••REPUBLIC OF RWANDA

MINISTRY OF HEALTH

P.O. Box 84 KIGALIWebsite: www.moh.gov.rw

MEMO

K. l' a 2 OCT 'kg1319a 1,

Ref20/ ..6::t.J-.S ../DG PHIS/2013

From : Honorable Minister

To VChair of Health Sector Technical Working Groups (MOH)

Date :01/10/2013

Cc:

Honorable Minister of State

Permanent Secretary

Re: Restructure of Health Sector Technical Working Groups(HSTWGs) .

Dear Sir, Madam,

l am pleased to inform you that the Health Sector Technical Working Group(HSTWGs) have beenrestructured in order to make them more active, useful and align them to the main components ofI;ISSP III.

Two levels of health sector working group have been proposed instead of three; the Health SectorWorking Group(HSWG) and the Health Subsector Technical Working Groups (HSTWG).Thenumber ofHSTWG have been reduced from 27 to12.

In order to have the fruitfully TWG, the chairs of TWG are requested to propose the institutionsmembers including the MoH &RBC departments, Development Partners, Civil SocietiesOrganizations and Private Sector, working actively in the specifie TWG area. Please send a list ofthe proposed institutions members to the Director General of Planning &Health information System,Ministry of Health no later than 08th October 2013, in order to ask them officially to nominate theirfocal point.

Attached, you will find the new structure of TWG and the generic TOR with more detail onfunctionality ofTWG.

•REPUBLIC OF RWANDA

MINISTRY OF HEALTH

P.O. Box 84 KIGALIWebsite: www.moh.gov.rw

o 2 OCT 2013Kigali, - -

G.,;)6' PRcf 201. .. ' 0 JDG PHIS/20 13

From : Honorable Minister

To : Chair of Health Sector Technical Working Group (RBC)

Date : 01110/2013

Cc:

Honorable Minister of State

Permanent Secretary

Director General of RBC

Re: Restructure of Health Sector Technical Working Groups(HSTWGs).

Dear Sir, Madam,

l am pleased to inform you that the Health Sector Technical Working Group(HSTWGs) have beenrestructured in order to make them more active, useful and align them to the main components ofHSSP III.

Two levels of health sector working group have been proposed instead of three; the Health SectorWorking Group(HSWG) and the Health Subsector Technical Working Groups (HSTWG).Thenumber of HSTWG have been reduced from 27 to 12.

In order to have the fruitfully TWG, the chairs of TWG are requested to propose the institutionsmembers inc1uding the MoH &RBC departments, Development Partners, Civil SocietiesOrganizations and Private Sector, working actively in the specifie TWG area. Please send a list ofthe proposed institutions memhers to the Director General of Planning &.Health information System,Ministry of Health no later than 08th October 2013, in order to ask them officially to nominate theirfocal point

Attached, you will find the new structure of TWG and the generic TOR with more details onfunctionality ofTWG .

1

Terms of Reference for the Health Sector Working Group (HSWG) and

Technical Working Groups (TWGs)

These terms of reference clarify the Health Sector Working Group’s (HSWG) background, objectives,

leadership, membership, modalities and frequency of meetings under the Economic Development and

Poverty Reduction Strategy (EDPRS) institutional framework.

1. Background

Since 2008, the Government of Rwanda started implementing its second generation Poverty

Reduction Strategy, the EDPRS, which covered the period 2008-2012. Currently GoR is

implementing its second EDPRS which runs from 2013-2018 and represents the comprehensive

development agenda of the nation in the medium term which is aligned to the Vision 2020 and embeds

the spirit of the Millennium Development Goals (MDGs).

The EDPRS is a national strategy which involves all stakeholders at all levels in its elaboration and the

same approach has and will be maintained during the implementation and evaluation phases, hence the

need to continue to strengthen the SWG approach.

2. Membership

The HSWG brings together Central and Local government institutions, Development Partners, Civil

Society and the Private Sector involved in the Sector or with an interest in the Sector’s development.

Members of the HSWG include but are not confined to the following;

The Ministry of Health (MOH) and its implementing agencies (e.g., RBC)

Development Partners active in the sector

Prime Minister’s Office

Ministry of Finance and Economic Planning (MINECOFIN)

Representative of the Ministry of Local Government

Civil Society

Private sector institutions

Health-related institutions of higher learning (e.g., KHI)

3. Objectives

The overall objective of the HSWG is to;

Provide a forum for dialogue, ownership and accountability of the development agenda by all

stakeholders at Sector level.

Build synergies in policy formulation, implementation and enhance regular reviews.

2

The specific objectives of the Health Sector Working Group are:

Coordination of activities within the sector and ensure alignment and harmonization to reach

sector outcomes

To develop and update the Health Sector Strategic Plan (HSSP)

To update the Health Sector Logical Framework (log frame) as needed

To develop, update and validate the sector M&E Framework

To Conduct Joint Sector Reviews (JSR) at least twice a year as per planning calendar; and timely

disseminate related reports

To strengthen the Sector-wide Approach (SWAp).

Facilitate dialogue and report to MINECOFIN on Sector Budget Support (SBS) -related

indicators, including EDPRS indicators related to the sector

Regularly discuss issues related to sector budgets (according to requirements of SBS donors

and/or donors contributing to joint financing mechanisms)

Mobilizing of resources for the sector in line with Rwanda’s Aid Policy

4. Key roles and responsibilities

4.1 Ministry of Health (Chair of the HSWG)

It is the responsibility of Ministry of Health (Chair) to:

Convene HSWG meetings, including setting the agenda in consultation with the lead donor (co-

chair).

Chair HSWG meetings.

Ensure relevant government institutions, civil society organizations and private sector are invited to

participate in the HSWG and its Technical Working Groups (TWGs).

Prepare bi-annual backward- and forward-looking JSR meeting, including necessary background

documents, such as progress reports on the status of Sector Strategy implementation, budget

execution reports, etc.; these reports should be shared with SWG members.

Lead the preparation and update of the Health Sector Strategic Plan and present it to the HSWG for

validation.

Lead the development the Sector M&E framework, present it to the HSWG for validation, and ensure

its operationalization.

Update the Health Sector log frame as needed and present such updates to the HSWG for validation.

Update the health-specific elements of the EDPRS matrix.

Communicate all relevant information concerning the HSWG to members; this may include strategic

documents, reports, meeting agenda and schedules.

Establish TWGs wherever necessary and appropriate.

Assign to member institutions of the HSWG any other relevant work as deemed necessary and

appropriate.

Mobilize resources for the sector in line with Rwanda’s Aid Policy.

3

4.2 Lead Donor (Co-chair)

It is the responsibility of the lead donor (Co-chair) to:

Co-Chair HSWG meetings.

Assist MOH with the coordination of the HSWG and to ensure the donors active in the sector are

fully represented in every HSWG meeting.

Support MOH in preparation of Joint Sector Reviews.

Coordinate common donor responses and activities in line with sector priorities and plans.

Approve the updated EDPRS health sector matrix annually with the Chair.

Contribute to the mobilization of resources for the Sector in collaboration with MOH.

Contribute to the improvement of the donors scoring in the HSWG on the Development Partners

Assessment Framework (DPAF).

Co-sign the agreed minutes of HSWG meetings

Contribute actively to and ensure effective dialogue within the health sector.

An alternate lead donor, nominated by Development Partners, assists the lead donor (Co-chair) in

discharging its duties and serves as the de facto Co-chair in the absence of the lead donor.

NB: The Chair of the HSWG may notify MINECOFIN of a request to change the Co-chair. However, the

Development Partners Coordination Group (DPCG) has the mandate to approve the new Co-chair.

4.3 Ministry of Finance and Economic Planning (MINECOFIN)

It is the responsibility of MINECOFIN to;

Provide overall Leadership.

Act as a second Co-chair in Joint Sector Reviews.

Provide strategic orientation on the planning, budgeting as well as monitoring and evaluation process

to the HSWG.

5. Frequency of meetings

The HSWG holds its meetings at least on a quarterly basis. However, the HSWG may convene extra

meetings whenever the Chair and Co-Chair deem appropriate.

In line with the national planning calendar, the HSWG will convene as the Joint Sector Review (JSR)

forum. The first JSR will be primarily backward-looking, focusing on sector performance as agreed in the

EDPRS sector matrix and budget execution for the previous fiscal year. Backward-looking reviews will

typically be held during the first quarter of the new Fiscal Year. The chair and co-chair will make sure

that backward-looking JSRs are conducted in line with the terms of reference provided by MINECOFIN.

Budget Support donors are requested to provide firm commitments of budget support by 15th January –

beginning of 3rd

quarter – to the extent possible.

4

The second JSR will be mainly forward-looking, focusing on plans and proposed budget outlays for the

next Fiscal Year and medium-term. These plans will be aligned to sector strategic plans and EDPRS.

Forward-looking Joint Sector Reviews will typically be held toward the end of the third quarter of the

Fiscal Year in line with the terms of reference provided by MINECOFIN so that they can inform annual

budget preparations.

6. Reporting and information sharing

The HSWG reports directly to MINECOFIN through its Chair. The Chair of the HSWG also reports to

the Chairs of the EDPRS Thematic Areas (currently, Economic Transformation, Rural Development,

Productivity and Youth Employment; and Accountable Governance) to which the HSWG directly

contributes. The HSWG chair will ensure forward and backward linkages between the HSWG and

EDPRS Thematic Working groups, including in terms of information sharing and updates on progress.

Within the HSWG, the reporting system is to be facilitated by a secretariat composed of at least one

representative from the Lead Ministry, Lead Donor and MINECOFIN. The goal of the secretariat is to

ensure the effective functioning and coordination within the sector.

Specific tasks of the secretariat include:

Developing agendas for HSWG meetings;

Recording meeting minutes;

Ensuring monitoring and follow-up of decisions taken in the meetings;

Ensuring coordination and coherence within the HSWG;

Circulating/publishing information to all HSWG members through their e-mail or web site,

Managing logistics for the HSWG.

The secretariat will be working closely with planners and budget officers from Ministries/agencies and

technical officers from member institutions of Development Partners, Private Sector and Civil Society. It

is the responsibility of all the members of the HSWG to share information relating to their development

interventions as required by the HSWG Chair.

7. Technical Working Groups

Since 2009, several Technical Working Groups (TWGs) operating under the authority of the HSWG

were established with the main objective of supporting and advising the HSWG in the overall

implementation of the SWAp, including the implementation of sub-sector strategies and policies and the

development of relevant guidelines and tools to be used by the implementing agencies. The TWGs were

expected to facilitate the alignment of all interventions with the National Health Policy and to support the

development and implementation of the Health Sector Strategic Plan (HSSP).

5

In 2013, the Health Sector TWGs were restructured to reduce their number as well as improve their

effectiveness and efficiency. The twelve current TWGs are diagrammatically depicted in Annex 1.

7.1 Roles and Functions of Health Technical Working Groups

The health TWGs play a key role in facilitating coordination, information sharing, and policy dialogue at

the sub-sector level. They will interface with the HSWG via both “top-down” and “bottom-up” roles:

“Top-down”: Sub-sector policies and strategic directions determined at the HSWG level and/or

identified and agreed upon in the Joint Health Sector Reviews are passed down to the TWGs for

support in operational planning and execution, and to develop relevant guidelines and tools to be

used by the implementing agencies.

“Bottom-up”: By virtue of their knowledge of the context, realities, successes and challenges of

the health system in Rwanda, and the specificity of their technical expertise, the TWGs will

recommend policy and strategic modifications, and propose innovations to the HSWG. The

TWGs will also support the HSWG in the development of evidence-based policies and strategies.

The TWGs will report quarterly to the HSWG (see Annex 2 for the reporting template) against a work

plan that focusses on substantive outputs. The work plan can be adjusted once a year as a result of

decisions taken in the forward-looking JHSR.

Annex 3 describes the scope of each TWG’s work in general terms. TWGs are not required to develop

individual terms of reference and are free to organize themselves as they deem necessary, including

through the establishment of more specialized sub-working groups, in order to fulfil their work plans.

7.2 Composition of TWGs

Chair: Relevant heads of Departments or Units at MOH or RBC.

Co-Chair: A representative of DPs elected by the members of the Development Partners Group

(DPG) according to the institution’s expertise in the technical area of the TWG and its capacity to

contribute meaningfully to the technical area in regards to staff skills and time.

Alternate Co-Chair: A representative of DPs elected by the members of the DPG that assists the Co-

chair in discharging its duties and serves as the de facto Co-chair in its absence.

Secretary: A member elected by the TWG.

Membership: MOH, Development Partners, including CSOs and Private Sector working in the

specific TWG area.

The TWGs will meet monthly in ordinary sessions and can schedule ad hoc meetings as determined

necessary by the chair and co-chair.

6

Annex 1: New HSWG and TWG structure (HSSP III)

Health Sector Working Group

Component I:

Programs TWGs

MCH( FP, ASRH, CH, Nutrition )

DPC (Infectious diseases: HIV, Malaria, TB, NTD, EID, VPD)

DPC (NCDs):CVD, Palliative care, RD, Cancer, Injuries

Health promotion

&Environment Health

Component II: HSS TWGs

Planning M&E and HIS (HMIS, E- Health, HRTT,

HRIS etc)

HRH(Institutional capacity, medical &Nurse Education

Health Financing

Infrastructure and Supply Chain (commodities, technology, Infrastructure, medical products, diagnostic services)

Health Research and Knowledge

Management

Component III: Service delivery TWGs

Quality &

standards(accreditation ,

District/Provincial/Referral health services,

SAMU )

Mental health

Community Health

7

Annex 2: New TWG Structure chairs and co- chairs

No Technical Working

Group

Chairs Co-chairs.

MOH/RBC

Division/Unit

Names Institution Names

1. Maternal & Child

Health

MCH

Department

Dr Ngabo

Fidele

UNICEF Mohamed

Cisse

2. Planning M&E , and

HIS Planning &HIS

Dr Parfait

Uwaliraye

USG Dr. Michael

Karangwa

3. Human Resources for

Health HRH

MUKAKIGELI

Daphy

USG Dr. Maestro

Evans

4. Health Financing HFU

Dr Kayobotsi

Pascal

BTC Dr. Nicole

Cuti-Kanyoko

5. Quality &Standards Clinical Services

Dr Theophile

DUSHIME

BTC Dr. Vincent

Tihon

6.

Health Research

&Health Knowledge

Management Planning &HIS

Dr

UWALIRAYE

Parfait

SDC Tommaso

Tabet

7. Community Health CHD

Cathy

MUGENI

UNICEF Dr. Emmanuel

Manzi

8.

Diseases Prevention

and control/Infectious

Diseases IHDPC

Dr Ngirabega

Jean De Dieu

USG Dr. Eugenie

Kayirangwa

9. Diseases Prevention

and control/NCD NCD

Dr

MUHIMPUND

U Marie Aimee

WHO Dr Chantal

Gegout

10. Mental Health MH

Dr Yvonne

Kayiteshonga

BTC Dr. Achour

Ait Mohand

11. Infrastructure and

Supply Chain MPPD

Celsa Gaju

Muzayire

WHO Mrs Stella

Tuyisenge

12. Health Promotion RHCC

Nathan

MUGUME

UNICEF Siddartha

Shrestha