The Philippines- Australia Public Financial Management Program (PFMP) is assisting the Department of Health (DOH) in systematizing and harmonizing its civil society and other stakeholder engagement in public expenditure matters. The assistance entails the formulation of a policy framework that will enable the DOH’s bureaus and offices to harmonize the department’s various interactions and mechanisms for civil society engagement.
Many CSOs and stakeholders interact with DOH and influence how the department organizes its programs and sets spending priorities. These may be divided in three (3) general categories of organizations:
- NGOs acting as “watchdogs” and vanguards of the DOH’s activities or advocating certain approaches to health services provision;
- Specialized organizations who assist the agency in the delivery of health services through research initiatives, funding certain programs and other forms of cooperation; and
- Local and foreign partners, including development partners, who assist the DOH through their established lines of businesses and operations.
Some may be advocating for a stronger primary health care approach with corresponding human resource deployment implications; pharmaceutical companies may be promoting their interests by lobbying for the use of certain drugs and products; beneficiary representatives for groups such as the disabled, the elderly, or those with certain diseases like TB or HIV/AIDS, interact with DOH to influence the way those issues are addressed by DOH programs. In one way or another, these have influence over the planning, budgeting, and implementation of the agency’s programs and the Department needs a more structured approach to managing how such inputs influence expenditures.
PFMP’s current technical support is the second phase of assistance to the DOH. The first phase, implemented from January to October 2014, consisted of an institutional assessment of DOH’s practices with regards to CSO engagement in its budget process, and of the development of a policy options paper on improving CSO and stakeholder engagement.
These documents described the current state of DOH engagement with civil society and other stakeholders in the policy, planning and allocation of public resources for health programs. The policy paper provided recommendations on how DOH can pursue civil society and other stakeholder engagement in public expenditure matters and proposed immediate steps to operationalize these recommendations.
The paper highlighted the following:
- DOH has a long history of engagement with civil society and other stakeholders in pursuing health sector reforms. As early as 2007, the DOH issued Administrative Order no. 2007-0038: “Adopting the Sector Development Approach for Health (SDAH) in implementing the FOURmula One (F1) for Health” which serves as an overarching framework for DOH to engage with various stakeholders in the policy, planning, resource programming, and monitoring and evaluation of health programs according to respective pillars of F1 health sector reforms.
- Although DOH has been interacting with an array of civil society and other stakeholders on various aspects of public expenditure matters, it was observed that there was no systematic approach to maximize their input into the policy, planning, implementation, and spending of DOH public resources. This results in a fragmented and poorly coordinated approach to consultation and interaction with stakeholders. For example, the HIV/AIDS program office interacts directly with sector specific CSOs to ensure access to services such as the provision of retroviral drugs and counselling services. On the other hand, the “Health Partners Meeting” of the Department is the key venue for interaction with Development Partners involved in HIV/AIDS programs. A more pro-active approach to managing the inputs of the two groups would be to bring them together in one venue and consider all inputs influencing program planning and spending in a more structured and harmonized manner.
No Civil Society unit in DOH
The DOH has no specific unit to coordinate overall civil society and stakeholder engagement from a department- wide perspective. The lack of a specific unit limits the department’s ability to harmonize approaches and maximize stakeholder input in policy, planning and resource allocation processes.
To enable the DOH to better harmonize and systematize civil society and other stakeholder engagement in its public expenditure matters, the following recommendations were presented:
- DOH needs to clarify or recognize which civil society partners and stakeholders can best engage with the Department for a more meaningful input into DOH policy, planning, program implementation and spending.
- The Department also needs to identify the specific unit which can be responsible for the overall coordination of civil society and other stakeholder engagement in DOH public expenditure matters. Assigning a unit to undertake coordination work will ensure consistency of efforts to foster meaningful and constructive engagement.
Systematic reporting, stakeholder interaction needed
There needs to be a more systematic reporting of results and stakeholder interaction in the DOH’s public expenditure matters. The systematic reporting will enable DOH to make better use of stakeholder input in planning, budgeting and actual spending of public resources and will help institutionalize the culture of consultation as an important function of key offices.
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