REPORT ON THE TRAINING OF TRAINERS WORKSHOP ON DEVELOPMENT PARTNERSHIP WITH PRIVATE SECTOR FOR HEALTH AND SOCIAL PROTECTION

IN GHANA HELD IN KUMASI FROM 12TH MARCH TO 14TH MARCH AT THE ROYAL LAMERTA HOTEL. INTRODUCTION: This Trainer of Trainers workshop was called at the instance of the private sector Unit of the Ministry of Health (MOH) with support of GIZ to train participants on guidelines for the evelop!ent of "artnerships ( "") with the "rivate #ector in Health and #ocial "rotection$ "articipants ca!e fro! all across the country including representatives fro! the %egional Hospitals& "rivate !edical practitioners& "rivate Maternity ho!es& Ghana Health #ervices etc$ The !ain facilitator was r$ George '!ofa ((onsultant to GH# )MOH) supported *y Ms #arah (+acilitator ,GIZ)$ Day 1 The progra!!e started at a*out -./0a! after participants had gone through the process of registration for!al opening$ 's part of the process& a class prefect& ti!e keeper and rapporteurs were selected to play assigned roles throughout the progra!!e$ 'fter a welco!e !essage fro! the facilitator for GIZ& she undertook an e1pectation e1ercise which sort views fro! participants on their e1pectation for the progra!!e$ r$ George '!ofa (The !ain facilitator) introduced the !odules in his open re!arks and started that the !odules has *een divided into five (0) parts for the three,day workshop na!ely. Module One (2) 3 efinitions and 41a!ples of "" Module Two (5) 3"olicy +ra!ework Module three (6) 3"otential (hallenges for ""

Module four (7) 38essons 8earned fro!

"" )"""

Module five (0) 3%eco!!endation for #ustaina*le "" He also encourage participants to register with 9He#"': 3Health ; #ocial "rotection in 'frica (www$hespa$net) which is an infor!ation resource site operated and !anaged in Ghana$ He further stated that the goal of the training was to e<uip the pu*lic #ector !anagers with the re<uisite knowledge and skills to partner the private sector in a win,win situation to ensure health and social protection for the *eneficiaries of health care delivery$ O !"#$%&"' The o*=ectives of the workshop were to help participants to. 2$ 5$ 6$ 7$ 0$ Understand what "" entails "" for health ; social "" for Health and

eter!ine the rationale ; e1pected *enefit of protection$

iscuss the potential challenges for engaging in #ocial "rotection escri*e so!e lessons learnt fro! protection$

"" for health and social "" for health and #ocial

"rovide reco!!endations for sustaina*le protection$

M()*+" 1 , M"a-%-. a-) S#(/" (0 DPP efining "" for health ; #ocial "rotection. In si!ple ter!s& "" is a situation or !echanis! in which a govern!ent (govern!ental organi>ation) enters into an agree!ent with private sector to provide certain services in appropriate way to *enefit the vulnera*le$

DPP 1 P* +%# ,P2%&a$" Pa2$-"2'3%/ "artnership. 'ssociation of institutions and co!!unity agencies that =oin forces to address co!!on health issues ; (o!!unal outco!es$ The "rivate #ector "olicy of MOH defines """ as 9contractual arrange!ent *etween a pu*lic entity and a private sector party with clear arrange!ent on shared o*=ective for the provision of pu*lic infrastructure and services which are traditionally provided *y pu*lic sector:$ "" is a !echanis! designed to develop effective and sustaina*le solution through a colla*orative approaches and co!e a*out when organi>ations fro! different sectors !ay have co!!on or co!plete !onitory interest$

The rationale for engaging in "" includes addressing the issue of !utual !istrust *etween "u*lic ; "rivate #ector$ This engage!ent in the partnership is e1pected to *enefit the vulnera*le in the final analysis and therefore ensuring health and social protection$ #o!e *enefits of included. "" !entioned *y participants and discussed thoroughly

(ost efficiency I!prove!ent of Health (are delivery elegation of %esponsi*ility and i!proved efficiency

Increased productivity Mutual *enefit for career develop!ent %esource !anage!ent and increased access to Health (are (usto!er satisfaction )"rovide Healthy people in a health ?ation$

However to en=oy all these *enefits associated with ""& it was reali>ed that !ost "u*lic #ector Health Institutions are afraid engaging in these partnerships due to no legal policy guidelines)fra!ework$ M()*+" 2 , POLICY FRAMEWORK L"a2-%-. O !"#$%&"': after the !odule& participants will. D%'#*'' the need for legal policy fra!ework to support the "" M"-$%(- so!e policy guideline docu!ents they are fa!iliar with L%'$ the four o*=ectives of the private sector gov:t policy (5/25) A policy is a principle or rule to guide decisions and achieve rational outco!es$ A policy is a state!ent of intent& and is i!ple!ented as a procedure or protocol$ ' policy fra!ework is a logical structure that is esta*lished to organi>e policy docu!entation into groupings and categories that !ake it easier for e!ployees to find and understand the contents of various policy docu!ents$ "olicy fra!eworks can also *e used to help in the planning and develop!ent of the policies for an organi>ation$

W3y $3" -"") 0(2 P(+%#y F2a4"5(26 The policy fra!ework when e1ists. "rovides clarity )guidelines for *oth parties engaging in the partnership 4na*le partners agree!ent$ have si!ilar understanding of partnership

"rovides a road!ap for the partnership$ 4nsures !utual trust *etween the partners$

 Helps to define roles ; responsi*ilities of the partnership "rovides #anction Mechanis!s Monitor Goals )'chieve!ent There are <uiet a nu!*er of policy fra!eworks that support "")""" and gave =ustification for developing "artnership$ 41a!ple includes. 2--5 (onstitution& ('ct 6@. 5*&5c) The 8ocal Gov:t 'ct 7@5 (2--6) The Ghana Invest!ent "ro!otion 'ct 7A5 'll Mediu! Ter! Health #trategy ocu!ents fro! 2--/s "u*lic "rocure!ent 'ct @@6 +inancial 'd!inistration 'ct @07 and +inancial 'd!inistration %egulation$ In 5/25& MOH,"rivate #ector Health "olicy was developed with four !ain o*=ectives. I!prove the invest!ent cli!ate for private health sector growth To support the transfor!ation of private health *usinesses to !eet industry e1pectations To *uild the capacity of private health care providers Increase opportunity for the poor to access private Health (are services Generally& there is a good policy fra!ework in Ghana supporting "" T3(*.3 /(+%#y '*//(2$' 0(2.%-. /a2$-"2'3%/' %- $3" /2%&a$" '"#$(27 $3" /(+%#y 0(#*'7 *-$%+ -(57 3a' ""- 4('$+y (- 3(5 $( '$2"-.$3"- /* +%# 3"a+$3 '"#$(2 *$ -($ 3(5 $3" /* +%# '"#$(2 #a- " '$2"-.$3"-") $( /a2$-"2 $3" /2%&a$" '"#$(2.

M()*+" 8 ,P($"-$%a+ C3a++"-."' $( DPP ' nu!*er of challenges were enu!erated as those face *y those who have ever engaged in a "artnership$ '$ C(44%$4"-$ a-) 0*-)%-.: this issue arises ifB (hange in financial capacity of partners i!ple!entation of any pro=ect under ""$ can affect the

Inappropriate %epresentation at structuring level after which a higher authority can render any !e!orandu! signed as null and void$ Creach of contractual agree!ent *y *oth parties (hange in interest )priorities which can affect the direction of one or *oth parties to the pro=ect$ (hange in 8eadership in all for!s ("olitical& corporate& etc ) (hange in de!and *y end,users "oor needs assess!ent$ 9. M%'$2*'$ :P($"-$%a+ C(-0+%#$ ifferent *ackground )ideology of partners

8ack of infor!ation flow a!ong partners 'ct of readiness on the part of partners I!proper policy fra!ework )code of conduct 8ack of transparency ?on,co!!it!ent to partnership agree!ent$ C. I4/+"4"-$a$%(- 1 Ma-a."4"-$

 8ack of "lanning ; 'ssess!ent to deter!ine capacity level )gaps 8ack of data*ase for potential partners ifferent perspective ; strategies to specific pro=ects *y partners ifferent vision and e1pected outco!e

D. S*'$a%-a %+%$y Deak institutional arrange!ent in *oth pu*lic and private organi>ations co!ing into partnership 'ppropriate ownership )leadership is key to sustaina*ility$ 'ccounta*ility and Monitoring

M()*+" 4 ,L"''(-' +"a2-") "articipants discussed this *ased on e1periences they had in relationship to a private,pu*lic partnership$ The e1a!ples include. ?HI# "O8I(E o "olitical o #ocial protection (vulnera*le) ?'(" F '%T (8I?I(# in partnership with Glo*al +und 4<uip!ent )infrastructure were provided !ost Hospital nationwide (apacity was *uilt for !ost of the 8a*oratory Technician$ Ho Municipal Hospital in partnership with a "rivate Individual who assisted in supplying all the *uilding !aterials for the *uilding of the Mortuary until the Hospital raised the !oney to pay without charging any interest$

M'?E' G%OCO ('#4 (HIH #ervices) 8ack of enthusias! to continue with progra!!e Move!ent of "8

T4(HIM'? HO#"IT'8 F G%H s "eriodic surgeries )e<uip!ent donated %estructured theatre

II(OH4 F U#'I Gitchen renovation 4<uip!ent %eduction in (hild !ortality

%I G4 HO#"IT'8 F M # 8'?(4T "artnership Increased in range of la*oratory services Technology transfer Increase in revenue

Other lessons learned fro! previous "" generally centered on !utually *eneficial alliances and clarity of vision and cultural value syste! and inter, personal relationships$

RECOMMENDATIONS FOR SUSTAINA9LE DPP In order to ensure sustaina*ility of all there is the need for. 2$ ""s a facility !ay *e engaged in&

(o!!unication of co!!on grounds for partnership

5$

efinition of %oles ; %esponsi*ility %oles of each partner should *e defined including financial and in, kind contri*ution to the cause$ evelop this understanding into a contractual docu!ent to *e sign *y the partners at the highest level$

6$ 7$

Institutional 'rrange!ents for i!ple!entation$ %otate leadership of one partner$ "" a!ong partners rather than li!it it only to

for tactical reasons to ensure high level of representation at coordinating council !eetings$ 0$ @$ A$ Cuilding co!!it!ent ; %apport "rocedure for contractual engage!ent. the private health sector policy of MOH provides a nu!*er of guidelines$ #pecific to ?GOs. ?GO (ode of conduct for Health #ervice strengthening *y DHO includes ?GO will engage in hiring practices that ensure long,ter! health syste! sustaina*ility ?GO will enact e!ployees co!pensation practices that strengthens pu*lic sector ?GO pledge to create ; !aintain Hu!an %esource training and support syste!s$ ?GO will !ini!i>e !anage!ent *urden for !inistries ?GO will support !inistries of Health as they engage with co!!unities ?GO will advocate for policies that pro!ote ; support the pu*lic sector$

J$

(O?+8I(T O+ I?T4%4#T. i$e$ a situation in which a pu*lic official or fiduciary who& contrary to the o*ligation and a*solute duty to act for the *enefit of the pu*lic or designated individual e1ploits the relationship for personal *enefit$

CONCLUSIONS "articipants were put in groups and asked to pick an e1a!ple of use as case study to develop a co!prehensive pro=ect$ "" and

It was an e1ercise worth participating *ecause it *rought to the fore& other issues of "" which hitherto were not considered and it is hope that such training will *e regularly organi>ed not only under "" *ut also other e<ually i!portant issues concerning health$ The workshop was officially concluded at a*out 2.//p! with a call on participants to i!part the knowledge to other !anagers in their respective institutions$

RECOMMENDATION TO MANAGEMENT REGARDING IMPLEMENTATION OF DPP IN TAMALE TEACHING HOSPITAL In order to en=oy the full *enefit of the "" progra!!e we will like to reco!!end the following for !anage!ent:s consideration and i!ple!entation$ 2$ e*riefing Manage!ent and all Heads of epart!ents and Units

5$ (onduct a stakeholder analysis and needs assess!ent to help identify potential partners and areas of partnership that will *enefit the end users of these partnership agree!ents there*y ensuring health and social protection to our clients$ It is reco!!ended that this is done with the Heads of epart!ents to identify areas of co!parative advantages in relation to the private sector$ 6$ The Cusiness evelop!ent Unit *e e!powered to coordinate "")""" with the identified potential partners$

7$ 4sta*lish a local Manage!ent co!!ittee for all "")""" with the private sector to help i!prove the <uality of service in areas we have less co!parative advantage$