Project Management in
Health Services Restructuring

See chart: Integrated Project Management & Control

Introduction

As an integral part of our extensive participation in health services restructuring projects in various parts of the world we have developed a particular expertise in project management systems. This expertise has proved to be of considerable value to national project implementation units responsible for the development and implementation of such health restructuring projects. We consider that two elements of project management are of particular relevance. These are:

   Financial Management and Accounting

   The Procurement Consultancy

Project scheduling and monitoring technology has been well established and we at RMC utilize the most up-to-date project scheduling, resource allocation and project progress monitoring programs available. In light of this readily available technology we do not consider it necessary to develop our own technology in this domain.

In the area of financial management and procurement of goods and services, we have had the privilege to work on the following assignments over the recent past.

• As part of the $134 million IDB funded Health Sector Reform Programme, RMC was retained by the MOH of Trinidad & Tobago to assist the Project Administration Unit in the selection of appropriate consultants, the evaluation of their work and the administration of their contracts involving some 90 technical assistance projects encompassing:
  - Reform of the Ministry of Health,
  - Devolution of Service Delivery to RHA,
  - PHC Development, Promotion & Training,
  - Rationalizing of Health Service Delivery,
  - Germany : levitra generika on-line - Development of a Comprehensive Financing System, and
  in the process transfer such knowledge, skills and systems to the MOH and RHAs.

  Also acting as advisors to the Minister and senior Ministry officials on policy issues arising from the health care restructuring, as well as to undertake, on a sole-source basis, a number of the consultancies (1999-2003); for example:

  Organized and took active participation in a seminar and, in turn, a conference on health financing/cost recovery and the role of public/private participation, attended by senior personnel from Ministries of Health, Finance, RHAs among others, as well as representation from IDB and PAHO.
  

• Retained to provide financial management and procurement advisory services to the Albania Ministry of Health, PCU on a USD28 million W.B. funded (USD17 million) Health Systems Recovery and Development Project dealing with objectives governing three components (Phases 1, 2 and 3) listed below (1999-2001):

  The project objectives are to:

  • rationalize and strengthen the governance structure and management capacity at the national and regional levels; and
  • improve the effectiveness and quality of health service delivery in the Tirana Region through upgrading of selected health facilities as part of a regional health system. The proposed Health System Recovery and Development Project will build on the initial achievements and lessons learned from the on-going Health Services Rehabilitation Program by expanding the geographic scope of infrastructure rehabilitation and by supporting the institutionalization of techniques to improve the quality of service delivery.

The approved project has three components:

• National Capacity Building
  
• Governance and Management of the Health System in Tirana Region
  
• Tirana Regional Health System Delivery
  

• Procurement and management of relevant expertise (i.e., consulting firms and individual consultants) using well-defined and documented systems, and to transfer such knowledge, skills and systems to the MOH and Regional Health Authorities (RHAs). The management activity includes: procurement, planning and liaison, solicitation, evaluation, contract supervision and administration of consulting firms and individual consultants to execute RFPs in five broad categories (each of which consists of a number of technical assistance (TA) assignments), and individual consultancy assignments (97 TAs in total). Ministry of Health, Trinidad & Tobago as part of a $134 million IADB funded project (1999-2001). The broad categories include the following:
  1. Reform of the MOH
  2. Devolution of Service Delivery to RHAs.
  3. Human Resource Strategy.
  4. Rationalizing of Health Service Delivery.
  5. Development of a Comprehensive Financial System.
     
     
     
• Retained by the Hungarian Ministry of Health, World Bank Project Management Unit to provide assistance in financial management and procurement on a Heart Healthy Nutrition Project (1996-1997).
  
  
• Financial management and procurement advisory services (1996-1997) to the Georgia Ministry of Health, Project Coordination Unit on a World Bank funded project dealing with health systems, human resources, health financing and rehabilitation of health facilities.
  
  
• RMC assisted (1995-1996) the Health Project Coordination Unit, Estonia Ministry of Social Affairs in managing a World Bank funded project. Significant areas of involvement include staff training and support in accounting and administration; development of procurement systems and procedures; and the actual procurement of goods and services and financial management of the construction of the Biomedical and Health Sciences Complex.
  
  
• Provision of advisory services, in procurement and financial management (1992-1996), to the Poland Ministry of Health for the US$135 million World Bank funded Poland Health Project. Emphasis of the Project is on health promotion; primary health care, health management training, pharmaceutical monitoring; information systems; and materials and equipment management.

The by product of RMC's involvement in project management was the development of an integrated Management Information and Control System and Procurement Operations Management System addressing the needs of both the client and the funding agency in a cost-effective manner.