Training of Health Management Teams on Program-Based Budgeting- MTRH and JOOTRH At Fred Hollows Foundation

1. INTRODUCTION

The Fred Hollows Foundation (The Foundation) is a secular non-profit public health organization based in Australia, which was founded in 1992 by eminent eye surgeon Professor Fred Hollows. The Foundation focuses on strengthening eye health systems and the treatment and prevention of avoidable blindness caused by Cataract, Trachoma, Diabetic Retinopathy, and Refractive Error. The Foundation operates in more than 20 countries across Australia, The Pacific, South and Southeast Asia, and Africa. The Foundation was named The Australian Charity of the Year 2013 in the inaugural Australian Charity Awards.

2. PROJECT BACKGROUND

The FHF/Novartis Integrated Eye Health Project has the overarching goal of contributing to reduction of the prevalence of blindness caused by glaucoma and diabetic retinopathy in Kenya. The project which has been in implementation since 2022, seeks to increase equitable access to eye health services in Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu County and Moi Teaching and Referral Hospital (MTRH) in Uasin Gishu County. This is done by strengthening the capacity of the health system to provide high quality glaucoma and retinal eye health services across the patient pathway, to improve patient eye health outcomes for poor and vulnerable communities.

The project addresses gaps identified in the counties that include low eye health literacy which is as a result of inadequate integration of eye health into the health system hence patience missing critical opportunities for early detection, referral and treatment: fragmented patient pathway and weak service delivery capacity leading to situations where people who are identified as needing further screening, monitoring or treatment by an eye health specialist, often do not seek or reach the services they need: lack of skilled human resources for eye health where they are needed: poor patient outcomes that has been impacted by late detection of disease, people’s inability to return to secondary and tertiary services multiple times for ongoing treatments, and the high cost of complex and long-term management mostly for glaucoma and retinal diseases. Lastly, weak enabling health systems that hinders adequate planning and resourcing for eye health commodities.

The project aims to realise the following specific outcomes.

• Increased availability of skilled eye health workers for timely diagnosis and management of Glaucoma and DR at secondary and tertiary levels of care.
• Increased availability of eye health equipment, supplies and commodities at secondary and tertiary levels of care.
• Improved access to quality and specialized Glaucoma and Diabetic Retinopathy services at all levels of care.
• Improved leadership and governance for better planning and resourcing for eye health.

Rationale, Purpose and Objectives of the Training

The Program-Based Budgeting (PBB) training for the health sector seeks to enhance health outcomes through improved resource mobilization and utilisation for sustainable financing of health services. This training will build the knowledge and skills of participants on PBB concepts, techniques and practices. The training is aligned to the government development agenda, policies and changes in the health sector. This is also in line with Government’s commitment to improving performance in the public sector as evidenced by its adoption of various reform initiatives in financial management.

This training will benefit members of the health management teams: planning, finance, accounts, auditors, procurement, monitoring and evaluation officers responsible for county and facility health programmes. The targeted participants are officers directly involved in the budget process, heads of sections and those that influence planning and budgeting processes.

Purpose

The purpose of the training is to provide participants with knowledge and skills to enable them develop budgets that effectively link inputs to outcomes. The training is based on the need to improve financial management in the public sector and specifically in county governments. The program is specially designed to strengthen the capacity for health planning, budgeting and monitoring in the counties. The training will serve as an incentive towards realization of national and county goals including delivery of timely and quality services to the citizenry.

Specific Objectives:

By the end of this training, participants should be able to:

• Explain the linkage between policy, planning and budgeting
• Discuss the budgeting framework in the public sector
• Justify cost estimates for health sector programmes
• Appraise budget monitoring, evaluation and reporting processes
• Design health sector programmes

Expected Learning Outcomes:

This training is designed to enhance capacity of participants to:

• Prioritize critical areas within the public health sector
• Cost public health programmes
• Execute programme based public health sector budgets
• Apply the monitoring, evaluation and reporting framework
• Advocate for health budgets

Broadly, the training will cover the following areas:

• Planning in the Health Sector.
• Public sector Budgeting.
• Medium Term Expenditure Framework.
• Programmatic Approach to Budgeting.
• Costing of Programmes.
• Budget Monitoring, Evaluation and Reporting
• Programme Based Budgeting Practicum

Scope of the Training

The facilitator undertakes to perform the training with the highest standards of professional and ethical competence and integrity. The facilitator is strongly encouraged to develop highly interactive and practical outputs for this training. The facilitator is required to perform the following functions at minimum:

• Design the overall outline and content based on existing resources and good practice in program-based budgeting for health.
• Provide the necessary training materials and support (e.g. production of documents, tools and materials, etc.) to ensure successful conduct of the training sessions.
• Facilitate the training based on the agreed agenda, training objectives and outputs.
• Prepare a final report of the training that includes assessment of participant evaluations. The training materials will be finalised after conclusion of the training workshop based on participants’ observations and feedback and will be included in the final report.

Training Approach and Methodology

The facilitator is required to prepare an experiential based learning module where the ophthalmologists can share and build upon their expertise and practical knowledge. Use of lectures, discussions, videos, pictures, demonstrations and varied facilitation methods will be adopted to enable practice and skill development.

Results and Deliverables

The facilitator will provide the following:

• A training plan which details the methodology/approaches and timelines associated with this assignment and outlines a draft outline for the training workshop.
• The final agreed outline for the training and the full complement of the training materials.
• The final report on the training including a thorough evaluation of the workshop to be submitted within two weeks of the completion of the workshop.

The Foundation will provide the following:

• Focal person to support in undertaking the assignment
• Give feedback on the training plan and methodology
• Support coordination between the facilitator and partners during the training.

Level of Effort

Activity

Man Hours

Preparation of the training plan including pre and post evaluation tool

1 day

Design of workshop and preparation of agenda and training materials

1 day

Facilitation of the workshop

4 days

Preparation of final workshop report

2 days

Duration/Schedule

The training is expected to take place in October/November 2024 at Jaramogi Oginga Odinga Teaching and Referral Hospital and Moi Teaching and Referral Hospital. A detailed plan including logistics will be discussed and agreed with the facilitator.

Facilitator’s Qualifications and Experience

The training will be contracted to an independent and experienced facilitator who will work closely with The Foundation staff in the design and implementation of the training. The Foundation seeks to engage the services of an independent individual with the following experiences and expertise:

• Hold a degree in Social Sciences, Health Systems Management, Economics, etc.
• Demonstrated experience in developing and facilitating trainings on Program-Based Budgeting for Health Sector.
• Knowledge and a sound understanding of the working principles and operation of on Program-Based Budgeting for Health Sector.
• Experience in developing and delivering highly interactive and practical outputs for training especially health management teams at national and county levels.
• Ability to work independently, proactively seek information and manage feedback and input.
• Excellent spoken and written communication skills in English.

Management and Logistics

The training of health management teams on Program-Based Budgeting is being commissioned by The Fred Hollows Foundation Kenya. The Kenya program team will work closely with the facilitator to ensure delivery of quality training.

Confidentiality

The facilitator agrees to not divulge confidential information to any person for any reason during or after completion of this contract with The Foundation. Upon completion or termination of this contract, the facilitator undertakes to return to The Foundation any materials, files or property in their possession that relate to the work of The Foundation. The facilitator will be responsible for safety, security and administration of primary and secondary data collected from FHF or otherwise.

Intellectual Property

All intellectual property and/or copyright material produced by the facilitator whilst under contract to The Foundation remain the property of The Foundation and will not be shared with third parties without the express permission of The Foundation. The facilitator is required to surrender any copyright material created during the term of the contract to The Foundation upon completion or termination of the contract.

Safeguarding People

The Fred Hollows Foundation is committed to ensuring that its activities are implemented in a safe and productive environment which prevents harm and avoids negative impacts on the health and safety of all people, particularly children, vulnerable people, and disadvantaged groups. The Foundation has a zero-tolerance approach to sexual exploitation, abuse, and harassment of any kind. All personnel including contractors/ facilitators are expected to uphold and promote high standards of professional conduct in line with The Foundation’s Safeguarding People Policy including Code of Conduct. The facilitator will be expected to sign and adhere to The Foundation’s Safeguarding Code of Conduct and provide any background checks as required.

Insurance

Any facilitator involved in this assignment will be required to have in place insurance arrangements appropriate to provision of the requirements in this Terms of Reference including travel insurance.

Ethical and Other Considerations

The facilitator is expected to maintain high professional and ethical standards and comply with The Foundation’s policies. The Foundation is committed to ensuring a safe environment and culture for all people, including children, with whom we come in contact during our work.