Abstract
BackgroundThis case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years.MethodsDR Congo’s HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services.ResultsThe minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary.ConclusionsThe above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.
Highlights
This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years
This paper, a resource planning exercise done as an integral part of the Democratic Republic of Congo (DR Congo) Ministry of Health’s core functions, demonstrates how rational operational planning based on a health systems strengthening strategy can greatly contribute to health policy dialogue and decision-making over several years
The above results have been key in the policy dialogue process in DR Congo over the last few years: they have supported the Ministry of Health in the national discussion on affordability of the Minimum and Complementary Packages of Activities of the HSSS by providing an absolute minimum possible resource base and associated yearly required operational budget for the MPA and CPA
Summary
This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. What makes DR Congo’s resource planning unique is the fact that the full essential health services package was planned for (over 200 interventions), including district management and health prevention and promotion activities; in addition, it was done on a normative basis within the framework of the national health sector strategy (HSSS) so as to assure a certain service quality level while taking into consideration the local context We demonstrate in this descriptive analytical study relying on primary and secondary data that the normative model district is a realistic model DR Congo district, with standardized functionality, resource usage, utilization, and interventions provided. This paper gives examples of the longer-term impact of this work on the DRC health system
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