Program Progress
Recognising that change processes take considerable time to accomplish the HSMP life has been extended by 17 months up to the end April 2009 utilising the findings of an April Monitoring Mission. A Mid Term Review process was begun in November to re-assess the ways in which full benefit might be gained through this new opportunity.
During the year structures to support the management of activities within the Annual Work Plan were installed (Programme Management Units for the centre and two governorates). Implementation is well underway, including the finalisation of contracts for the supply of IT equipment and for services to support the development of the new Centre for Strategic Health Studies focusing on higher level learning programmes in management, health economics and public health, research. At a mid term perspective its consultancy capability will be developed and serve as a major source of policy advice for the Ministry of Health. Both contracts were valued at a total of around 9 million EURO. Attention has also been placed on enhancing the management information systems through developing a cohesive national information strategy. These significant advances in HSMP financial and contracts related and information system enhancement were both supported by the appointment of two additional technical assistance experts in February and May.
Health care delivery system modernisation has been further progressed with review of hospitals and primary care services organisation and management systems, and considerable further training programmes designed and executed both in Syria and in the region through several structured study visits, notably to Egypt in several fields (for example PHC and health financing related). The HSMP has supported the School of Health Management with the Directors of the 18 new district hospitals throughout the country, and in further programmed institutional development work MoH hospitals in the Governorates of Daraa and Lattakia. Systems have been designed and tested to support human resource development and management initiatives including training needs analysis procedures, performance appraisal with reference to the Presidential Decree No. 322. Training of trainers programmes run centrally and in health directorates applying management development training modules.
Action to promote quality management effectiveness particularly in the hospital sector, but associated with developments associated with primary care services, has been significantly advanced in terms of extensive staff capacity building on applying quality management techniques led through the Ministry's Directorate of Quality and Management Development supported with a series of STEs missions throughout the year. A more comprehensive Quality Policy Statement was issued for consultation, and is now being finalised. Progress in testing out hospital services to move eventually to a robust national accreditation system has been made with the inclusion of 14 hospitals from within and beyond the Ministry of Health's jurisdiction, including the private sector, in a number of participative events leading through to a quality standards self-assessment exercise in July, and review of the results in September. Hence, practical joint action has been taken to promote services effectiveness in critical areas (for instance on safety issues; infection control; resuscitation procedures) in readiness for a second exercise planned for July 2007.
Studies to identify issues concerning approaches to health financing have been designed and completed, using local contracted agencies. The results have been considered with a wide range of interests, particularly concerned in moves towards a national health insurance system taking full account of the Syrian Government's position and requests for information. Detailed investigation of the specific characteristics of the health insurance systems running for staff in many occupational groups in Syria has been undertaken. Agreement has been reached to include pertinent enquiries within the household expenditure survey programmes organised by the Central Bureau of Statistics. Awareness raising and further training on these "health economics" related issues have been continued for Ministry staff within the country.