2. Topics in this presentation
•
•
•
•
•
•
•
What is OneHealth?
What is the purpose of OneHealth?
Who will use it?
Why and how was it developed?
How will it strengthen strategic planning?
What is new?
What are the challenges?
2
3. What is OneHealth?
• A tool for medium term strategic health planning (3-10 yrs)
at national level
• A software that incorporates UN epidemiology impact
models to demonstrate the achievable health gains
• A unified tool in 3 ways:
– For joint planning, costing, budgeting, impact analysis,
and financial space analysis
– Disease programme + health systems
– One UN
• Aligned with Joint Assessment of National Strategies (JANS)
principles
3
4. What is the purpose of OneHealth?
Challenges:
Too many tools
De-linked planning cycles
Little consideration of
health systems
OneHealth Role:
Enabling integrated planning
Bringing partners together
Linking programmes to HSS
platform
"First plan… then costing" Costing as part of the Planning
process!
Budget should consider the
country fiscal space
Strategic Planning for Better Health Outcomes
4
5. Who should use OneHealth?
• A multi-disciplinary team
• Health Sector planners ( MoH Department of
planning)
• Disease-specific programme planners (e.g. EPI,
Malaria) , Health System component (e.g.,
Human Resource Department in MoH)
• NGOs and other agencies in countries
• Donors, academics and UN agencies
5
6. How was OneHealth developed?
2008: a meeting in Senegal reviewed 13
commonly used tools
• Agreement to develop a joint UN model.
• Inter-Agency Working Group on Costing (IAWG-COSTING) established in
2008 (WHO, UNICEF, WB, UNAIDS, UNFPA, UNDP).
• Partner support:
– The Global Fund to fight Aids, TB and Malaria, The Global Health Workforce
Alliance, The Health Metrics Network, Bilateral agencies, IHP+, have
provided funding and technical support.
– Other partners: UNIFEM and projects like USAID deliver, Optimize provide
technical inputs.
• Health Planners in Country Reference Group provide technical and user
related inputs into model development (Burkina Faso, Cap Verde,
Ghana, Mali, Mauritania).
6
7. Pre-existing tools incorporated into OneHealth
Tool
MBB
Specific areas incorporated
Bottleneck analysis, Fiscal space analysis;
Budget mapping
WHO (stop TB)
WHO (iHTP)
LiST (Lives Saves Tool)
TB planning
Detailed intervention planning for
RMNCH (staff time minutes; drugs
commodities)
Impact for child and maternal health
Resource Needs Model
AIM, GOALS
Costs for HIV/AIDS interventions
Impact for HIV/AIDS interventions
WHO ( Child Health Cost
Estimation tool)
FamPlan
Intervention costing for child health;
Overall Framework for Programme
Activity Costing
Impact for Family Planning interventions
UNFPA RH costing tool
Costing reproductive health interventions
7
8. OneHealth supports a planning process from inputs and
activities to outcomes and impact
Inputs
Process
Outputs
Interventions &
services,
Inpatient days,
outpatient visits
Health Systems
outputs (access,
quality,
availability, etc)
Outcomes
Coverage of
interventions;
Risk
behaviours,
effective
behaviours
Impact
Under 5 mortality
Maternal mortality
Nutrition outcomes
HIV/TB/malaria
incidence,
prevalence, mortality
Total fertility rate
8
9. Type of outputs (results) produced
1. Health impact: what will be my U5MR in 2020? Do I
expect to reach my MDG targets by 2015?
2. Health Systems investments and service outputs:
– Required investments in the Supply Chain
– Total & additional bed days and outpatient visits; requirements
for hospitals, facilities and community services
3. Costs: Costs by year, by programme, by inputs, etc.
4. Financial projections, fiscal space and expected
shortfall
5. Scenarios: how is cost and impact different for
alternative scenarios of packages, targets and activities?
9
10. Type of outputs: nutrition specific
1. Health impact:
a. how many deaths are averted by nutrition interventions
b. Reductions in stunting, wasting, IUGR
c. Breast feeding prevalence
2. Costs:
a. Commodities, drugs and supplies,
b. Programme costs: training, supervision, M&E,
administration, etc.
3. Health Systems:
a. proportion of health worker time used by nutrition
interventions
4. Scenarios: comparison of service delivery mechanisms10
11. Fiscal
Space
envelope
HS4. Health
Information
HS5. Governance
and Leadership
HIV
TB
Malaria
Immunization
WASH
Nutrition
Child Health
NCD
Outreach
Reproductive Health
Hospital
Others
Service delivery planning
Health System Envelope
Disease Programmes
National
Health Centre
HS6. Financing
Policies
Community
HS1. Infrastructure
and Equipment
HS2. Human
Resources
HS3. Logistics
11
12. What's new?
• User-friendly interface
• Modular format adaptable to different country
contexts
• Flexible structure corresponds to the ways in which
real-world health care system planning is performed
• User can choose the level of detail for planning
• Regularly updated software
• Direct links and checks built in between different
modules
12
13. How does OneHealth support
programme planning to be
aligned with Health Systems
planning?
13
14. Link between programme MNCH-related
Programme Planning & Health Systems implications:
activities and HSSWorker time (1/2)
#1 - Health investments
PROGRAMME
SYSTEM
Check""
((calculated
Nutrition Programme
Minutes of staff time
required for patient care
HRH
Staff requirements
Staff Costs
HRH planner
decides on HRH
plan
Potential
adjustment of
coverage targets
Nutrition Programme
of staff that need#
in-service
training
14
15. Programme Planning & Health Systems implications:
#1 - Health Worker time: example a
Estimated time
required for
programme scale-up
Available health
worker time
15
16. Programme Planning & Health Systems implications:
#2 - Demands on the Supply Chain
PROGRAMME
SYSTEM
Direct input
((calculated
Nutrition Programme
Specific requirements
for drugs /commodities
Logistics
Total volume of commodities
Supply Chain Requirements-<
Supply Chain Costs-<
16
17. Programme Planning & Health Systems implications:
#2 - Demands on the Supply Chain: example
Volume of commodities transported in Logistics system,
% share by programme
Non Communicable disease
Nutrition
Vaccination
HIV/AIDS
Malaria
TB
Child health
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Maternal/newborn and
reproductive health
17
18. Responding to data challenge:
Availability of Default data in the tool
• Baseline situation analysis: Epidemiology, Demography,
current coverage, and some HSS.
• Intervention standards: drug and supply cost per average
case (based on WHO treatment guidelines + international
drug prices from UNICEF, MSH and IDA) + estimated
personnel type & time required.
• Disease Programme activity standards: e.g., specific training
courses; surveys; specific equipment, etc.
• Standardised activities for health system strengthening:
Activities for Logistics, Governance, etc.
• Prices: from WHO-CHOICE database, WHO, MSH, UNICEF
• Expenditures & GDP growth: WHO/NHA database, IMF
18
20. User Guidance & Technical Documentation
Help screens in the tool
20
21. How can YOU use OneHealth to make a
difference?
• Common platform for national programmes + Health
systems.
• Ensure that health system capacity is driving the
planning process, to set realistic goals.
• From situation analysis activities outcomes
• Use evidence on expected health impact to inform
priority setting process.
• A "checklist" function, promote comprehensiveness and
inclusiveness.
• Transparent and accountable planning.
21
22. 3 key words
• FLEXIBILITY
– Country contextualisation
• STANDARDS
– Internal consistency, use of standards and defaults
• INTEGRATION
22
Editor's Notes
Interventions: estimate as to personnel types and time required to provide each of the interventions. Using this information together with the number of projected cases will generate an estimate of the number of staff and staff mix required to provide the specified package of interventions. The information is then fed into the Human Resources model where it can be used to check whether the chosen human resources scale-up is sufficient and appropriate for the chosen set of interventions.
All defaults can be replaced by the User.
