Structure Review of the Ministry of Health – Bangsamoro Autonomous Region of Muslim Mindanao TECHNICAL ASSISTANCE FROM THE WORLD BANK Final Draft: July 2019 MANILA, PHILIPPINES 0 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement Table of Contents I. The Technical Assistance to MOH - 2 1. Background & rationale 2. Project design & implementation 3. This report: An overview PART 1 II. The MOH Functional Structure - 5 1. Developing the structure 2. Organogram & features 3. Staffing pattern 4. Functional descriptions 5. Structures for decision-making and coordination PART 2 III. Recommendations for Structure Strengthening - 16 1. Translating MOH strategies through the structure 2. Preparing for recruitment and selection 3. Complementary support for structure implementation 4. Structure refinements: Options for the future ANNEXES A. Analysis of the MOH’s first organizational chart - 23 B. Findings from the Consultation Sessions in MOH - 27 C. Presentation slides used for the Validation Meeting with MOH - 34 D. Functional descriptions of the major offices in the MOH structure - 34 E. Staffing pattern for the major offices in the MOH structure - 56 F. The Technical Assistance Team - 58 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 1 I. The Technical Assistance to the Ministry of Health 1. Background & Rationale The Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) was formed through the ratification of the Bangsamoro Organic Law (BOL) for the BARMM in February 2019. The BOL (Sec 8, Art XVI) provides for a Bangsamoro Transition Authority (BTA) interim cabinet composed of 15 primary ministries, including a Ministry of Health (MOH) replacing the previous Department of Health – The Autonomous Region of Muslim Mindanao (DOH- ARMM). The MOH is also one of three agencies whose core staffing will be kept intact throughout the transition to ensure uninterrupted delivery of services. The Ministry of Health (MOH) is currently functioning through the organizational set up of the DOH-ARMM. Patterned after the structure of regional health centers, the Ministry currently has 73 plantilla positions in the regional office. These positions do not include the positions in the integrated provincial health offices (IPHOs). In other regional offices of the national DOH, at least two hundred personnel perform the same functions as that of the MOH. Moreover, as the Ministry continues to provide uninterrupted health services to the people, it is also confronted with simultaneous complex and unpredictable socio-political and economic challenges from transitioning into a new government with its own organic laws and new leadership, from new programs and services mandated by Universal Health Care (UHC) law, and from structural changes due to a parliamentary system. These challenges will require the Ministry and its leadership to develop a strategic vision and a set of institutional strategies that can rally the different stakeholders to continue the current services while building the best-fit yet agile organization for the BARMM Ministry of Health. It is in this context that the Ministry of Health requested the World Bank for technical assistance (TA) in organizational development. The TA provided inputs and designed processes to recommend a best-fit organizational structure that can translate the BTA’s and the Ministry’s health priorities within the realities of its current transition contexts. The final products of the TA consist of 1) a revised functional structure from various consultations and benchmark and legal studies, and 2) an optional functional structure with specific refinements for future considerations. The functional structure consists of new offices that are required by the Ministry to fulfill its key result areas and achieve the desired health outcomes for BARMM. This new structure captures the different tasks and activities done by the former DOH – ARMM in previous years but were not formalized. It also provides new functions that are required by national laws. As a whole, the design and implementation of this new structure present a new organizational experience for the current leaders, managers and staff of the Ministry. The Minister and his officers are likewise aware that this new structure may require further revisions and strengthening in the future, especially as the BARMM moves from a period of transition into normalcy. Hence, they are also looking at a system-wide organizational strengthening, from head office at the regional center to the local health offices, to ensure that all aspects of the organization are capable of implementing the health strategies and targets within the next three years. This effort will include a continuing assessment of the structure’s ability to implement the Ministry’s key result areas and attain its health targets World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 2 effectively and efficiently. In this regard, the TA team further provided an optional functional structure with specific refinements. 2. Project Design & Implementation The World Bank Technical Assistance (TA) provided expert advice to the MOH Minister and his key officers on 1) processes for further strengthening the first organizational structure, 2) technical and legal considerations in structure design and development, 3) features of structures from other countries with parliamentary system of government, 4) features of the DOH national’s organizational design that may be relevant for BARMM. Figure 1 below presents the first organizational chart of the MOH structure submitted by MOH to BTA. The TA team used the first design (Figure 1) as its jump off point for analyzing the needs and requirements of MOH central office at the BARMM regional compound. Annex A presents the TA team’s observation on the first organizational chart of the MOH and the initial recommendations toward revising this structure. To deliver the major output, a revised organizational structure with staffing pattern and functional descriptions, the TA implemented two major inter-dependent activities: 1) a series of interviews, group discussions and consultation meetings with the key internal stakeholders, including the Minister and his deputies, and analysis of different organizational structures of government health institutions and 2) a review of the different national laws and guidelines. An alternative structure was also created by the TA team to serve as an option for the MOH in the future. 3. This Report: An overview The terminal report of this TA presents the structures for the Minister of Health. To ensure consistency in terms used, this report will refer to the revised MOH structure as the functional structure. This term is used to differentiate it from the first structure (in Figure 1) that was designed by the MOH and was used by the TA team as the basis for analysis, comparison and consultations. Part 1 of this report presents all the features of the MOH functional structure: staffing pattern and the functional description of the all offices in the MOH central office, including its relationship with the national DOH. The term functional structure is also used to differentiate it from the structure presented in Part 2, the alternative structure. This alternative recommends specific refinements to the MOH functional structure; it is presented as a possible option should the MOH consider further revisions to the functional structure in the future. Part 2 also provides the recommendations of the TA team in further detailing the organizational design so that it can be used for budget planning, recruitment and selection and performance evaluation of the agency. Other recommendations pertain to complementing organization development activities that will support the structure and its people in attaining health targets. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 3 Figure 1. MOH original structure submitted to BTA 4 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement The alternative structure was designed by the World Bank TA team based on the following factors: 1) a more balanced distribution of work load across the organization given the right number of staffing complement, 2) a tighter clustering of functions or offices to reflect a more focused specialization of work groups or bureaus, and 3) a more effective and efficient management of tasks and processes versus resources and results. PART 1 II. The MOH Functional Structure This section presents the organizational structure that was designed from several consultations, benchmark and legal studies: the organogram or the organizational chart, its features, staffing pattern and its relationship with the DOH – national. It also presents the process of designing this. 1. Developing the structure The MOH functional structure went through several iterations so that several realities presented by the leaders and managers of the MOH are considered, and at the same time, comply with the legal guidelines provided by national oversight bodies for organizational design of government structures. The one and half month TA implemented two inter- dependent set of activities: 1. Consultation and design validation with internal stakeholders. Consultations were conducted with the Minister and all heads of offices of the MOH including their senior technical staff (organic employees). The consultations, through interviews and group discussions, were held in the office of the MOH in Cotobato City. A total of 32 respondents were consulted during the field visit in June 2019. Annex B presents a summary of findings from the consultation sessions. A validation session with the Minister, his deputies, and the heads of offices were held to present the proposed revisions to the first MOH structure (Figure 1). The animated discussion further surfaced current organizational and local realities that the MOH structure must be able to respond to. Annex C provides the powerpoint slides used during the validation session held in Manila in June 2019. 2. Benchmark studies and structure analysis. The organizational set-up, specifically of federal states in Australia and Malaysia, including the DOH – national and regional offices, provided further basis for analyzing the first MOH structure and in recommending revisions to this. The TA team reviewed pertinent national laws and guidelines provided by the Department of Budget and Management (DBM) and the Civil Service Commission (CSC) to guide in designing the details of the functional structure. The TA team (in Annex F) is composed of Filipino experts in organizational design and development and an international expert in health organizational design. 5 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement The structure analysis used Galbraith’s STAR1 model to ensure alignment of organizational features with institutional mandates and priorities, strategies and key result areas. A comparative analysis was also done with the organizational structure of DOH national since the key result areas of the two agencies are similar. 2. The Organogram The organogram of the functional structure is presented in Figure 2, page 8. Except for the office names for the Office of the Minister and the Office of the Secretary General, which are patterned after a parliamentary structure, all offices are named using the national organizational structure guidelines set by the Department of Budget and Management (DBM). In the future, the BARMM government will provide its own official government structure terminologies for the offices of all ministries. Such policy will be the basis for revising the titles of offices and positions in the MOH structure. The revisions in the functional structure is indicated in Figure 3, page 9, and further explained in the next section. 3. Major features of the functional structure The structure was developed using the following critical elements and principles in organization design: specialization, span of control, coordination and efficiency, and balance, and functional integrity. Specialization is clustering those with related competencies, functions and services, deliverables and outputs together. The principle on span of control prescribes the number of personnel directly reporting to a single leader; the more complex functions are, the smaller span of control should be. Coordination and efficiency, on the other hand, is considered by grouping offices that have closely interrelated processes and thus require constant communication and working together to deliver services and target outcomes. Putting them directly under one leader will help ensure efficiency, cohesiveness, and responsiveness. Balance is important to ensure that the size of the units and the authority that managers hold are commensurate to the scope of work and deliverables and that span of control allows for leaders and employees to meaningfully interact and work together. Functional integrity is ensuring checks and balances across the structure is in place where there is a clear split in lines of accountability between units implementing programs and those that monitor, quality assures, and regulates them. Applying these principles of organization, functional structure, as presented in Figure 2, below, has been organized such that: ● Units providing strategic support services and/or requiring ease of response are directly placed under the Office of the Minister. 1 Jay R. Galbraith: The STAR Model. http://www.jaygalbraith.com/images/pdfs/StarModel.pdf World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 6 ● Key results areas and major clusters of functions and deliverables are grouped and organized as bureaus. There are 4 bureaus, each performing particular roles and providing specific services and value to service delivery. These are: 1. Public Health Bureau which is responsible for health program development and monitoring; 2. Health Systems Bureau for developing, maintaining, and continuously improving policies, processes, and standards for health planning, research, facility development and regulation, and health performance monitoring and evaluation; 3. Field Operations Bureau which shall provide oversight supervision to implementing units, ensuring that they are provided technical assistance and capacity building for effective program implementation and service delivery; and, 4. Finance and Administrative Bureau, which provides critical support services to all MOH units to ensure smooth operation. ● Span of control is balanced - narrower (lesser direct reports) for those with complex functions, and wider (more direct reports) for those with focused or routine functions. The BARMM and National Government relationship as articulated in the Bangsamoro Organic Law (BOL). Based on the BOL, BARMM as a political entity shall establish its own basic government structure that reflects the aspirations, secure the identity and posterity of Bangsamoro people and Muslim Filipinos. It is important therefore to ensure that the overall BARMM structure, and consequently the structure of BARMM Ministries like MOH, supports this same purpose. The BTA is tasked to prepare the mandated Codes for BARMM to guide its operations. These codes include Administrative, Civil Service, Education, Local Government and Revenue. In the BOL, specific provisions relating to health are expressed in broad terms under Article VI Section 13, which emphasized the continuous funding from the National Government for National Programs and Projects such as operations of the DOH-retained hospitals and PhilHealth. The Bangsamoro Government in its discretion may provide supplemental funding. The main provisions on health is under Article 9, Basic Right Section 22, which mandates the Bangsamoro Government, presumably through the MOH, to: 1) Adopt a policy on health that shall provide a comprehensive and integrated health service delivery 2) Establish general hospital system that shall provide excellent and affordable medical services 3) Promote rights to health and access to essential goods, health and other services 4) Assist and cooperate with the National Government in the provision of quarantine services to prevent and control entry to the country of communicable diseases. The finer definition of the relationship of the National Government, through the DOH, with the Ministry of Health are expected to be set out in the Administrative Code and Health Code. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 7 Figure 2. The MOH structure organogram. 8 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement Figure 3. The organogram in color coding. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 9 The following tables provide the explanation of the functional structure: new offices created, names changed, and new positions of offices within the structure. For each revision, the rationale behind the change is provided. Annex D presents the specific functional statements for the major offices. NEW OFFICES CREATED Offices Rationale Health Systems Bureau This bureau is created to develop, install, and maintain important systems and structure that will ensure effective delivery of health services and programs i.e. planning, policy development, performance monitoring, regulations, and capacity development. This also effectively separated all systems development and maintenance from program development function, the latter being the purview of Public Health Bureau. Health International This unit will assist the Minister in ensuring that all external Cooperation Unit funding assistance from various agencies and entities are optimized and directed towards strategic priorities of the sector and MOH. It will also monitor the implementation of projects to ensure that commitments made by MOH and development partners are followed through and reported accordingly. Health Performance This office will perform the monitoring and evaluation Monitoring Division function for the MOH and BARMM health sector as a whole. A strengthened M&E will inform MOH if MOH is on track in delivering its outcomes, and its programs are able to improve health outcome indicators for BARMM. Quality Assurance Monitoring This office will monitor that health facilities, public or private, Section (under Health are able to comply with the set standards. Regulation Division) Policy Development Section This office will ensure that policies initiated by various units and MOH as whole are developed following set standards and are aligned with strategic priorities of the organization. It will also serve as clearing house for all policies that will be introduced, ensuring harmonization, alignment, and quality. Environment and Occupational This section will cover health programs related to Health Section (under Disease environment and occupation. This is aligned with the key Control and Prevention programs of national DOH. Division) Hospital Monitoring Services This service recognizes the importance of hospitals in health service delivery, and as such, all hospitals in the various provinces in BARMM need to be closely monitored and provided with the necessary assistance to improve their capacity for quality and timely service delivery. This function is to ensure that the necessary capacity development needs of hospitals are recognized, analyzed, planned for, and provided 10 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement by necessary assistance from MOH. The regulatory function for hospital facilities, on the other hand, is lodged in the Licensing and Regulatory Section of the Health Regulation Bureau to ensure functional integrity. Institutional Development and This section will look after MOH’s organizational health and Human Resource Management effectiveness and ensures that systems and processes for Section (under Administrative employee performance, promotion, succession, and career Services) pathing are in place. Supply Chain Management This division will ensure that MOH have the right and timely Division provision of equipment, materials, and supplies needed for its operation. NEW NAMES OF EXISTING OFFICES New Name Old Name Rationale Legal and Legislative Legal Unit Expanded role to include legislative Liaison Unit liaising. Media and Public Media Relations Expanded role to include “public Relations Unit relations” work. Field Operations Unit Operations Unit Put emphasis on “field” to differentiate it from operations at the MOH regional. Policy Development and Planning Division Expanded role to include policy Planning Division development and research. Licensing and Licensing Section Two sections merged into one. Accreditation Section Accreditation Section Disease Prevention and Disease Prevention For consistency with nomenclature. Control Division and Control Bureau Operating under a bureau, and thus a division. Administration and Administration, Removal of the regulation function, Finance Bureau Finance and transferred to Health Systems Bureau. Regulation Bureau Health Human Resource Health Human For consistency with nomenclature. Development Division Resource Operating under a bureau, and thus a Development Bureau division. NEW POSITIONS OF EXISTING OFFICES Office From To Rationale for the new name Health Public Health Health Systems Clustering of specialization; managing of Facilities Bureau Bureau span of control of Public Health Bureau Developm to ensure effectiveness; providing focus ent for both bureaus. Division World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 11 NEW POSITIONS OF EXISTING OFFICES Office From To Rationale for the new name Health Health Systems Clustering of specialization. Health Regulation Administratio Bureau regulation should be grouped with those Division n and Finance overseeing the different health systems. Bureau Administration and Finance Bureau to provide support services. Local Public Health Field Focuses the role of the division and Health Bureau Operations brings it closer to the field units Systems Bureau implementers which is its key clientele. Division Pharmacy Administratio Field Brings the division closer to the field Quality n and FInance Operations units where there is direct access and Assurance Bureau Bureau coordination that will ease in Division monitoring and quality assurance function. 4. Staffing pattern The indicative staffing pattern as outlined below was developed by combining the staffing numbers of the first MOH structure (Figure 1) and adjusting this pattern based on the changes introduced to the functional structure in Figure 3. The adjustments subscribed to the staffing guidelines promulgated by the Department of Budget and Management 2. From the proposed 290 positions, plus the original 73 plantilla positions, the total positions in the functional structure is 363. A summary is provided below, and a detailed breakdown of the staffing pattern per office is presented in Annex E. Office of the Minister 55 Bangsamoro Secretary General 5 Public Health Bureau 85 Health Systems Bureau 98 Field Operations Bureau (excluding PHOs, 21 CHOs, and Hospitals) Administration and Finance Bureau 83 Attached Agencies 16 Total 363 5. Structures for decision-making and coordination The functional design of the MOH organizational structure will require cross-functional groups (bureaus, divisions, units) to convene and ensure that mission-critical and strategic decisions are effectively made by pertinent leaders and technical experts within concerned 2 DBM’s Resolution No. 1 Series of 2006, Rationalization Program’s Organization and Staffing Standards and Guidelines. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 12 offices. These cross-functional groups, which may be called technical working committees or task forces, are created through administrative issuances to formalize their respective charters (purpose, objectives and target results, including roles and responsibilities of members) and to ensure accountabilities for expected processes and results. The cross-functional groups also serve as structures to ensure and enforce coordination of personnel, processes, tasks and outputs across different offices. Such coordination creates synergy that is required to deliver major results that directly impact health outcomes. Preventing and addressing outbreaks, for example, will require the synergy between and among different offices within and across bureaus. Without the presence of cross-functional groups, a functional design like the MOH’s structure may create silos (or highly independent offices) in the organization and perpetuate a culture of non-cooperation that will result to duplication of activities and outputs, bottlenecks in work processes and delayed services, among others. Three major cross functional structures are presented below: 1. The Executive Committee – the main cross-functional body that provides strategic and operational information for top level decision-making, especially for the Minister of Health. It is primarily focused on the governance of the entire Ministry: strategic direction, policy formulation, navigation of the Ministry in the external environment and its different stakeholders. Figure 4 below presents the structure of the committee and its members. Office of the Chair: Minister Minister Alternate: Deputy Minister Co-Chair: Secretary MOH Executive General Committee Members: Attached Agencies, Bureau Directors; as appointed Structures for effective Secretary General decision-making & efficient coordination Bureau Director: and delivery of Bureau Director: Bureau Director: Health Field Bureau Director: Public Health Health Systems Finance & Admin services: Operations Executive Level Main functions: • Provides key inputs for governance and management of MOH; • Aligns policy and program direction and results; • Integrates resource utilization, operations and MOH response to external publics; • Plans strategic direction of MOH and evaluates overall performance • In the event of vacancy in Minister and Deputy Minister positions; the Co-Chair, assisted by members of the Excomm provides leadership of the MOH Figure 4. The Executive committee of MOH. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 13 2. The Management Committee – the cross-functional body that ensures alignment of operational decisions and actions with the policy and direction set by the Minister and the Executive Committee. Its purpose is also to tighten coordination of action and to assure integration of programs and performance indicators across different offices within the entire organization, including pertinent external partners. This committee is responsible for operational efficiencies, client satisfaction and organizational well-being. It is accountable to the Minister of Health and report to the Executive Committee. Figure 5 presents the structure and its members. Each Bureau may also create its own Bureau- level management committee with the same purpose. Secretary Chair: Secretary General General Co-Chair: By Management Rotation Committee Members: Bureau Directors, Division heads; as appointed Structures for effective Bureau Director: Bureau Director: Bureau Director: Bureau Director: decision-making & Public Health Health Systems Health Field Operations Finance & Admin efficient coordination and delivery of Division Heads Division Heads Division Heads Division Heads services: Management Main functions: Level • Translates Excomm directives into an integrated plan of action across bureaus • Ensures cross-functional efficiency and alignment of strategies and resources across bureaus • Addresses key issues, challenges in implementation of strategic and functional plans • Analyzes MOH performance indicators regularly and identifies successes and risks, opportunities and challenges Figure 5. The MOH Management Committee. 3. Mission-critical sub-committees or Technical Working Groups (TWGs) – the two cross- functional committees identified in the next page will require membership from different offices since these offices provide essential inputs to the required services and results of the Ministry as a whole and of specific bureaus. These committees are adjunct technical working groups (TWGs) of the Management Committee; and chaired by the Director of the bureau whose main functions are relevant to the outputs of the TWG. Each of these TWGs must be provided with a formal and clear charter, through Ministry issuances, to ensure results-orientation and delivery. The charter will also have to include provisions for performance evaluation (group and individual levels) linked to the Ministry’s performance management system, and provisions for dissolution and inclusion of other members. a. TWG/Committee for Health Promotions – the TWG integrates key messages of the MOH, its plans, programs, policies, including health standards and important public health information. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 14 Public Health Media and Province & Public City Health Structures for effective Relations Offices decision-making & Office efficient coordination Health Health Education, Advocacy Promotions and delivery of Division & Information Working services: Committee External Health Partners; Health Attached Systems Promotions Agencies Field Operations Figure 6. The Health Education, Advocacy and Information working committee. b. TWG/Committee Performance Monitoring and Evaluation of the Ministry and the health outcomes of the BARMM – aligns health indicators across health outcomes and streamlines processes monitoring and evaluation and knowledge management. Epidemiology Division Structures for effective decision-making & Health Health IT efficient coordination Research Division Services and delivery of services: Health Performance Performance Monitoring Performance Monitoring Division Working Committee Monitoring for PhilHealth & Policy & MOH & BARMM attached agencies Planning Division Health Sector City/Province Epi & Surveillance Figure 7. Performance Monitoring working committee. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 15 PART 2 III. Recommendations for Structure Strengthening 1. Translating MOH strategies through the structure I. The MOH structure implements the Ministry’s strategic plan – implementing strategies expressed in plans, policies, programs and projects through the different functional groups in the structure. The alignment of the MOH’s Theory of Change and the different change outcomes and preconditions with the appropriate functional groups is vital in achieving actual results. The MOH will have to clearly define the roles of the different functional groups involved in each of the health outcomes: who will be the main responsible and accountable office (leading), the key contributing offices (supporting), and offices that will have to approve outputs (approving). The cross-functional groups within and across bureaus will also have to be determined: the purpose and outputs of such inter-office arrangements, modes for decision-making, resource sharing and working collaboratively. Another critical element in implementing the strategies through the functional structure is the presence of defined and efficient work processes or work flows: what are required work processes in each of the major priority areas of MOH. In increasing the skilled birth attendant (SBA), for example, what processes are involved, who are accountable for each sub-process, what are dependencies of these processes with each other, what resources and competencies are required by each of these processes. Defining the work processes involved within and across the functional groups further clarify the structure and how it is implemented. This will also provide feedback to the leaders of MOH on what areas of the structure can be further fine-tuned to ensure that it can effectively implement plans and deliver results. 2. Preparing for recruitment and selection The recruitment and selection system will have to be in place for the MOH to implement its staffing pattern. The system includes major activities: Job design and analysis. Job designing entails organizing and clustering the different tasks and deliverables of each office (unit, division, bureau) to determine the optimal work division that will ensure effective delivery of expected results. This will then lead to drafting of the job description per position. The thorough job analysis will also determine the required competencies, qualification standards, position titles, and ultimately the salary grade for each position. Only after determining the salary grades of all positions can the MOH determine its overall personnel cost. This process shall be guided by existing guidelines and standards introduced by the DBM and the Civil Service Commission. Recruitment & on-boarding. Recruitment and on-boarding include critical preparatory and post-recruitment activities to ensure that the right persons are placed in the right jobs. These inputs and activities include: World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 16 1. Developing a recruitment plan. A recruitment plan must be in place to guide the approach, process, and proper pacing of the recruitment process. The plan may adopt a phased approach and prioritize positions and offices that are consistent with the MOH health priorities. Positions that will deliver critical results in the first year for the organization must be identified and prioritized. A number of highly technical and highly specialized positions may require special recruitment strategies to engage qualified candidates. The phased approach also considers the realities of recruiting – the sources of qualified health personnel may be difficult to find, and applicants for higher and highly technical positions may not be plenty. 2. Developing a hiring policy. If and when a BTA-wide hiring policy is prescribed, MOH can operationalize and further detail this to suit the context of the BARMM health sector. If there is none, it is even more important that a hiring policy (or a merit selection plan) is adopted to ensure a merit-based, transparent, and fair hiring process. This must also account for the personnel action in relation to existing employees of old structure which are expected to be absorbed into the new structure. 3. Creating and training the Recruitment Team. This team will drive the pace and process, monitor progress, and backstop the administrative requirements of the recruitment, selection, and placement process. 4. Creating and training the Personnel Selection Board (PSB). The PSB shall assist the appointing authority in screening and selecting the right candidates in strict accordance to the hiring policy/merit selection plan prescribed. To be able to effectively perform this task, the PSB members must be trained on the process and be equipped with the right skills for interviewing and assessing applicants. 5. Recruitment and Selection Proper. Depending on the priorities and time table set out in the recruitment plan, and the capacity and availability of the PSB and the hiring policy to guide them, a series of recruitment and selection activities shall ensue which may include document screening, proficiency exam, interview, and/or demonstration. 6. Placement and Onboarding. Proper onboarding of new hires is important to ensure they fully understand MOH as an organization, their individual functions and deliverables, and ways of working. Proper onboarding will ensure strong and consistent employee engagement and performance. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 17 3. Complementary support for structure implementation Determining physical lay-out for offices: improving physical environment of the work place for current and expanded staff and equipment, confidential files Structure Engaging officers and key staff in defining office charters and implementation job descriptions: increasing cross-functional coordination and teamwork; increasing ownership of responsibilities support and MOH organization development: Orientation, on-boarding of newly hired employees and newly Urgent transferred employees requirements 2019- 2020 Leadership and management competency-building for all positions with management & supervisory functions; strengthening work relationship of the leaders of the MOH 20 Figure 8. Complementing organizational strengthening. The following organizational elements are important considerations to complement the functional structure so that implementing the roles, responsibilities and accountabilities of the different offices will be made much more effective and efficient while caring for the well- being of the MOH personnel. If the functional structure will be implemented within 2019, it is highly recommended that the MOH attends to these complementing organizational development initiatives: Employee engagement in detailing the office functions . The effectiveness and well-being of the people within the new MOH structure are further enhanced by ensuring that they are engaged in the detailing of their office charter, which defines the identity of the office and its accountabilities and relationships with other offices and MOH partners. This level of engagement will assure group ownership of formal functions and inter-office team work. Healthy work environment for MOH people. The physical space, lay-out and features of the offices contribute to performance. The absence of these, as expressed by the MOH respondents to the interviews, significantly affect productivity, mental and physical health and sustainability of motivation and effective relationships within the office and with external clients. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 18 Relevant information and competencies to support functions . Newly hired and transferred personnel and all leaders and managers of the Ministry must be able to access pertinent information so that they can fulfill their functions and accomplish targets and results. On- boarding processes and competency building opportunities are essential for people to implement the structure of the MOH. A priority competency building program must focus on the leaders and managers of MOH, from the regional to the provincial and city health offices. 4. Structure refinements: Options for the future The MOH leaders deem the current revised structure as responsive to both transition requirements of BARMM and its leaders. They see how the structure can translate the strategic direction of MOH and the target health outcomes in BARMM into concrete plans and programs delivered by the different functional offices. But they are likewise cognizant that whatever structure they will finally implement now may be changed in the future based on their experiences and the changes in the context of BARMM and the country as a whole. In light of possible changes and opportunities to shift the MOH’s organizational design in the near future, the World Bank TA team recommends further refinements to the functional structure in Figure 2. These refinements are presented in the alternative structure in Figure 8 below. The alternative design aims to further strengthen the way the Ministry can deliver its results. It provides features that incorporate important key result areas needed by the BARMM health sector and its geographical realities (e.g. quarantine). It also distributes workload more efficiently in different specializations (bureaus) and lines of authorities (Office of the Minister and Office of the Secretary General), while bringing together highly inter- dependent work processes within the same functional groupings to create greater efficiency. These features are further discussed below. Additional guidelines are provided for changing features or functional arrangments in the structure. The TA team’s observations on the functional structure (Figure 2) , which was designed through consultations in MOH, were the basis in designing an alternative structure that may be considered in the future. These observations and refinements in the alternative design in Figure 8 are described below: World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 19 Figure 8. Alternative structure for MO 20 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 1. Inclusion of Food and Drug Administration (FDA) and PhilHealth as attached agencies. The functional structure in Figure 2 created a Pharmacy Quality Assurance Division that derives its standards from the FDA. As an attached agency, the functional relationship of this Division is clearly established. The PhilHealth provides important inputs for the MOH while relying on the MOH for the delivery of health services. The interdependencies of these two organizations are formally recognized if PhilHealth is an attached agency of the MOH. 2. The Office of the Minister has fewer units requiring day-to-day operational supervision. These offices provide strategic and independent analysis and inputs for the Minister and support the requirements of governance and external relations: Legislative Liaison Unit, Media and Public Relations Unit, and the Internal Control Unit. This also maintains a manageable number of direct reports to the Minister. 3. Project Management Unit (called International Health Cooperation Unit in the MOH- approved structure), Health Emergency Management Service (HEMS), and Bids and Awards Committee (BAC) are lodged under the Office of the Bangsamoro Secretary General. These units require close supervision, given the sensitive nature of their roles. As direct reports to Secretary General, moreover, these units will be able to faster and easier coordination and cooperation from other units – an imperative for successful delivery of their respective functions. 4. Health Information and Promotion, a section under Disease Prevention and Control Division in the functional structure (Figure 2), is lodged as a Division directly reporting to the Director of the Public Health Bureau in Figure 8. Making this a division underscores the premium given to promotion and education as critical strategy for disease prevention. This would mean higher capacity and at the same time bigger accountability for the unit. 5. The Surveillance Section under the Epidemiology Division is renamed Epidemiological Analysis Section to distinguish its work from offices performing data collection at the field. The Analysis Section consolidates and analyzes various data from the field, and present these into meaningful information that guides management action. 6. The hospitals, which under the functional structure in Figure 2 reports directly to the Ministry, are devolved to their respective Provincial Health Offices and City Health Offices, in keeping with the national strategy on integration and with the requirements of the Universal Health Care. The support to hospital through monitoring and capacity building shall be subsumed under the function of Local Health Systems in MOH . 7. A Quarantine Division is created and lodged under the Field Operations Bureau. This arrangement will allow for easier coordination of the Division with other health facilities should an immediate response be needed. 8. The Health Information Technology Section (HITS), originally directly reporting under the Office of the Minister, is now lodged as a unit under the Administrative Division. The 21 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement nature of HITS is to provide support services to all offices in MOH by maintaining information technology infrastructure. As such, it must be consolidated under the Administrative Division. 9. The Procurement Section is created to act as secretariat to the BAC, among others. This is lodged under Supply Chain Management Division. 10. The Institutional Development and Human Resource Management is elevated as a division from being a section under the Administrative Division in Figure 2. This major function will implement different important systems for the entire MOH: performance management, recruitment and selection, reward and recognition, employee welfare, among others. As a section, it will be limited in capacity and therefore in its ability to perform major services. A unit has specific limitations under the DBM regulations; increasing its staffing pattern beyond the limitations will lead ultimately to creating a division. In adopting further revisions to the functional structure, it is an important practice and discipline to undergo a structure review. In particular, any/all areas of poor performance will have to be carefully analyzed to determine how a different structure can eliminate or significantly minimize such level of performance. The analysis to determine root causes of under-performance can be helpful in identifying the need for adjustments to the structure, and to the roles and responsibilities of the different functions. At the same time, frequent and relatively minor changes in the structure can have a negative impact on organizational performance and staff morale. An example of this may be moving divisions across bureaus several times within a period of six months. It is suggested, therefore, that for an initial period at least, any changes in the structure are implemented on a ‘clustered’ basis or by related functional groups, e.g., changes within related divisions in a bureau. Such changes however will have to be managed: planned implementation within a determined period and with appropriate preparations provided to the affected personnel. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 22 ANNEXES ANNEX A Analysis of the MOH’s First Organizational Chart The table presents the TA team’s analysis of the chart presented in Figure 1: the first organogram of the MOH. OFFICES OBSERVATIONS & ANALYSIS RECOMMENDATIONS & RATIONALE Functions vital to the Overall, expand the Office by creating Office of the managing external relations two additional offices: Minister and the publics are not · Legislative Liaison Unit included in the support staff · External Relations and Project Deputy of the Office of the Minister Management Minister Three attached agencies have Include the Food and Drugs been excluded in the Administration (FDA), Quarantine, and structure – Food and Drugs PhilHealth, as attached agencies in the Administration (FDA), Minister’s Office. These attached Quarantine, and PhilHealth, agencies are basic and key support to and this may affect the MOH core mandate, health service effectiveness of health program delivery, and policy guidance. service delivery and compliance with overall government policy, rules, and regulations. Inclusion of Health Move HEMS Division to either the Emergency Management Public Health Cluster or Health Field Service (HEMS) Division Operations Cluster, as either Clusters under the Minister’s Office would be in a better position to may be too detailed a perform HEMS functions. In support of function for that Office. The this, the Minister can issue an Order to basis for this needs to be giving HEMS Division operational defined more in terms of authority and control to undertake policy and operational quick emergency response activities. contexts. Create a “Health Emergency Working Group” under the Office of the Minister to focus on more strategic health emergency and overall DRRM- programs. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 23 OFFICES OBSERVATIONS & ANALYSIS RECOMMENDATIONS & RATIONALE Internal Control Unit is underMove Internal Control Unit directly direct responsibility ofunder the responsibility of the Deputy Minister. Minister’s Office for overall guidance and accountability. The use of the office name Change the office name to “Information Technology “Information Technology Management (IT)” by per se and as System” and incorporate Knowledge currently presented is not Management as part of its functions. clear. Though the role of A national law requires ICT and an ICT “IT” and its placement under officer in every key government office. the Minister’s Office remains The Universal Health Care (UHC) Bill valid. also requires systems and structures for performance monitoring. Public Health Overall, the use of “Bureau” Make the group a “Bureau” and all Group for offices under this group offices under the Bureau are called may need to be changed to “Division” better reflect proper hierarchy. Public Health Service Public Health Service Health Education Promotions Include HIVAIDS & TB under under this office has a cross- Communicable Diseases cutting and higher function and may need to be re- Elevate Health Education Promotion as positioned outside of this a Division to emphasize promotion as a office. critical approach to disease prevention. Policy and Systems Bureau Policy and Systems Bureau The four (4) offices currently Include a Performance Monitoring included may not be enough Division. UHC requires the inclusion of to effectively perform the performance monitoring as a formal functions of this Bureau. office. Change name of two divisions to The inclusion of Local Health “Policy, Planning & Systems” and Systems Division in the “Policy and Research” Bureau may not appropriate, given the nature of its Move Local Health Systems Division to functions. Director for Operations Health Facilities Development Create a Health Devices and Technology Section World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 24 OFFICES OBSERVATIONS & ANALYSIS RECOMMENDATIONS & RATIONALE Operations The name of office Change the office name to “Field Group “Operations” may be Operations” to emphasis its focus and misconstrued with functions on managing and overseeing administrative functions and the delivery of health programs and need to be changed. services, and on implementation of pertinent policies, rules and regulations during implementation. Current composition of Expand Cluster offices health offices – Provincial Create additional units on: Health Offices, City Health Unit for performance monitoring Offices, and Hospitals not enough to justify and support Unit for planning and budgeting (to the desired functions for this consolidate requirements from Cluster. different field units) Add the following offices: Health Emergencies Management Division (originally from the Minister’s Office) Local Health Systems Divisions (originally from Public Health Cluster) Health Regulation (Originally from Finance & Admin) Provincial Health Offices Provide clarity on functions, vis-à-vis BARMM MOH goal Change name to “Integrated Provincial Health Offices” to better reflect the strategic direction towards better integration of health program and service delivery, in a sector-wide context. City Health Offices Position in structure should be parallel to PHOs Provide clarity on functions, vis-à-vis BARMM MOH goal and, as with PHO, CHO functions should reflect the strategic direction towards better World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 25 OFFICES OBSERVATIONS & ANALYSIS RECOMMENDATIONS & RATIONALE integration of health program and service delivery, in a sector-wide context. Expand this office to include divisions Finance & on: Administration Procurement and Contract Group Management IT Infrastructure Support and Maintenance Finance Division – none Admin Division Remove Personnel and transfer to HRM and Institutional Development Health Regulation Transfer Health Regulation to Field Operations Create “HR Management and Institutional Development” World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 26 ANNEX B Findings from the Consultation Sessions in MOH Respondents’ Participants’ feedback & recommendations Observations & analysis of office consultants Public Health Common feedback and recommendations: Current situation has been Division affecting: · Limited number of plantilla or organic · work performance – staff, which then resulted in (i) several limited efficiency and key functions being performed through effectiveness to deliver Job Orders or contractual staff, (ii) core results team doing multi-tasks that causes · staff motivation – jigh work overload, or (iii) use of level of motivation is designated/seconded staff from other eroded due to overwork offices. and multi-tasking · Need to improve physical office · work relationship and structure and work areas/spaces dynamics – noted lack of · Need to improve IT infrastructure, equity in workload availability of basic software, and · work demeanor – created presence of IT infrastructure support anxieties over security of and maintenance. tenure · Continue with teamwork · Urgent to finalize the structure to guide Specific to recommended work and functions, determine salary staffing requirements, these grade, and provide staff training and need to be studied, analyzed, development to develop and/or and confirmed further, based enhance competencies required by the on all other information job. gathered. · Provide concrete solutions to improve physical work environment and IT- related issues. Health · Only one (1) organic staff. Emergency Specific recommendations: Management · Retain under Office of Minister to cut- Service off bureaucracy, ensure immediate response/proactive, facilitate imprimatur, and promote positive impact on people being assisted (i.e. manage expectations) Staffing requirements: 20 organic staff, with 15 of this total dedicated to the Prevention, Mitigation and Preparedness Unit, but however capable of being re- configured/moved to the Response and Rehabilitation Unit during actual emergency World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 27 Respondents’ Participants’ feedback & recommendations Observations & analysis of office consultants situations or as needed. Ten (10) staff are being planned for recruitment this year (2019). RESU · Only one (1) organic staff Specific recommendations: · improve internal coordination with surveillance unit and field offices (LGU level) on data sharing/validation; · conduct more Program Implementation Review, consultative meetings, and monitoring with PESU and other stakeholders and to promote two-way coordination and communication; · improve referral systems and procedures on use of health facilities outside of BARMM, but being used by BARMM residents; · strengthen capability to conduct monitoring to inform relevant prevention and response activities, and provide guidance and justifications on when to declare (or not) an outbreak; · move RESU under Public Health/EPI, as a division, with FHSIS and Research as separate units Staffing requirements: 15 organic staff, with eight (8) of this total to be initially recruited this year (2019) Health · Three (3) organic staff Facilities · Three additional feedback (issues) Development provided were (i) limited logistics support (transport), (ii) long turn- around time for reimbursement of expenses, and (iii) lack of licensed software (Autocad) to use. Specific recommendations: · Strengthen coordination with Admin and Finance Division for better logistics support and financial support; · Staffing requirements: total of 32 organic staff; · Health Facility Planning & Engineering - 15, Construction Engineering – 17 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 28 Respondents’ Participants’ feedback & recommendations Observations & analysis of office consultants Research and Specific recommendations: Development · Consider R&D as a formal unit (and not Program just a program) of proposed new structure under Policy and Systems Division, given the strategic and policy importance and relevance of the work of R&D. · Retain its focus on sector-wide R&D within BARMM and not just for MOH to distinguish its functions with those of RESU, for example. · Develop clear research plan and agenda for different users of research outputs, e.g. on nutrition, life-style diseases, mental health Staffing requirements: eleven (11) organic staff composed of 1 senior research specialist, 3 health program researchers, 3 research assistants, 2 admin/clerk, 1 head, 1 technical writer General recommendations: Programs · Strengthen inter and intra-coordination between and among other units – communications/PIO, field operations, policy, systems; · Strengthen logistics support, including providing distinct assistance to program-related logistics and admin/office logistics. This should be coordinated with Admin Unit; · Include Environment and Occupational Health in proposed structure under Disease Prevention and Control to cover policy formulation and implementation related to potable water system, WASH, toilet facilities, and the like; · Combine health promotions and public information as a Division, under the Office of the Minister, to do education awareness on all cluster concerns; · Include in promotion materials the cultural practices (FATWA) on specific health programs, e.g. child health, maternal health, WatSan, etc.; World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 29 Respondents’ Participants’ feedback & recommendations Observations & analysis of office consultants · translate in the local language the promotion materials, publications and other collaterals; · hire Development Management Officers (DMOs) at provincial level to coordinate promotions work with MOH and down the line (below provincial level) Staffing requirements (organic): Infectious/Communicable Diseases – 16 Infectious Diseases Cluster – 16 Family Health Cluster – 12 Non-communicable Cluster – 16 Mental Health – 10 Health Promotions & PIO – 7 Licensing and · At BARMM MOH level, authority to 1. Consider Licensing and Regulation issue license is limited only to renewal of Regulation as a Division due to license and only for level 1 health facilities its major function. such as infirmary, birthing facility, and laboratory and based on the Certificate of 2. Place this Office under Needs (CON). either Health Operations or Health Systems (due to · DOH retains licensing control over standards). first time application for level 1 health facilities and full undelegated control ove 3. Include two sections or second level facilities (e.g. provincial units: hospitals, district hospitals) and up. · Regulation/Compliance/ Enforcement to focus on · FDA retains the licensing and minimum standards, regulation of pharmacies and use of X-ray. issuance and revocation of license certificate · Current with nine (9) staff: 3 organic staff, 2 JOs, 4 designated · Standards and Quality Assurance to focus on implementation and compliance monitoring Health Human · Responsible for training of all MOH Resources personnel and health service providers, using overall competency standards of Development government · Lack of clarity on the division and inter-relationship of HR functions between Personnel and HHRD · With five (5) organic staff World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 30 Respondents’ Participants’ feedback & recommendations Observations & analysis of office consultants Specific recommendations: · cover health sector HR concerns, thus their focus should be on training, deployment, screening and monitoring of health personnel responsible for delivering health programs and services. · Locate under Field Operations · Remove and transfer to Admin Personnel the ST&D of all MOH-based personnel HHRD functions to cover: · L&D such as conducting TNA (core), developing a system to provide units for attendance in training/seminars of health personnel · human resource for health such as those involving fellows and health personnel deployment · scholarships and grants · focus will be made on the following areas of concerns: · career management – higher learning and specialist course, facilitates specialist training application and documentation, identify institutions or organizations that provide training · Learning and Development – provision of routine and basic skills training, matching training demand (participants) and supply (service providers) · Contracting – implement system for return service in contracts of concern health personnel · Performance evaluation – in coordination with Admin – HRM and monitoring of performance commitments · Monitoring – where they should be (based on contract/deployment) · Management of training information system for health service personnel, including keeping related records Staffing requirements: increase from 5 to 12 (encoder, training staff, scholarships, World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 31 Respondents’ Participants’ feedback & recommendations Observations & analysis of office consultants recruitment /deployment, IT for database management -HRIS) Field Pharmaceutical Given the nature of its Operations functions: · Only 1 organic staff. Rest of team (6) are part of the HHRDB deployment A change in the office name program of DOH and are thus funded by from “Pharmaceutical” to Pharmaceutical DOH. “Pharmacy Quality Assurance Unit Service” has been discussed Work coverage is from provinces (IPHOs) to and agreed with staff. barangays (RHUs/BHSs) of BARMM This office is proposed to be Focus on education and advocacy included under Field Operations responsible for implementing and monitoring FDA requirements. advice, work with, and assist FDA on selection, licensing, revocation of license of health facilities, e.g. hospitals and Botika ng Bayan. Recommended staffing requirement: 8 organic staff Finance & · Limited number of plantilla or organic Current situation has been Administration staff, which then resulted in (i) several key affecting: functions being performed through Job work performance – limited Orders or contractual staff, (ii) core team efficiency and effectiveness to Finance doing multi-tasks that causes work deliver results Division overload, or (iii) use of Admin Division designated/seconded staff from other staff motivation – lessened offices. interest, possible burn out · Need to improve physical office structure and work areas/spaces work relationship and · Need to improve IT infrastructure, dynamics – tendency to availability of basic software, and presence compare work with others, of IT infrastructure support and noted lack of equity in maintenance. workload Recommendations: work demeanor – created · Continue with teamwork; anxieties over security of · Urgent to finalize the structure to guide tenure work and functions, determine salary grade, and provide staff training and The MOH Strategic Plan development to develop and/or should be able to take on enhance competencies required by the these recommendations, job; particularly big-ticket items World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 32 Respondents’ Participants’ feedback & recommendations Observations & analysis of office consultants · Provide concrete solutions to improve requiring substantial budget physical work environment and IT- such as improvements of related issues. physical offices and IT infrastructure and other IT- Staffing requirements: related concerns. Finance Division Retain current 3 sections on Accounting, Specific to recommended Budget, and Management staffing requirements, these Increase the number of organic staff for need to be studied, analyzed, these 3 sections from 11 to 22 persons. and confirmed further, based Add Cashier as another section, with its on all other information current 7 staff. gathered. Admin Division Create three new offices: Procurement Service to provide logistics, secretariat and documentation support to BAC on procurement for major infrastructure, goods and services. Supply Chain Management unit or division to look after concerns on asset management, inventory management, managing facilities, logistics and to coordinate with MOH offices. Quality Management – to provide overall quality assurance and ensure and monitor compliance with QA systems. Staffing requirements: total of 64 organic staff (Office of Admin Chief – 5, Procurement Service – 5, Supply Chain Management – 15 if unit or 25 if division, Personnel/HR – 20, Records – 6, General Services – 10, QM – 3) World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 33 ANNEX C Presentation slides used for the Validation Meeting with MOH Please see attached separate file labelled ANNEX C ANNEX D Functional descriptions of the major offices in the MOH structure 1. OFFICE OF THE MINISTER OF HEALTH Offices Functions 1.00 OFFICE OF THE MINISTER OF HEALTH 1.10 Office of the Chief of Staff a. Manages the resolution of issues that is brought to the Office of the Minister; b. Organizes the different technical and operational coordination processes of the MOH; c. Provides the Minister with technical (health-related), strategic and management advice; d. Advise the President on matters related to education; 1.20 Health International Cooperation Division a. Develops and implements frameworks, policies, guidelines, standards and protocols on partnership, resource generation and mobilization, and networking with stakeholders including but not limited to bilateral or multilateral agreements and pledges of commitment b. Provide recommendations for the setting of international cooperation agenda aligned with the thrusts and direction of the Ministry and BARMM- wide priorities and programs. c. Manage and coordinate with relevant offices the compliance and completion of the Ministry’s commitment to partners, both local and international entities. d. Enhance the Ministry’s cooperation and participation in international cooperation programs in health that would benefit and support BARMM’s health priorities and agenda. e. Develop program proposals for consideration of donor partners f. Develop implementation guidelines of programs/activities funded by donor partners World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 34 Offices Functions g. Monitor all major ongoing programs and projects, and evaluate completed ones for the purpose of policy formulation, proposal development, and program design and implementation h. Coordinate visits of dignitaries and delegates from partner agencies or other countries 1.30 Legal and Legislative Liaison Unit a. Provide legal advice to the Ministry b. Interpret laws and rules affecting the operations of the Ministry c. Prepare contracts and instruments to which the Ministry is a party d. Interpret provisions of contracts covering work performed for the Ministry by private entities e. Assist in the promulgation of rules governing the activities of the Ministry f. Answer legal queries from the public g. Develops and recommend to the Minister legislative agenda of the Ministry and of health sector h. Drafts legislations for health i. Prepares comments and position papers on proposed legislation on health or with implications on health j. Liaises with the legislative committees on health and with legislative units on their concerns related to health 1.40 Public and Media Relations Office a. Provides strategies and technical advice on publicity campaigns related to positioning the image of the MOH in the general public and in special interest groups; b. Produces information packages and manages press releases, inquiries from the public, the press, social media c. Monitors and analyses image perceptions and feedback about the MOH and its officials and provide necessary response strategies to these; 1.50 Health Emergencies Management Services a. Leads the coordination of response and usage/sharing of resources in cases of health emergencies as well as incidents with potential of becoming an emergency. b. Mobilizes technical experts, health response teams and logistics needed in case of health emergencies. c. Maintains updated information on emergencies, and coordinates the same to relevant agencies, subject to set protocol. d. Facilitates and maintains efficient communication between and among concerned agencies to ensure coordinated and immediate response to health emergencies. e. Leads in the development of health management plan and protocol in view of potential disasters and emergencies. f. Designs, develops, install and continuously improves systems, process and standards for ensuring health emergency preparedness and response. g. Provides technical assistance and advisory service in developing programs and plans for health emergency preparedness World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 35 Offices Functions 1.6 Internal Control Unit a. Assures alignment of organization's objectives in operational effectiveness and efficiency, reliable financial reporting, and compliance with laws, regulations and policies b. Assist management in achieving effective and efficient fiscal administration and performance through the conduct of appraisal of procedures as to efficiency or adequacy, appraisal of personnel efficiency, analysis of financial operations, compliance to accounting procedures, regulations and Ministry policies, special investigation and assistance as necessary. 1.7 Health Information and Technology Service a. Formulates plans, policies, programs and standards for systems & process improvement, systems and software development; b. Establishes and maintains information and communication technology (ICT) solutions including related security requirements and management of data, information and knowledge sources and systems; c. Conducts systems & process engineering, software development, software configuration management; d. Develops and manages the MOH corporate database, datawarehouse, other health information resources, library services and document management and archiving services; e. Develops and manages the MOH ICT infrastructure and provide ICT related- services to the MOH including computer networking and voice communications services and data exchange; f. Coordinates and works with various MOH offices, other BARMM and national government agencies and health partners on eHealth and health data/information/ knowledge management and in the implementation of the eGovernment Master Plan and the Philippine Digital Strategy ; and g. Advises the Minister of Health on matters pertaining to information and knowledge management systems and services, and ICT-related services. 1.8 Attached Agencies 1.8.1 Commission on Population a. Leads the development, promotion, and implementation of plans, policies and programs related to population. b. Coordinates and monitors implementation of plans, policies and programs related to population with appropriate agencies. c. Provide capacity building activities and technical assistance to delivery partners through training, coaching, and other skills building opportunities, to ensure effective implementation of programs and activities. d. Establishes and maintains strong networks and linkages of stakeholders, including but not limited to local government units, interested private entities, and international development agencies. 1.8.2 Regional Nutrition Council World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 36 Offices Functions a. Leads the formulation, promotion, and implementation of food and nutrition policies, plans and programs. b. Coordinates and monitors implementation of food and nutrition plans, policies and programs. c. Provide capacity building activities and technical assistance to delivery partners through training, coaching, and other skills building opportunities, to ensure effective implementation of programs and activities. d. Establishes and maintains strong networks and linkages of stakeholders, including but not limited to local government units, interested private entities, and international development agencies. 2. OFFICE OF THE SECRETARY GENERAL Offices Functions 2.00 OFFICE OF THE SECRETARY GENERAL General Office Functions: a. Provides integration and ensures alignment in the design, delivery, evaluation of plans, programs and policy implementation. b. Translates executive policies and priorities into operational processes to deliver results; ensures alignment of these to the organizational key result areas, mission, mandates and target outcomes. c. Provides mission-critical data and information to the Office of the Minister. d. Provides pertinent data and information from the Office of Minister and attached agencies, including external stakeholders to the entire organization. e. Provides management supervision to the direct reports, including necessary coaching and mentoring. 3. OFFICE OF THE PUBLIC HEALTH BUREAU Offices Functions 3.00 PUBLIC HEALTH BUREAU General Office Functions: Promotes and ensures the general health and wellbeing of the public through the development, implementation and monitoring of plans, programs, and policies that prevent, control, and eliminate diseases and outbreaks, and through advocacies and campaigns that raise awareness on health issues, risk factors, and access to health services and programs. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 37 Offices Functions The Key Results Areas (KRAs) are: • KRA 1: Disease Prevention and Control • KRA 2: Epidemiology and Health Surveillance • KRA 3: Health Promotion and Campaigns • KRA 4: Systems Installation and Standard Setting • KRA 5: Program Management 3.10 Office of the Director 3.20 Disease Prevention & Control Division a. Leads in developing, designing, and monitoring policies, plans, programs and activities for the prevention, control and elimination of communicable and non-communicable diseases, and the promotion of family and mental health in BARMM. b. Designs, develops, install, and continuously improves system, processes, and standards that shall define and guide the development, implementation, monitoring and implementation of plans, programs, and activities related to prevention, control, and elimination of diseases in BARMM c. Coordinates and collaborates with implementing units tasked to carry out the programs and activities in the field d. Support implementation of health programs and activities by ensuring ensures availability of and access to allocated resources, and by providing technical assistance and other capability building opportunities to implementing units to ensure effective implementation of programs. e. Monitor progress of implementation, and where warranted, calibrate plans, program implementation design, and infuse new resources, based on results of monitoring activities. 3.2.1 Office of the Division Chief 3.2.2 Communicable Disease Section i. Develops policies, standards, and guidelines for the prevention, control, and elimination of communicable diseases. ii. Develops plans, programs, and projects to carry out preventive and control strategies against communicable diseases. iii. Provide technical assistance to strengthen the capacity of the provincial health offices and city health offices and all personnel involved in the implementations of plans, programs, and projects on communicable diseases. iv. Conducts progress monitoring of plans, programs and projects being implemented to prevent, control, and eliminate communicable diseases. 3.2.3 Non-communicable Disease Section i. Develops policies, standards, and guidelines for the prevention, control, and elimination of essential non-communicable diseases. ii. Develops plans, programs, and projects to carry out preventive and control strategies against essential non-communicable diseases. iii. Provide technical assistance to strengthen the capacity of the provincial health offices and city health offices and all personnel World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 38 Offices Functions involved in the implementations of plans, programs, and projects on essential non-communicable diseases. iv. Conducts progress monitoring of plans, programs and projects being implemented to prevent, control, and eliminate essential non- communicable diseases. 3.2.4 Family Health Section i. Develops policies, standards, and guidelines for the promotion of family health. ii. Develops plans, programs, and projects that focus attention on and promotes support for family health. iii. Provide technical assistance to strengthen the capacity of the provincial health offices and city health offices and all personnel involved in the implementations of plans, programs, and projects on family health. iv. Conducts progress monitoring of plans, programs and projects being implemented related to family health. 3.2.5 Mental Health Section i. Develops policies, standards, and guidelines for the promotion of mental health. ii. Develops plans, programs, and projects that focus attention on and promotes support for mental health. iii. Provide technical assistance to strengthen the capacity of the provincial health offices and city health offices and all personnel involved in the implementations of plans, programs, and projects on mental health. iv. Conducts progress monitoring of plans, programs and projects being implemented related to mental health. 3.2.6 Environment and Occupational Health Section i. Develops policies, standards, and guidelines for the prevention, control, and elimination of environmental-related and occupational diseases. ii. Develops plans, programs, and projects to carry out preventive and control strategies against environment-related and occupational diseases. iii. Provide technical assistance to strengthen the capacity of the provincial health offices and city health offices and all personnel involved in the implementations of plans, programs, and projects on essential environment-related and occupational diseases. iv. Conducts progress monitoring of plans, programs and projects being implemented to prevent, control, and eliminate environment-related and occupational diseases. 3.2.7 Health Information and Promotion Section i. Develops strategic communication plan and health promotion campaign and activities in support of the implementation of major programs and health priorities of the Ministry. ii. Designs, develops, install, and continuously improves system, processes, and standards that shall define and guide the designing, World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 39 Offices Functions implementation, and monitoring and evaluation of health promotion campaigns and activities. iii. Designs and produces information and education campaign materials for various health campaigns. iv. Provides technical assistance and other capability building opportunities to units and personnel at provincial and city health offices responsible for carrying out health promotion campaigns and activities. v. Provides technical expertise in communication planning and creative materials development. vi. Facilitates and monitors media placement in various formats (television, print, radio, social media, outdoor advertising). 3.30 Epidemiology Division a. Leads the collection and analysis of health data, and undertakes surveillance of notifiable diseases, and ensures timely dissemination of health information to relevant stakeholders as necessary input to management decision, planning and program development and implementation, and resource mobilization, or emergency response. b. Investigates disease outbreaks and other threats to public health, in partnership and collaboration with the Health Emergencies Management Division, and relays findings to appropriate units to ensure coordinated and immediate response. c. Designs, develops, install, and continuously improves system, processes, and standards that shall define and guide the collection, investigation, analysis, dissemination of health data and information. d. Builds and maintains a network of public health laboratories to facilitate epidemiological and surveillance activities. e. Provides technical assistance and other capability building opportunities to units and personnel responsible for carrying out epidemiological and surveillance activities. 3.3.1 Office of the Division Chief 3.3.2 Field Health Service Information Section i. Develops, installs, and maintains process, standards, and tools that facilitate for the systematic documentation, consolidation, and reporting of epidemiological data as collected by field epidemiology units of the PHOs and CHOs. ii. Maintains the facility and technology infrastructure iii. Provides technical assistance to all users of the FHSIS system. 3.3.3 Surveillance Section i. Oversees surveillance of notifiable diseases through the field surveillance personnel at the PHOs and CHOs. ii. Develops, installs, and continuously improves process, tools, and guidelines that promotes efficient and effective data gathering, consolidation, analysis, and reporting. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 40 Offices Functions iii. Develops and implements plans, programs and projects that will ensure the MOH readiness and capacity for surveillance, and in collaboration with HEMS, capacity for urgent response in cases of outbreaks. iv. Provide technical assistance and advisory service to units and field personnel engaged in data gathering, analysis, and reporting of epidemiological data. 4. OFFICE OF HEALTH SYSTEMS BUREAU Offices Functions 4.00 HEALTH SYSTEMS BUREAU General Office Functions: Promotes access of the public to quality health care by ensuring that health programs that meet public needs are planned for and adequately funded, health policies developed and implemented are evidenced-based, health professionals are adequately competent to perform their roles, and health facilities are operating according to set standards. The Key Result Areas (KRAs) are: • KRA 1: Strategic and Operational Plans • KRA 2: Health Policies and Research • KRA 3: Organization and Sector M&E • KRA 4: Health Human Resource Development • KRA 5: Health Facilities Development • KRA 6: Health Regulation • KRA 7: Systems Installation and Standard Setting 4.10 Office of the Director 4.20 Policy Development & Planning Division a. Designs, develops, installs, and continuously improves the framework, system, processes and standards for planning, research, and policy development of the Ministry, ensuring coordination and complementation across these three distinct but related management functions. b. Provides the Ministry with efficient and effective technical services relating to strategic and operation planning, program development, policy formulation and enhancement, and research coordination and management. 4.2.1 Office of the Division Chief 4.2.2 Planning Section i. Leads the strategic planning processes for the Ministry, especially in defining organization and health sector-wide goals, targets, and World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 41 Offices Functions strategies and in ensuring alignment with and support to BARMM- wide priorities and programs. ii. Provides guidelines and technical assistance in the preparation of annual operational plans of the various units at all levels of the organization; and reviews and consolidates the same to ensure alignment and complementation of plans, budgets, and other resources. iii. Designs, develops, installs and continuously improves the system, processes, and standards for strategic and operational planning. iv. Prepares MOH annual plan and budget in collaboration with Finance Division. v. Provides technical support and services to executive and/or management committees for concerns related to plans and budget preparation. 4.2.3 Policy Development Section i. Leads in the formulation of policy agenda for the ministry and the sector, especially ensuring alignment with the Ministry’s and BARMM-wide priorities and programs. ii. Serves as clearing house for all policies pertaining to organizational or program concerns. iii. Designs, develops, installs and continuously improves the system, processes, and standards for policy analysis, formulation, adoption, monitoring and evaluation. iv. Provides guidelines and technical assistance in the analysis and formulation of policies. v. Provides technical support and services to executive and/or management committees for concerns related to policy analysis and formulation. 4.2.4 Research Section i. Leads in the formulation of research agenda for the ministry and the sector, especially ensuring alignment with the Ministry’s and BARMM-wide priorities and programs. ii. Serves as clearing house for all research to be undertaken using funding from the Ministry or from external sources that have been entrusted to the Ministry. iii. Designs, develops, installs and continuously improves the system, processes, and standards for research management. iv. Undertake and oversee conduct of health research, and where necessary provide technical assistance to offices or personnel within the Ministry, or at the PHOs and CHOs undertaking research. v. Establishes and maintains linkages with organizations that promote and support conduct of health research for purposes of collaboration, information sharing. 4.30 Health Human Resources Development Division World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 42 Offices Functions a. Develops, designs and implements policies, programs, and activities that will improve the technical and leadership competencies of all health professionals in BARMM b. Designs, installs and continuously improve system, process, and standards that define the manner by which learning and development of health professionals of MOH and the public health sector shall be determined, conducted, monitored and evaluated. c. Develops competency frameworks (core, leadership, and technical) that shall guide and harmonize the learning and development initiatives and programs for all health professionals in BARMM. d. Undertakes research that shall provide input in planning, developing, and implementing professional development programs of health professionals. e. Recommends human resource development policies and standards that will promote and prioritize the upskilling of health professionals f. Provides technical assistance to MOH units conducting learning and development activities, and quality assures their program design and implementation; g. Manage scholarship programs and professional development support initiated by MOH or through funding of external partners. h. Build and maintain a network of reputable learning service providers that can be tapped to deliver training and coaching programs for MOH and sector personnel. 4.40 Health Performance Monitoring Division a. Leads in monitoring and evaluating the over-all performance of the Ministry and of the health sector against goals and targets; b. Designs, develops, installs and continuously improves the system, processes, and standards for monitoring and evaluation for the Ministry and for the health sector; c. Prepares sector-wide reports on the Ministry’s progress in its short-term and long-term plans as well as in the implementation of major health programs and initiatives; d. Provides inputs in policy development, planning, program development and implementation, and research priorities based on M&E results; e. Provides technical assistance and other capability building opportunities to units and personnel assisting in monitoring activities. 4.50 Health Regulation Division a. Designs, develops, installs, and continuously improves the system, process and standards for monitoring compliance, issuance and revocation of licenses and accreditation of health facilities and pharmacies. b. Issues licenses to operate to hospitals and other health facilities that meet the standards set by the Ministry. c. Monitors licensing compliance of both private and public health facilities d. Provide technical assistance, consultation, and advisory services to stakeholders regarding health facilities and services regulations. e. Acts on complaints and other concerns against hospital or other health facilities. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 43 Offices Functions 4.5.1 Office of the Division Chief 4.5.2 Licensing and Accreditation Section i. Evaluate and act on application for licensing and accreditation and permit to construct ii. Designs, develops, implements, and continuously improves system, process and standards for licensing and accreditation. 4.5.3 Quality Assurance & Monitoring Section i. Conducts inspection of hospitals and health facilities for monitoring of compliance to set standards. ii. Provide technical assistance, consultation and advisory services to stakeholders regarding health facilities and services regulations. iii. Conducts investigation on complaints lodge against health facilities and services; documents process and result, and transmits recommendation to the Health Regulations Division for appropriate action. iv. Designs, develops, implements, and continuously improves system, process and standards for quality assurance and monitoring of hospitals and other health facilities. 4.60 Health Facilities Development Division a. Develops plans, policies, and technical standards for health facility planning, design, operation, maintenance, and enhancement. b. Leads in developing master plan for health infrastructure and equipment for the entire BARMM, with inputs and participation from CHOs/PHOs and other MOH units, and monitors implementation of the same. c. Prepares site development plans, and oversees and coordinates health infrastructure projects. d. Prepares document for infrastructure and equipment procurement and coordinates the same to the Procurement Service Unit. e. Evaluates infrastructure designs and equipment proposals guided by approved technical standards and plans. f. Provides technical assistance and advisory services on health facility design, development, planning, implementation, operation, standards and maintenance. 4.6.1 Office of the Division Chief 4.6.2 Planning & Design Section i. Develops and updates technical standards on health facility design and operation and building and equipment maintenance ii. Provide technical assistance or advisory services to stakeholders on planning and design of health facilities and equipment requirements 4.6.3 Infrastructure and Equipment Section i. Prepares site development plans, and oversees, coordinates and monitors health infrastructure projects World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 44 Offices Functions ii. Coordinates master plan for infrastructure and equipment with CHOs, PHOs, and other stakeholders, including but not limited to local government units, funding partners. iii. Review and evaluate infrastructure designs and equipment proposals vis-à-vis set standards, and submit the result to the Division Chief for appropriate action. iv. Serve as clearing house for all plans and planned procurement of equipment and enhancement and/or development of infrastructure. 5. OFFICE OF FIELD OPERATIONS BUREAU Offices Functions 5..00 FIELD OPERATIONS BUREAU General Office Functions: ▪ Provides oversight supervision, technical support and project management support to the implementation of health policies and systems and public health programs in BARMM provinces and cities. ▪ Monitors and reports on progress and status of field operations in BARMM provinces and cities. ▪ Provides support in coordinating with all relevant stakeholders involved in the implementation of health programs and services and research activities in BARMM provinces and cities ▪ Provides technical support and assistance in assessing health needs in BARMM provinces and cities, including, if appropriate the drafting of plans, updates including reports on progress, system review and operational management related to formulation of program policies and implementation procedures. ▪ Ensures compliance with all the health policy and regulatory requirements The Key Result Areas (KRAs) are: • KRA 1: Capacity Building for Health Offices • KRA 2: Implementation Monitoring of Key Program and Policies • KRA 3: Technical Assistance and Advisory 5.10 Office of the Director 5.20 Local Health Systems Division a. Coordinates with the Health Policy Bureau and the Public Health Bureau in cascading, managing, and monitoring the implementation of health policies, systems, guidelines at the Provincial, City, Municipal, and Barangay level through its various offices and instrumentalities World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 45 Offices Functions b. Identifies and implements continuous improvements in the application of health policy and systems to further suit local conditions, needs and requirements of BARMM c. Identifies and develops additional local health policy and systems for more effective implementation of health service and programs and better service the needs of communities. This can be in the areas of inter-local health zone referral systems and resource sharing. 5.30 Provincial Health Offices a. Overall responsible for the planning, implementation, and monitoring of health programs and services that are geared towards and with priority focus on the preventive-side of health delivery. b. Oversight supervision on the implementation, monitoring and reporting on Provincial Epidemiology Surveillance activities within the province. c. Coordinates with hospitals and other health facilities such as Rural Health Units and Barangay Health Stations on the implementation of health systems and programs in municipalities and barangays within its geographical area. d. Coordinates with provincial hospitals and other health facilities on the implementation of health systems and programs in the province, municipalities and barangays not covered by CHOs. e. Monitors the adherence of relevant health facility and organizations within its jurisdiction to the program IRR, policies and objectives of the BARMM MOH. f. Oversees the implementation of programs led by technical Bureaus that include policies, regulations, Health Emergency and Surveillance, and training requirements and guidance, and provide the necessary support to coordinate with, inform and monitor, if required, general hospital operations in relation to public health services in BARMM. 5.40 City Health Offices World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 46 Offices Functions a. Overall responsible for the planning, implementation, and monitoring of health programs and services that are geared towards and with priority focus on the preventive-side of health delivery. b. Oversight supervision on the implementation, monitoring and reporting on City Epidemiology Surveillance activities within the city. c. Coordinates with hospitals and other health facilities such as City (Rural) Health Units and Barangay Health Stations on the implementation of health systems and programs in municipalities and barangays within its geographical area. d. Monitors the adherence of relevant health facility and organizations within its jurisdiction to the program IRR, policies and objectives of the BARMM MOH. e. Oversees the implementation of programs led by technical Bureaus that include policies, regulations, Health Emergency and Surveillance, and training requirements and guidance, and provide the necessary support to coordinate with, inform and monitor, if required, general hospital operations in relation to public health services in BARMM. 5.50 Hospital Monitoring Service a. Overall responsible for the planning, implementation, and monitoring of health programs and services that are geared towards and with priority focus on the curative-side of health delivery. b. Exercises oversight responsibility of all private and other public hospital operations within BARMM areas to ensure their compliance with government mandates, policies and regulations for hospitals. c. Coordinates with Provincial Health Offices and City Health Offices within BARMM on the implementation of health systems and programs within BARMM areas, and provide the necessary support to coordinate, inform and monitor the status of public health service delivery in BARMM. 5.60 Pharmacy Quality Assurance Division a. Develops and plans education awareness and advocacy campaigns. b. Oversees implementation of pharma activities such as education campaign -rationale use of medicine, generic, misuse of anti-biotics, and conduct lectures on these matters in the field c. Monitors status of medicines procured and distributed in health facilities, e.g. their storage, potency, expiration. d. Provides technical assistance to Botika ng Bayan such as recommending action to take for expired medicines e. Supervises public health policy staff at IPHOs, in so far as FDA requirements are concern. f. Provides QA on us of e-medicines system g. Reports to FDA status of pharmacies and Botika ng Bayan and recommend necessary actions to take. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 47 6. OFFICE THE FINANCE AND ADMINISTRATION BUREAU Offices Functions 6.00 FINANCE AND ADMINISTRATION BUREAU General Office Functions: ▪ Ensures efficient administrative and financial management systems are developed and implemented to provide stability, credence and integrity to the overall operations of the Ministry of Health. ▪ Ensures that the Ministry has the necessary resources such as people, budget, facilities and equipment to operate and achieve its mandated objectives and that these resources are properly and efficiently used and accounted for. ▪ Provides overall quality assurance and continuous improvements on the administrative and financial business processes in support of the planning, implementation, monitoring, and evaluation of health programs and projects. ▪ Implements and monitors compliance on good governance practices and requirements by Government The Key Result Areas (KRAs) are: • KRA 1: Institutional Capacity Building • KRA 2: Systems Installation and Standard Setting • KRA 3: Operations Management 6.10 Office of the Director 6.20 Finance Division a. Ensures the soundness, adequacy and application of accounting, financial and management controls and promote the most effective control at reasonable cost. b. Monitors adherence to and use of required financial rules, guidelines and regulation by all MOH personnel. c. Provides technical assistance on the adoption and application of internal controls systems and procedures in all operating units, health program and services. d. Ensures compliance with the government mandate, policies, regulations, established objectives, systems, procedures and processes on accounting and financial management. 6.2.1 Office of the Division Chief 6.2.2 Accounting Section i. Maintains, improves, updates and implements accounting policies, rules, systems, guidelines and regulations and activities, in accordance with existing audit and accounting policies of the Government. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 48 Offices Functions ii. Ensures proper, complete, accurate, recording of all financial transactions, including receipts of revenues and disbursements. iii. Ensures proper identification, installation and use of charts of accounts, consistent operations and implementation of health programs and services iv. Keeps all financial and accounting records and documents v. Prepares the standard financial reports required for BARMM MOH and by Government vi. Ensures compliance with the government mandate, policies, regulations, established objectives, systems, procedures and processes on accounting and financial management. vii. Provides technical assistance on the adoption and application of internal controls systems and procedures in all operating units, health program and services. 6.2.3 Budget Section i. Ensures the preparation of consolidated annual Budget Plan of the BARMM MOH and its submission to the Budget Department. ii. Provides technical assistance and guidance in preparing budgets to MOH programs, operation and technical units for the implementation of their health projects and activities iii. Formulates and ensures adherence of all MOH offices and programs to an efficient budgetary system, methods and procedures. iv. Coordinates with, monitors and provides technical assistance to MOH offices in the implementation and execution of their budget. v. Provides technical assistance on the adoption and application of internal controls systems and procedures in all operating units, health program and services. vi. Manages, records and controls fund allocations of MOH offices and programs, based on approved budget policy and plans, and communicate their status and budget performance to respective MOH offices and programs. vii. Provide top management with periodic reports and technical advice on budget-related matters 6.2.4 Management Section i. Provides technical assistance in formulating and implementing the financial management system and procedures, including on planning and monitoring the Ministry’s financial resources to hel p achieve BARMM MOH overall goals. ii. Monitors adherence to and implementation of established financial management system, guidelines and procedures by all Ministry offices, units, personnel and staff and by those involved in implementation of health program and services in BARMM provinces and cities. iii. Provides technical assistance on the adoption and application of internal controls systems and procedures in all operating units, health program and services. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 49 Offices Functions 6.2.5 Cashier Section i. Develops and implements an efficient and effective system, guidelines and procedures for providing cashiering services to MOH administrative operations and management. ii. Ensures that implementation of cashiering functions from payment processing either in the form of cash or checks and in managing cash box or registers, are error-free, accurate, complete and efficient. iii. Manages and maintains optimal cash balance and promptly process and issue checks for payment of authorized financial obligations. iv. Ensures effective control and monitoring of cash advances, disbursement , collections, deposit and daily balances of Notice of Cash Allocations. v. Manages and maintains complete, accurate and updated record of all payment transactions, such cash receipts, deposits, disbursement, cash advances and checks of funds of MOH. vi. Ensures that all payment documentation and other supporting file are kept safe vii. Provides technical assistance on the adoption and application of internal controls systems and procedures in cashiering functions and activities in all operating units, health program and services. viii. Verifies and ensures the correctness of requests for funds and budget releases and the completeness of supporting documents attached to vouchers, payroll and other payments of obligations that have been authorized for payment before checks are issued for payments; 6.30 Administrative Division a. Plans, implements, monitors, and ensures continuous improvements on administrative services to support the effective implementation of health programs and services. This includes general services, central filing and recording, payroll, personnel records keeping, compliance and administrative discipline, security and safety, and other similar duties b. Develops and plans a comprehensive Quality Management Systems for managing and implementing policies, processes and procedures that encompasses the inter-dependence and inter-link between and among different management, operating, administrative, and technical sections of BARMM MOH to enable them to effectively plan and execute MOH health programs and services that will then enable MOH to achieve its goals. c. Ensures availability of updated Quality Systems Manual (or Administrative and Financial Operations Manual) for the BARMM Ministry of Health. d. Develops and implements a robust system to promote effective coordination, communication, and interaction between and among different staff and personnel in the MOH and among those involved in the implementation of health programs and services in BARMM provinces and cities. 6.3.1 Office of the Division Chief World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 50 Offices Functions 6.3.2 Personnel Section i. Ensures that all mandated provisions are implemented and provided to all personnel such as on salary, leave benefits and other entitlements, health and medical coverage, social costs. ii. Coordinates with concerned offices such as BIR, GSIS, PAGIBIG, PHILHEALTH , CES Board, CSC and other relevant agencies on the implementation of guidelines, and regulations relevant to personnel; iii. Administers personnel actions related to selection and placement, classification and pay, career and employment development, performance rating, employee relations and welfare services including processing claims for retirement/separation and terminal leave benefits; iv. Manages and maintains complete, accurate, and updated records and database of all MOH personnel v. Manages and monitors all matters concerning attendance, leave of absence, personnel movements (e.g. transfers, details, reassignments, reinstatements and separation from the service) and other pertinent personnel transactions. vi. Ensures that all personnel issues, concerns and grievances are heard, considered, and addressed in timely, practical and appropriate manner. vii. Ensures the application of due process in addressing all personnel issues, concerns and grievance, in accordance with the process and procedures required by law and the Civil Service Commission. viii. Administers and monitor personnel actions related to selection and placement, classification and pay, career and employment development, performance rating, employee relations and welfare services including processing claims for retirement/separation and terminal leave benefits. ix. Manages, maintains, and ensures updated and complete personnel masterlist, vouchers and payrolls for payment of salaries, benefits and services of regular and non-permanent employees/contracts of service, x. Monitors and ensures updated, complete and timely remittances of contributions to appropriate government offices (GSIS, PAGIBIG, Philhealth, BIR, Provident Fund and payments for loans and other deductions). 6.3.3 Records Section i. Develops, maintains, implements and provides continuous improvements on the policy, system, guidelines and procedures for record management, including the creation, maintenance, use , safekeeping, and disposition of records, in accordance with government rules, regulations and laws. ii. Manages and maintains complete, accurate, and updated database of files, records and documents. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 51 Offices Functions iii. Manages, maintains, and provides adequate, orderly, efficient, effective, and economical system for storage and documentation of all records received and released to concerned offices and requesting parties. iv. Manages, monitors, and ensures safety and confidentiality of personnel files and other records in its custody and safekeeping, including files on legal proceedings and decision on administrative cases and other legal matters. v. Provides technical assistance and guidance to all personnel, offices and programs on the proper use and application of the record management systems and protocol, particularly filing and safekeeping. vi. Manages and implements an efficient system for receiving, releasing, disseminating and distributing all official communication, and correspondence to different MOH offices and programs. 6.3.4 General Services i. Manages and provides an overall efficient, effective, and economical support services system such as on housekeeping, motor pool, security for MOH offices and personnel. ii. Manages upkeep and cleanliness of office and work areas and looks after minor repairs and maintenance in offices and workstations, to ensure safe, clean, and comfortable work environment of MOH staff and personnel. iii. Provides office logistics support such as driving and minor errands, as may be required. iv. Manages and ensures availability of security and safety services for the MOH offices and personnel. v. Manages and ensures adherence to and implementation of government policies, laws, guidelines, rules and regulation pertaining to Building Code of the Philippines, Clean Air Act, Waste Management, Clean and Green Program, Occupational Safety and Health, rules on the proper use of government vehicles and among other pertinent laws, rules and regulations on both national and local. 6.3.5 Institutional Development and HRM Formulates strategic approaches to effectively management MOH personnel work performance, their needs and expectations to enable them to be part of and contribute to achieving the Ministry’s goals. 6.3.5.1 Staff Recruitment, Selection and Placement Unit o Develops, maintains, and implements efficient recruitment and selection systems, guidelines and procedures for BARMM MOH, and undertakes continuous improvements thereabout, World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 52 Offices Functions in accordance with mandated provisions and principles of the Civil Code and qualification standards set by Government. o Develops and implements an overall Recruitment Plan for BARMM MOH, based on the approved organizational structure and staffing pattern. o Develops the job and person specifications for positions required by individual units, programs and services, and the documentation necessary to start the recruitment process. o Manages the recruitment process, from selection up to the employment, deployment and orientation of new staff. 6.3.5.2 Staff Performance Management Unit o Develops, maintains, and implements an efficient and effective performance management system that innovative mechanism and tools to guide and encourage good performance, in coordination with all units and offices and based on the principles espoused under the Strategic Performance Management System (SPMS). o Manages and coordinates with respective units and offices the conduct of staff performance assessment focused in carrying out their assigned responsibilities and in determining factors that affect work delivery and behavior. o Provides support and monitor the implementation of agreed performance management measures to enable staff and personnel to meet performance commitments. 6.3.5.3 Quality Management Unit o Develops and plans a comprehensive Quality Management Systems for managing and implementing policies, processes and procedures that encompasses the inter-dependence and inter-link between and among different management, operating, administrative, and technical sections of BARMM MOH to enable them to effectively plan and execute MOH health programs and services that will then enable MOH to achieve its goals. o Develops and implements a robust system to promote effective coordination, communication, and interactional pattern between and among different offices and personnel in the MOH and among those involved in the implementation of health programs and services in BARMM provinces and cities. o Monitors, reports, and introduces continuous improvements in the QSM system, where needed. o Considers and recommends improvements in the adoption and application of internal controls systems and procedures in QSM functions and activities in all operating units, health program and services. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 53 Offices Functions 6.40 Supply Chain Management Division a. Develops, maintains and implements appropriate and practical policy, regulations, system, guidelines and procedures for an effective Supply Chain Management for BARMM MOH, in accordance with relevant Government mandates and provisions and to help achieve t he Ministry’s goal. b. Establishes, maintains, implements an efficient and effective Logistics Support System to all units and offices of BARMM MOH and to those involved in the implementation of health programs and services in BARMM provinces and cities, and ensure continuous improvements of the Logistics Support System is made, at appropriate times. c. Provides technical assistance on the adoption and application of internal controls systems and procedures in all operating units, health program and services. 6.4.1 Office of the Division Chief 6.4.2 Facility and Asset Management Section i. Develops, plans, maintains, updates and implements an efficient and effective system, guidelines and procedures for the acquisition, utilization, acceptance, managing, maintenance and disposal of BARMM MOH facilities and assets such as warehouses, hospitals and office and hospital furniture, fixtures and equipment, in accordance with government policy, rules and regulation. ii. Monitors and provides quality assurance on the implementation and application of the Asset Management Systems, and introduce continuous improvements, where needed. iii. Manages and maintains an updated, complete, and accurate database on the profiles and status of all MOH facilities and assets, to guide decisions and requirements for repairs and maintenance, replacement, or disposal. iv. Provides technical assistance to individuals and unit/office of MOH and health facilities in the provinces and cities in BARMM to develop their capacities to undertake facility and asset management in their geographical areas. v. Monitors adherence and application of guidelines and procedure by all personnel, staff, and units of MOH and those involved in the implementation of health programs and services in BARMM provinces and cities vi. Recommends innovations to facility and asset management systems that have bearing on overall health operations, delivery of health program and services, in the most effective and economical way. vii. Identifies and develops a clear system and procedure for the pre- qualifications of potential suppliers and service providers, in accordance with the policy, guidelines, regulations and other legal provision of RA 9184 (Government Procurement Law). viii. Provides technical assistance on the adoption and application of internal controls systems and procedures in all operating units, health program and services. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 54 Offices Functions 6.4.3 Inventory Management Section i. Develops, plans, maintains, updates and implements an efficient and effective inventory management system, guidelines and procedures for BARMM MOH, in accordance with Government-related policy and regulation and to support the achievement of MOH goals. ii. Identifies and develops a clear system for the pre-qualifications of potential suppliers and service providers, in accordance with the BARMM and national policy, guidelines, regulations and other legal provision; iii. Manages, maintain, and monitors the updated database and records of stock to guide requirements for requisition, procurement, replenishment, disposal, and storage of commonly-used supplies and materials. iv. Provides technical assistance on the adoption and application of internal controls systems and procedures on inventory management in all operating units, health program and services. 6.4.4 Procurement and Logistics Section i. Develops, plans, maintains, updates and implements an efficient and effective system, guidelines and procedures for managing procurement and logistics support to BARMM MOH personnel and staff, and to those involved in the delivery of health program and services in BARMM provinces and cities, in accordance with government policy, rules and regulation. ii. Identifies and develops a clear system and procedure for the pre- qualifications of potential suppliers and service providers, in accordance with the policy, guidelines, regulations and other legal provision of RA 9184 (Government Procurement Law). iii. Manages, monitors and implements an efficient, effective and economical systems on the receipt and delivery of supplies and materials for MOH staff and personnel and for health programs and services. iv. Monitors and prepares report on status of procurement and logistics support and recommends innovations to procurement and logistics support to better support overall health operations, delivery of health program and services. v. Monitors, reviews and consolidates procurement requirements and requests of the different MOH offices for the acquisition and distribution of critical supplies, materials, equipment and electronic devices and to ensure effective utilization of resources. World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 55 ANNEX E Staffing pattern for the major offices in the MOH structure 1.0 Office of the Minister 55 1.1 Office of the Chief of Staff 12 1.2 Health International Cooperation Unit 4 1.3 Legal and Legislative Liaison Unit 4 1.4 Public and Media Relations Unit 4 1.5 Health Emergencies Management Services 20 1.6 Internal Control Unit 3 1.7 Health Information Technology Service 8 1.8 Attached Agencies 16 1.8.1 Commission on Population 8 1.8.2 Regional Nutrition Council 8 2.0 Office of the Bangsamoro Secretary General for Health 5 3.0 Office of the Public Health Bureau 85 3.1 Office of the Director 4 3.2 Disease Prevention and Control Division 71 3.2.1 Office of the Division Chief 2 3.2.2 Communicable Disease Section 16 3.2.3 Non-Communicable Disease Section 16 3.2.4 Family Health Section 16 3.2.5 Mental Health Section 10 3.2.6 Environment and Occupational Health Section 7 3.2.7 Health Information and Promotions Section 4 3.3 Epidemiology Division 10 3.3.1 Office of the Division Chief 2 3.3.2 Field Health Service Information System Section 3 3.3.3 Surveillance Section 5 4.0 Office of the Health Systems Bureau 98 4.1 Office of the Director 4 4.2 Policy Development and Planning Division 18 4.2.1 Office of the Division Chief 2 4.2.2 Planning Section 6 4.2.3 Policy Development Section 6 4.2.4 Research Section 4 4.3 Health Human Resource Development Division 18 4.4 Health Performance Monitoring Division 18 4.5 Health Regulations Division 24 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 56 4.5.1 Office of the Division Chief 2 4.5.2 Licensing and Accreditation 16 4.5.3 Quality Assurance and Monitoring Section 6 4.60 Health Facilities Development Division 22 4.6.1 Office of the Division Chief 2 4.6.2 Planning and Design Section 10 4.6.3 Infrastructure and Equipment Section 10 5.0 Office of the Field Operations Bureau 21 5.1 Office of the Director 4 5.2 Local Health Systems Division 6 5.3 Provincial Health Offices 5.4 City Health Offices 5.5 Hospital Monitoring Service 5 5.6 Pharmacy Quality Assurance Division 6 5.7 Hospitals 6.0 Office of the Finance and Administration Bureau 83 6.1 Office of the Director 4 6.2 Finance Division 29 6.2.1 Office of the Division Chief 2 6.2.2 Accounting Section 8 6.2.3 Budget Section 8 6.2.4 Management Section 4 6.2.5 Cashier Section 7 6.3 Administrative Division 29 6.3.1 Office of the Division Chief 2 6.3.2 Personnel Section 6 6.3.3 Records Section 6 6.3.4 General Services Section 8 6.3.5 Institutional Development and Human Resource 7 Management Section 6.4 Supply Chain Management Division 25 6.4.1 Office of the Division Chief 2 6.4.2 Facility and Asset Management Section 9 6.4.3 Inventory Management Section 5 6.4.4 Procurement and Logistics Section 9 TOTAL 363 World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 57 ANNEX F The Technical Assistance Team Ruth Rosario D. Gerochi, PhD Organization Development & Change Management Project Team Leader Maria Felda C. Alarkon Organization Diagnosis & Design Specialist Virginia Ongkiko Operations Specialist Philip Davies International Resource Person Health Sector Specialist World Bank Technical Assistance for MOH-BARMM: Structure Review & Enhancement 58