Quarterly Report 1: January – March 2010

The project's main focus during the first quarter was the start-up and planning of the project, the integration of the project's work team, and the coordination with main counterparts and partners. This was achieved successfully, while also initiating key technical activities that took advantage of opportunities that arose during the period. The project's work team was installed in the main office in Lima and in six regional offices in Apurimac, Ayacucho, Cusco, Huanuco, La Libertad, and San Martin. The Chief-of-Party (COP) and Deputy Chief-of-Party (DCOP) visited four of the regions to present the project objectives and main activities to the Regional Governments, including the President, Regional Social Manager, and Regional Health Director. Project regional advisors have been working with the Regional Government technical teams in developing an implementation plan based on the project work plan that could achieve some specific benchmarks by December, when the current regional and local authorities will be finishing their government periods. The project provided technical assistance to the Decentralization Office of the Ministry of Health (MOH) for the organization of the meetings of the Intergovernmental Health Commission (IHC) and facilitated these meetings, resulting in the approval of the IHC work plan for 2010 and the constitution of four work groups. The MOH formally requested the project for continuous technical assistance to these groups. The project also provided technical assistance to the Regional Government of San Martin to implement the unique reorganization process of the Regional Health Directorate (RHD). The project analyzed the Municipal Incentives Program, discussed its implementation with the MOH and the Ministry of Finance (MOF), and facilitated an agreement between the Regional Government of San Martin and the Local Governments that constitute AMRESAM (Municipal Association of San Martin) for a coordinated implementation of the program. The team provided assistance to the MOH (Planning and Budgeting Office, Human Health Directorate, and Public Health Insurance) and MOF to develop the new Result-Based Budget programs, as established in the 2010 Budget Law. The project advanced in the methodological discussion for the estimation of human resources gap for Universal Health Insurance implementation, the technical discussion for the definition of key human resources management and planning processes, and procedures to define management competencies of health services staff. The project defined the tools for a rapid assessment of the medicines supply management system at the regional level. Project activities during the next quarter will cover the national, regional, and local levels. In Health Governance, activities will address support to RHD in the reorganization of their health services networks, support to fostering groups of policy dialogue among political parties in Lima and in six regions, and the discussion of anticorruption issues in Huanuco. In Health Financing, the project will promote the discussion of the basic features of a Health Financing Law, and technical assistance at the regional level to link budgeting processes of results-based-budget to local government incentives. In Health Human Resources, regional workshops will begin in the six regions to train RHD officials in the analysis of HR gaps, the methodology to define job competencies, the definition of managerial competencies, and the features of a HR planning system. In Medical Products, the project team will conduct the rapid assessment of the pharmaceutical supply system in the six project regions. A collaborative activity for this quarter between the project and the USAID|Quality of Care is the elaboration, jointly with the RHD of San Martin, of a comprehensive health intervention model that shall integrate changes at the support systems level with changes at the service provision level, in order to guarantee resolution and quality of care. Additionally, coordination meetings with PARSalud will contribute to joint work in the regions of Apurimac, Ayacucho, and Cusco.