program Aid Manager Rebecca Lineham

UNFPA, Assistant Representative Dr Gilbert Hiawelyer

World Bank Human Development Operations Ms. Ellen Kulumbu




1 These figures need to be updated with 2011 census figures.

2 National Health Expenditure Indicators WHO 2010. Note: General government health expenditures, as given by WHO, include capital expenditures and are collected from national health accounts, when available, and other government sources. Refer to WHO website: http://www.who.int/healthinfo/statistics/indhealthexpenditure/en/index.html Accessed 30 April 2012.

3 ABG’s MTDP 2011-2015, page 131


4 The Bougainville Administration, pages 71-72

5 Autonomous Region of Bougainville, Health Capacity Diagnostic Report (March 2012) Pages 20-21.

6 An estimated 300,000 kina in revenue added to the quoted figure of 8.6 million kina. Source: Health Sector Partnership Committee, Agenda Papers (Feb 2012) Page 20.

7 Health Sector Partnership Committee (February 2012) Page 34.

8 Made up of staffing costs of K3 million, recurrent funding of K0.426 million and operational funding to 13 DHCs of K0.29 million. – Source: Autonomous Region of Bougainville, Pages 19-21.

9 MSF Funding is 800,000 euro per year for 4 years (verbal source) = 2.14 million kina per year at 1: 2.67 exchange rate, as at 13 April 2012 – Source www.xe.com.

10 Based on overall PNG medical supplies and equipment spending divided by the population estimate and indexed for the ABG population. (awaiting an alternative estimate from NDOH).

11 Included in 2011 Restoration and Development Budget rollover – Source: Autonomous Region of Bougainville, Pages 22-23.

12 Based on verbal discussions with NZAID that DHFF expenditure for 2011 was just short of 1 million kina. DHFF is the Direct Health Facility Funding program (awaiting an alternative from NDOH).

13 Source: Health Sector Partnership Committee, Agenda Papers (Feb 2012) Page 20.

14 Autonomous Region of Bougainville, Health Capacity Diagnostic Report (March 2012) Page 21

15 2011 Restoration and Development Budget rollover – Source: Autonomous Region of Bougainville, Pages 22-23. Note: 1.593 mill kina is capital funding, 0.363 mill kina is recurrent.

16 ADB Infrastructure Program of US$82 mill over 8 Provinces, 70% spent in Province over 5 years.

17 Source: National Statistical Office of PNG, PNG Census 2011, Preliminary Figures of 234,280 indexed up to 2012 by 2.3% estimate only, Page 5.

18 Using exchange rate of 1 kina = 0.489 US$ - Source www.xe.com.

19 National Health Expenditure Indicators WHO 2010. Note: General government health expenditures as given by WHO, include capital expenditures. They are collected from national health accounts, when available, and other government sources – refer to WHO website: http://www.who.int/healthinfo/statistics/indhealthexpenditure/en/index.html.

20 From World Health Report 2010 chapter 2 pages 22-23



21 For the purposes of these scenarios, it has been assumed population will increase by 2.3% to 2020 and then by 2.0% to 2030.

22 This is used given the latest rates of suppliers of goods and services vary from 2.9% to 11.7% (Australia 2010 2.9%, PNG 2010 6.8%, China 2010 5%, and India 2010 11.7%). Source: http://www.indexmundi.com/

23 Note $120 per capita expenditure in 2012 dollars is equivalent to S342 per capita in 2030 dollars. 120X(1.06)18 = US$342.52. If this is divided by 0.489 to convert to kina and then multiplied by the projected population in 2030 of 350,443 the answer is 245,467,000 kina. This is the same as the projected total expenditure inflation adjusted in the table above (rounding off explains the small difference).

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