News

MannionDaniels has been contracted by the Swiss Development Cooperation to undertake a health sector assessment as part of its implementation of a new ‘Horn of Africa Cooperation Strategy (2013-2016)’.

A pastoralist community’s camel herds

The strategy focuses on support to the dry lands of the region and particularly pastoralist communities in Somalia and  Somaliland, the Somali Region of Ethiopia and North Eastern Kenya.   The health team has visited various locations including Jijiga, Isiola, Hargeisa, Berbera and Burao across the region.  The focus of the assessment is to look at ways that the new cooperation can transition from humanitarian support to more health development approaches.  In this drought-prone and conflict affected environment there are many challenges, not least the long distances and dispersed communities, that need to be considered if health services and public health messages are to be more accessible and better utilised by pastoralist communities.  The work is on-going and the team will report back to SDC in late June.

MannionDaniels Africa’s new premises in Karen, Nairobi.

In January 2013, just prior to the national elections in Kenya, Mannion Daniels Africa Limited was registered as a new company.  This new company will lead MannionDaniels’  short term consultancy work in health and social care in the East and Horn of Africa Region. The new office opened this week and recruitment is underway for new positions based in Nairobi.   Our work in the region currently includes supporting the development of the health component of a newly released Swiss Government “Horn of Africa Cooperation Strategy (2013-2016)”.  The focus of the cooperation will be on arid/dry lands and pastoralist communities.  We are also starting an annual review of the DFID funded Health Consortium Somalia programme that includes reviewing the work of five implementing agencies across the three zones of Somalia.  We see the East and Horn of Africa region as a key focus area for our company over the coming years in view of the health and development challenges facing governments and communities across the region and the need to transition from humanitarian assistance to building sustainable health and social care systems appropriate to the different socio-political situations that exist.

This month we are very happy to be welcoming Catherine Ainsworth to the MannionDaniels team as a Programme Manager.

Catherine holds an MSc in International Relations from Loughborough University which focused on the impact of migration on development.  For the past 5 years she has been working in the international development sector mostly within West and Central Africa.   Catherine started as an intern within the United Nations in New York before working with the World Food Programme as a youth outreach consultant.  Her interest and experience lie within programme management, aid effectiveness and monitoring and evaluation.  Previous to her position as Programme Manager for MannionDaniels Catherine worked for International Medical Corps for two and a half years.   Her last assignment was in the Central African Republic managing a portfolio of emergency primary health care interventions.

Motorbike traffic in Kathmandu

MannionDaniels have been contracted by HEART (Health and Education Advice and Resource Team – funded by DfID and managed by Oxford Policy Management) to participate in a Mid-Term Review of Nepal’s second Health Sector Programme (NHSP II).  This is a 5 year programme whose wide-reaching aims include:

• Improved sector management
• Improved service delivery
• Improved health governance and financial management
• Reduced cultural and economic barriers to accessing health care services
• Strengthened human resources for health
• Increased health knowledge and awareness
• Improved M&E and health information systems
• Improved physical assets and logistics management
• Improved sustainable health financing

This project has involved a team of 9 consultants, working alongside the Nepalese Ministry of Health and Population.  During their trips to Kathmandu and Biratnagar, the team have visited health facilities, talked to district health workers, and looked at private sector facilities and pharmacies to measure the progress made in implementing strategies.

Dr Narmeen Hamid, a member of the team evaluating the improvement of health service provision, finds:

“Despite the challenges of political instability, a long conflict and resource constraints, Nepal has managed to make great strides in the health sector. Bringing in the experience from another developing South Asian country, Pakistan, it was interesting to see the completely different way health is prioritized in Nepal with a much higher budget allocation, emphasis on primary rather than tertiary care and constitutional commitments to free basic health, and yet how both countries also face similar pitfalls of aid management, over-centralization and inequities that pose serious challenges to the delivery of effective health care to the people”.

Another aspect of the health sector being evaluated by the review is gender equity and social inclusion (GESI).  Dr Poonam Thapa, a member of the team evaluating GESI, explains its current position and importance:

“GESI institutional mainstreaming is still far from being well integrated with service delivery and quality of care.  The lack of full implementation of Human Resources for Health (which is actually GESI sensitive) remains the weakest link in the system. There is hope, in that some critical training programmes are being adapted, pro-poor targeted programmes are slowly but surely being expanded and GESI operational guidelines introduced. If planning and management are even more serious about GESI, Nepal could be much closer to achieving most of the MDG targets by 2015 even in the face of current cut backs in public health investment. GESI cannot remain an option on the side for health because the full achievement of it is a necessity for the people of Nepal.”

 The team, led by David Daniels, presented its findings to the Nepalese government and development partners in late January 2013.

MannionDaniels has recently completed a series of assignments in Somalia. Three MannionDaniels teams spent most of January in Garowe, Hargeisa and Mogadishu working alongside the Health Authorities of Puntland, Somaliland and the (new) Federal Government of Somalia to support them to complete their first Health Sector Strategic Plans.  The HSSPs provide a strategic guide for the Health Authorities and their development partners to improve the effectiveness of investment in the sector.  As stability returns to the three zones, it is urgent that a 20-year long emergency response to health crises moves to a strategic process of health systems development.  At a cost of around $100 million each over four years, the three Plans are affordable with present levels of external support.  A new structure that clarifies donor and government responsibilities is included in the Plans; if implemented, this will facilitiate significant gains in the efficiency of external support and better value for money will result.

MannionDaniels’ consultants have also finalised the design of a long-term “Governance, Leadership and Management” capacity development programme with the Somali Health Authorities.  Begun in 2011 with a needs assessment, the Programme has been incorporated into the Health Sector Strategic Plans and carefully costed by a team of international and Somali finance experts.  An international training institution will be sought to implement the Programme, working with a consortium of Somali institutions.

Finally, with annual budgets in recent years of as little as $500,000, the Somali Health Authorities have had to rely on development partners to pay their staff a living wage.  This has resulted in an unregulated system of “salary top ups” or “incentives” being offered by different agencies to health workers.  MannionDaniels, working with Charlie Goldsmith Associates, has just completed a study of health workers’ remuneration packages in order to recommend a series of more rational options, and the resultant report has been submitted to UNICEF Somalia.