By Allieu Sahid Tunkara
The stubbornness of the Ebola outbreak in Sierra Leone, compounded by its re-emergence in the neighboring Liberia, has forced Sierra Leonean health officials to adopt a new health plan known as the Service Level Agreement (SLA).
This new plan is geared towards enhancing proper coordination between the Ministry of Health and Sanitation and local and international non-governmental organizations (NGOs) that seek to invest in the health sector. The adoption of the policy clearly indicates that before now investment in the health sector was haphazard as the MoHS was not in full control of the situation. This lack of coordination largely manifested itself in the fight against the Ebola epidemic.
The new plan would strengthen the long standing partnership between the NGO community and the MoHS, Dr Ernest Surrur, Secretary to Cabinet and Head of the Civil Service, told audience during the official launch of the document on July 3rd.
He explained that the plan would bring about a sharing of mandate between the ministry and its partners. He said the policy would improve accountability and transparency in the health service delivery system.
“There is a need for coordination in the monitoring of service delivery at all levels. This will help solve the problem of fragmented systems in the health sector,” he added.
But many Sierra Leoneans are unsure about whether the new policy would stand the test of time.
The country’s Chief Medical Officer (CMO), Dr Brima Kargbo, made a one-hour power point presentation trying to explain to the audience at the Miatta Conference Center on the overall nature and ramifications of the plan. He said the new document would guide the implementing partners and that the policy was set to offer quality healthcare service delivery.
In May 2010, the MoHS signed a similar policy known as the compact agreement which binded the implementing partners, particularly the NGOs, to offer health assistance in accordance with government priority areas. This, Dr Kargbo said, was aimed at putting an end to the duplication of resources allocated to the health sector.
The SLA therefore resonates with the compact agreement as the former seeks to augment the latter.
According to the Health ministry, one of the overriding principles in the new health plan is ownership. This principle would ensure that the MoHS takes complete ownership of the health system and regulate the activities of all investors in the health sector.
“Every implementing partner would be required to submit documents to the Ministry of Health and Santation for my signature as well as the signature of the implementing partner. But the implementing partner would be free to use their own template to prepare his budget,” the CMO explained.
The other side of the SLA is the monitoring and reporting system.
Every investor or implementing partner would be required to submit quarterly reports to the MoHS and copy foreign agencies. This would ensure that the implementing partner carries out his work in accordance with accepted standards.
The plan also obliges the implementing partner to develop a cogent exit strategy when their work is on the verge of folding up. This strategy would compel the investor to explain to the relevant stakeholders how they intended to leave things after the period of investment.
However, there are many challenges confronting the health sector and prominent among them is the human resource constraints in the ministry. The Ebola epidemic has clearly worsened the situation with the deaths of dozens of health workers.
“For too long the people of Sierra Leone have been deprived of quality healthcare service delivery,” said Dr Abu Bakarr Fofanah, Minister of Health and Sanitation.
He said before the new policy was promulgated they assessed the current status of the health sector and picked up the problem of lack of proper coordination which has plaguing the health sector.
The minister said an SLA management unit within the ministry was in position to ensure a timely submission of reports for inspection.
“SLA does have potential to promote transparency as citizens would be empowered to know what is operating on the ground,” Sally Taylor, Head of the UK`s Department for International Development (DFID) in Sierra Leone. As a major development partner of Sierra Leone, DFID looks forward to a focus on certain critical issues on the Ebola recovery plan, including transparency in the health sector.
For the United Nations Development Programme (UNDP), another major development partner of the country, rapidity in the implementation process is crucial for making an impact.
The UNDP`s representative at the launch of the policy, Jason Lee, spoke of the need for massive improvement in the sector. And to this effect, he said, “any delay would hamper the effort to getting to zero [new infections in the Ebola virus disease.
“We should not be complacent as the Liberian case has taught us a serious lesson,” he warned.
(C) Politico 11/08/15
