VISAO MISAO OBJECTIVO HAKSESUK BOLA FH KKN HOME FH LPV ARTIGOS FH MUZIKA LIA MENON FH RESPONDE
Bloku Unidade Popular Associação Popular Monarquia Timorense Kmanek Haburas Unidade Nasional Timor Oan Partido Esperança da Pátria Partido Socialista de Timor Partido Desenvolvimento Popular Congresso Nacional para a Reconstrução de Timor-Leste Partido Republicano União Democrática Timorense Partido Democrata Cristão Partidu Movimento Libertasaun Povu Maubere Partidu Libertasaun Popular Partido Democratico União Nacional Democrática de Resistência Timorense Partido Unidade Desenvolvimento Democrático Partido Timorense Democratico Frenti-Mudança Partido Social Democrata Centro Ação Social Democrata Timorense Partido do Desenvolvimento Nacional Frente Revolucionaria de Timor-Leste Independente
“O povo de Timor-Leste está reconstruindo com o seu próprio suor, com o seu próprio sangue uma pátria revolucionaria democrática, uma terra livre para gente livre”.

I N T E R F E T
15 Setembro 1999
O Conselho de Segurança da ONU aprova a Resolução n° 1264,
que autoriza a criação de uma força internacional para Timor-Leste (INTERFET)
TIMOR-LESTE



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segunda-feira, 2 de agosto de 2010

JOINT HEALTH SECTOR MID-TERM REVIEW “LESSONS LEARNED AND THE WAY FORWARD FOR A HEALTHY TIMOR-LESTE”

IV GOVERNO CONSTITUCIONAL
MINISTÉRIO DA SAÚDE
Gabinete do Ministro

JOINT HEALTH SECTOR MID-TERM REVIEW
“LESSONS LEARNED AND THE WAY FORWARD FOR A HEALTHY TIMOR-LESTE”
Opening Speech by H.E Dr. Nelson Martins,
Minister of HealthDili, 26July 2010

Distinguished Guests,

Members of the Diplomatic Corps United Nations

Representatives Programme

DirectorsHeads of Departments and other Departmental Officials

Ladies and Gentlemen

Good Morning!

It is my pleasure to welcome you all to the 2010 Joint Health Sector Mid-Term Review meeting whose main purpose is to continue to strengthen the partnerships between the Ministry of Health of Timor-Leste and its Development Partners.

I wish to firstly thank our development partners for the support provided to the Ministry of Health over the past years. A lot have been done, but with so many challenges still ahead, I think that we must look back from where it all begin … back from 1999 in order to fully comprehend the advances that were made in the country and in the health sector in particular.

It has been a long time since we have all gathered together, many of us are here because we care, because we strive for a common goal, to share great dids and achievements, as well as challenges and concerns deriving from different perspectives, different ears and different eyes.

I think that I shall be speaking for all us when I say that there is wide international consensus that investment in health is critical for the socio-economic development of any society. With the contribution on many partners present here today, joint efforts were made and continue to be made to help improve access and quality of health services, through investment in our Human Resources, health Infrastructures and general support systems required to deliver adequate health services to the Timorese population.

This forum allows us to discuss at a high level the national health interventions and evaluate progress made so far. I must state that we should not wait for meetings like these to share lessons and the challenges that confront the health sector. I take this opportunity to appeal to all of you……to help us find the solutions together as problems arise and not wait! Although the Government is ultimately responsible for ensuring the best possible health care system to people of Timor-Leste, I must also acknowledge the fact that we can not work alone. This meeting therefore should assess our ability to work effectively and efficiently with one another. The framework for our engagement is straightforward: government sets the agenda in terms of priorities and engages with our partners to see how best their assistance can be used in assisting us to meet our priorities. This means agreeing on workplans, monitoring systems as well as communication channels.

We already have some successes in this regard which we can all learn from and build on. For examples the MoH has good relationship with the UN Agencies such as WHO, UNICEF, UNFPA, WFP, with Bilateral Agencies such as AusAID, IPAD and USAID and with many NGOs and Community Organizations. Equally, the World Bank worked closely with us in ensuring the Donor Trusted Funds speaks to our priorities despite of our differences in the way we do “business”.

After experiencing some challenges in the area of coordination, the Ministry of Health is very committed in ensuring appropriate donor coordination mechanisms and systems are in place. Opportunities like this Mid-Term Review are unique in a sense that it reemphasizes the need for better coordination, harmonization and alignment in search for a Sector Wide Approach to Health. In this context, the Paris Declaration is critical to framing the terms of development assistance.

Ladies and gentlemen,

Given that health needs often outstrip available resources, I would like to highlight a few issues that I committed myself over the past nearly three years since I took office as Minister of Health on the 8th August 2007.

Firstly, I wish to remind you of the vision of the Ministry of Health, which is “healthy Timorese People in a Healthy Timor-Leste”. In order to contribute towards the attainment of this vision, I visited some of the districts to see for myself and to ear by myself the concerns and challenges that both the communities and health staffs were facing and, my immediate reaction was: we still a long way from the vision!

The challenges shared in different districts are very much common! Limited human resources with limited skills, lack of water, no electricity, and some people travel great distances to access a health facility, not enough incentives for those staffs working away from their families in very remote villages, etc…

Secondly, I was very concerned with our ability to achieve MDGs: how to halved prevalence of communicable diseases, reduce maternal, infant and child mortality rates as well as combat malnutrition in our country? In this regard, accurate health information was imperative in understanding where we were……… how far where we towards achieving the MDGs 4, 5, 6 and 7! Reports from various sources were different and not really corresponding to the reality, particularly when considering the amount of assistance and resources invested in the health sector!

As a result, the legacy of maintaining the Alma Ata Declaration alive, proved to be a significant approach towards moving into the right direction through SISCa with a package of basic health care services available to those people with limited access to the services.

} SISCa approach believes in using real data to make plan and propose health needs intervention

} SISCa approach believes in local Solution to Local problem while respecting the international best practice and standards

} SISCa approach believes in community participation and decision on community health

} SISCa approach believes on Trans departmental and institutional collaboration in health

} SISCa approach believes in the empowerment of community leaders, village heads, members of Suco Council in mobilizing resources available to ensure healthy life in a healthy environment.

Furthermore, I fully endorsed advocacy to the research studies on health and health related issues and practices as a means for understanding health care seeking behavior in order to guide policy-making to improve health practices.

After all, Timor-Leste has its particularities which require in-dept assessments and studies in order to guide decision-making that best corresponds to our country’s nature and identity. I would like to thank AusAID, once more, for funding the Health Care Seeking Behavior Study – I must add that the recommendations made in this study are not ignored, but on the contrary, they being taken seriously. I need additional support to translate all recommendations into practice.

I would like to take this opportunity to urge all of you who have participated on or conducted any study relevant to the sector to SHARE then with me!

If you have any access to any studies conducted in Timor-Leste that may help me formulate better policies and regulate the system, please do not hesitate to share them with me.

Ladies and Gentlemen,

Since 2007 till now, key initiatives introduced by the Government are as following:

· Change the MOH Organizational Structure as to strengthen central and district health services, as well as coordination with external partners through DPM and Office of External Cooperation

· Revitalize SAMES to improve procurement of drugs and stock-outs through the establishment of a Ad-hoc Commission for Procurement of Drugs and Medical Supplies.· Strengthen Laboratory Services through the appointment of a new Administrative Board actively engaged in reforms and getting positive results.

· Strengthen Hospital and Referral Services in the country as well referrals overseas – despite indicating our limitations for secondary and tertiary health care, overseas referrals shows that the Government is fully committed to ensure that every Timorese shall have access to health care, specially the most vulnerable such as children, mothers, the elderly and the disable.

· Introduction and gradual implementation of SISCa in all Sucos – SISCa could have achieved a lot more if only everybody contributes, but unfortunately there is still little support from the partners and the MoH has limited staff to fully engaged in SISCa in a equitable manner.

· Introduction of Pasta Mutin to better integrate budget to planned activities· Procurement of Multifunctional Vehicles to improve access to health services at sub-district level

· Construction of Maternity Clinics to improve access to appropriate health care to pregnant women and newborns

· Establishment of Faculty of Midwifery and Nursing at UNTL to help feel the BSP identified gaps

· Establishment of Health Research and Development Office · Government Resolution endorsing “Registo de Saúde Familiar” as the official source of health information – it is about time we all share data and utilise official channels for health information analysis and publication, we are not communicating well in this regard

· Government Resolution on National Plan for Reintegration of Medical Students returning from Cuba – the Government is preparing the return of over 465 students from Cuba who will be finalizing their Medical Education in Timor-Leste

· Publication of Health Indicator Book

· Development of a 20 Years National Health Strategic Plan

At the same time, donors contribution in help tackling health challenges in Timor-Leste have been paramount in addressing maternal and child health issues, malnutrition and also in help controlling communicable diseases. In general, external funding to the health sector has been primarily in the following areas:

- European Commission through SIHSIP– Rolling-out Basic Services Package for Primary and Hospital Care; Technical Assistance for Health Workforce Plan and Medium Term Expenditure Framework; Review of Health Sector Strategic Plan.

- Global Fund TB - Diagnostic & Treatment Support (including medicines for TB patients) TA for TB, Research and Capacity Building on Drugs Management.

- Global Fund HIV - Lab consumable support, research, Management support and TA support for 1 health promotion specialist, 1 HIV-AIDS Specialist, 1 Surveillance Specialist, 1 BCC Specialist, 1 M&E Consultant, 1 VCT Specialist, 1 Blood Bank Specialist and 1 National Program Consultant.

- Global Fund Malaria - Diagnostic & Treatment Support, Research and Capacity Building on supportive environment, information system and operational research, service delivery and human resources.

- World Bank - Civil Works at Hospitals, Central Laboratory and CHC; Drugs and medical supplies; and Equipment for Hospitals, Equipment for CHCs and HP.

- Australian Development Cooperation - Training and Fellowships; Support the implementation of Health Sector Strategic Plan Project; Health Care Seeking Behaviour Study).- China - Technical Assistance at HNGV (12 medical specialists and supplies for the Chinese medical team), donation of malaria treatment drugs.

- Cuba – Medical Assistance and Training of Medical Students;- Korea - Donation of 10 Ambulances, CT scan and Haemodialysis machine.

- Portuguese Cooperation - Institutional Capacity building to the Institute of Health Science.

- New Zealand - Eye Care through Fred Hallows Foundation

- USAid - Technical Support through TAIS & HAI on safe motherhood, family planning, child survivor (IMCI, new born care, nutrition), family health promoters, BSP and improving child care in hospitals.

- UNFPA - Support Family Planning, Adolescent Reproductive Health, Emergency Obstetric Care, General Reproductive Health and Project Management Costs).

- WFP - Supplementary Feeding for Children under 5 years old and support pregnant women;

- UNICEF - Immunization Support, Child Survivor Program (New Born Care, IMCI, Nutrition)

Ladies and Gentlemen,

It is fair to acknowledge that the development of national health system is a result of collective effort by many organizations and individuals represented in this room. Many of you worked very hard, some more than others, to help improve the health profile of Timor-Leste: results from the recent Demographic Health Survey and 2009 Health Statistic Report shows significant improvements made!

However, despite successful results, it is important to continue investing in Health Management Information System with special attention to “Registo de Saúde Familiar” or Family Health Registration through SISCa.

I strongly believe that Timor-Leste can go beyond the MDG targets if current resources are appropriately utilized by:

· Ensuring availability of funds to implement Annual Action Plans;· Maximizing support to SISCa;

· Investing in the Faculty of Health Sciences at UNTL and continue support to ICS;

· Supporting the integration of medical students returning from Cuba

· Provision of Scholarships for training of Midwives, Nurses and Allied Health Sciences in the region;

· Assisting National Directorate of Human Resources in establishing relations with relevant training institutions overseas to help implement HR development plan

· Supporting the Office of Health Research and Development

· Supporting District Health Management Offices, Management of National and Referral Hospitals, as well as Management of National Laboratory – attention to customer services, management of medicines and consumables, quality control and staff management are among key priority needs.

· Assisting the National Directorate of Planning and Finance with Budgeting, Financial Planning and Execution of both Government and External Funds.

It is for this reason that we are here today to gain consensus over a process that is reviewing our framework to inform us; what we have done right, what we have not done, what gaps exist, where we need to improve and how we must move, etc. The process is participatory and as usual, will benefit from your wealth of expertise in the different themes.

The MTR is happening at a time government is developing the 20 Years National Health Strategic Plan (NHSP 2011-2030). The timing provides us with an opportunity to articulate issues of access to primary, secondary and tertiary health care, health system strengthening, the challenges of developing the right quality and quality of human resources, infrastructure component and support services required to achieve the targets set.

As from 2011, MoH priorities will focus on Human Resources Development as to be able to achieve within the next 20 years 1 doctor, 2 midwives, 2 nurses and 1 lab technician per Suco with at least 1000-1500 population. Investments in teaching institutions for training of other professional categories are urgently needed if we want to strengthen primary, secondary and tertiary health care services.

Therefore the MTR specifically aims to achieve the following objectives:

· to evaluate the MoH and stakeholders’ performance during the period of two and half years of MoH / IV Constitutional Government governance in delivering health policies/strategies and the implementation of health programs and projects throughout the country.

· to review the Health Sector Strategic Plan-Support Project (HSSP-SP), funded by AusAid and IDA/World Bank, and the Closing Out Project of the EC grants under the Health Support Program for Timor-Leste, Trust Fund TF 54512 and identification phase for the EC joining the Multi Donor Trust Fund in 2011.

It is with great disappointment that I heard about a separate review conducted between the 22nd until yesterday by the World Bank and AusAID regarding the HSSP-SP, Closing out of the EC grants under the TFET and identification phase for the EC joining the Multi Donor Trust Fund in 2011. How can a review of this nature be conducted without consulting the Ministry? Are you going to share the findings with all of us here? I wish we could work together not only as implementing partners, but also during the planning, monitoring and evaluation process. I would like to extend this message to all our partners as it is important that together we share responsibilities in a transparent and responsible way.

I have no doubt, therefore, that your contributions will guide the Ministry to focus in the right direction and to draw a clear road map for the way forward. Future plans should be integrated as one Country Plan for Health, with combine funding from different sources.

It is fair to add that we must work together not only in identifying the challenges and problems that we are so familiar with already, but let’s work together to implement the various recommendations that each year wit set ourselves to commit too!

I thank you once again for turning up and I appeal to you to sustain and even scale up your commitment for a “healthy Timor-Leste”. I am convinced that this partnership that has thrived over the years continues to be of great benefit to all Timorese people, as together we have done and will continue to do more.

I wish you all a productive and fruitful week.

Thank you!

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