““Managing Regionalism for Managing Regionalism for Health”Health”

RMI Kumiti PresentationRMI Kumiti Presentation

52nd Meeting of the Pacific Islands Health Officers Association

June 11-15, 2012Guam

ObjectivesObjectivesBurden of DiabetesPlanning process w/documentsWeaknessesStrengthsRecommendations

Burden of DiabetesBurden of Diabetes• Leading cause of death in the RMI since 2008• Leading cause of hospital admissions since

2008• Leading cause of inter island referrals • Accounts for more than 50% of the MoH’s

budget• Affects the productivity and livelihood of the

RMI population• 90% of all TB relapse are diabetic patients• Co-infection of HIV and TB• Evident in younger age groups• Can be controlled, reversed and prevented• Lifestyle and Behavior Change

Update on NCD-DiabetesUpdate on NCD-DiabetesDeclaration of Month of November as

National Diabetes MonthStrengthening of PHC

programs/services- outreach/house-to-house initiatives: OI- integration of PHC at the clinical services- “wellness” programs: school health programs, physical activities in schools, communities

Update (cont)Update (cont)Community support for NCD activities

- Creation of the “kumit” concept with NGOs support- Strong health promotions/health education: community awareness

Weaknesses- ‘shared’ health responsibility concept- MOH still responsible for health- others challenges

RMI Planning DocumentsRMI Planning DocumentsVision 2018 National Strategically Developmental Framework

Subscribing to the principles of democracyMutual understanding and respect for one anotherPrudent use of resources and an environmentally friendly populationHigh regard for moral and ethical standardsSensitivity to the culture and pride in the Marshallese cultural heritageEquality, professionalism and a strong commitment to quality standardsHealthy life styleStriving for excellence and confidence Communal sharing and caring

Ministry’s (MOH) Strategic Plan 2012-2014.

NCD Strategy 2008-2012: The NCD Strategy 2008-2012: The Kumit PlanKumit Plan

Process - NationalProcess - NationalDepartmental/Agency HeadsPlanners/StatisticiansReview data/statisticsPrioritizeTimelinesDevelopment of goals and objectives

Consultants

Process (cont)Process (cont)MOH Strategic Plans

◦ Senior staff, middle managers, medical providers, & consultants

◦Plans are used for developing annual performance based-budgeting

◦Plans are used for strategic plans for MOH

WeaknessesWeaknessesPlans are sometimes not monitored on a regular basis: challenges on HRH

Not all the right people are involved in planning process

Plans are sometimes not fully understood and so are not fully utilized

Lack of feedback on planning documents

HIS/quality data

WeaknessesWeaknesses (cont) (cont)Challenges in personnel, finances, economy, - negative impact

Changes in political leadership – negative and positive impact on health plans/activities

Weaknesses (cont)Weaknesses (cont)Weak in health promotions/health education activities

Lack of involvement of community/civil society – ‘communications’

Set agenda (consultancy)‘Regionalism’ – not part of the national plans; “no one-size fits all” regionalism concept

Regional partners ‘confusion’

Strengths Strengths Ownership of plans – having the

right/skilled staff in the planning processStaff/personnel from outside health

involved in the planning processDevelopment of mechanism to monitor

progress of plansMonitoring/reviewing progress of plans

with the right staffMaking the right changes accordingly

based on challenges: personnel, finances, etc

Consultants: thinking process, support

Recommendations Recommendations Established multi-sectoral body to develop and oversee implementation of the Plan

Ensure adequate health system support: personnel, financial, policies, political leadership

Streamlining of NGO support for healthy lifestyle programs

Traditional support

Recommendations (cont) Recommendations (cont) Involving the right people in development of plan

Advocacy for support: all levels including communities

Development appropriate and specific protocols/legislation

Multi-disciplinary approach Adequate HRHStrengthen the “sense of ownership”

Kommool Tata