This third training was held with the approval of MOHS and under its leadership in collaboration with UNOPS. The two-day training was held in six batches in two parallel sessions per batch (with close to 80 participants per session) for 12 days.

To decide the participants for the current training, we reviewed the list of health staff who had already participated and gave priority to those who had not already done it, such as the newly inducted staff and those involved with fund management, for example financial clerks. Participants included State/Region, district/township public health officers and AIDS, TB and malaria national programme officers. Government accountants and financial personnel are already familiar with the government rules and regulations, but they should also know the Managed Cash Flow SOPs developed in collaboration with UNOPS, and so we also included them.

Through this training, they will know more about SOPs for procurement and financial management and then the health system will be strengthened. All health staff from various States/Regions and districts/townships representing all 330 townships across Myanmar should know these SOPs. They are for strengthening the health system and protecting our health staff, benefiting all health stations/posts across the country with reduced risk and errors. This will in turn benefit both the donors and recipients through efficient and effective fund management.

The training sessions are logically presented and interconnected. There are two main parts. On the first day, Managed Cash Flow SOPs are presented and discussed. Disbursement, reimbursement and advance payment are explained, followed by group work in the afternoon. On the second day, procurement principles are explained, followed by a session on monitoring and evaluation. Government financial rules and regulations and systems are also explained by the responsible officers from MOHS.

Participating health staff from various townships across the country get the chance to share their views and the challenges they experience on the ground.

No SOPs can be 100% perfect, and so these are a living document that can be constantly amended, improved and adapted as needed in response to real-time experience and challenges.

Capacity building of health staff should be an ongoing exercise. In the future, this kind of large-scale national training will be organized based on the availability of funding and support.

There is constant mobility of health staff due to changes, transfer and promotion, and staff can use these skills wherever they are posted.

The success of this training is due to our teamwork and collaboration – MOHS, DOPH, Disease Control Unit, UNOPS and all its units: programme, finance, PSM and communications. We will include this kind of national-level training as much as possible in the future.

My thanks go to all participating health staff from the 330 townships across the country for their time and efforts with full commitment to deliver quality healthcare services for the people of Myanmar.

In my view, MCF is not just about cash. It is a tool that helps build capacity of the system to build bottom-up planning in a top-down management structure. If you can have good plans coming up from the bottom, the cash will automatically flow against those plans. We are also helping government health staff to build their capacity on the best use of finances. These are their supporting tools, as these include their management structure such as who holds delegation of authority, who are the people who can make changes, which unit costs are to be used, which are the eligible and ineligible costs, and how to do procurement and guidance.

For a national-level high attendance meeting, we need a lot of planning and preparation. The national programmes, MOHS and DOPH have been very helpful. We have multiple cooperation and collaboration meetings with the national programmes in advance to make sure that all preparations are as close to perfect as possible. They have provided support in developing the training materials and finalizing amended SOPs. They also provided quick approval, editing, proofreading and nomination of the focal persons for each thematic area. Everything was done very efficiently by our partners from the national programmes. I am grateful for this. My own team also visited the MOHS and the training venue several times.

The training will help reduce errors in putting up claims, so that these are in line with the SOPs. We reviewed existing activities and added points that are needed.

We have held this kind of training two times previously, in 2013 and 2015. Based on the activities in those years, we reviewed the financial management and decided how best to improve it and update the SOPs accordingly. 

This is the first time that I have attended the training. In programme implementation, we need to follow instructions from top down – from central to State/Region and then to township – and at the same time we need to fulfil the needs based on the implementation on the ground.

When we are implementing the activities, we need manpower, material and financial resources, which have to be managed well. The training will enable us to do the financial management effectively and efficiently.

I attended the previous training. The Global Fund had just started then, and we were not very familiar with the rules and regulations. Now we have become used to filling forms and we want to know more about it.

For implementation, though we have the government funding, we rely on other donor funding for the needed areas. Therefore, we need to improve the financial management skills to make sure the funds flow efficiently down from State/Region to district/township.

We need to build a workplan and then a quarterly plan based on the activities in the National Strategic Plan and then the budget will be allocated. There are currently two modalities – disbursement and reimbursement – but starting from the end of 2016, there will also be an advance payment modality, for faster and more efficient cash flow.

This is the first time that I have attended this kind of training. In implementation, it is important to do proper planning and budgeting based on the real needs on the ground. Kayah State is the smallest state and it is still developing; there are many needs to be fulfilled for the community there.

The drawing officers and financial clerks are included in the training and we need to share back what we have learnt with other staff in the hospital. With the support of the MCF-Field Finance Assistants stationed at the government health stations who handle cash on our behalf, the health staff’s workload is reduced and they have more time to concentrate on healthcare work. In addition, data assistants should be appointed to further reduce their workload.

For the community level trainings, midwives, lady health visitors and health assistants are targeted, but health staff involved in medical care at the hospital should also receive this kind of training. In fact, the Medical Care and Public Health units go hand in hand to strengthen the health systems. There is a daily interaction between patients and doctors and sometimes there can be misunderstandings. Thus, training to improve communications skills will be beneficial for healthcare staff, as will training in leadership, management, team building and Total Quality Management (TQM).

Management skills for the health system are very important. Once these are improved, healthcare service delivery will be improved, with faster delivery, improved quality and better results. Financial clerks are providing support to health staff and so they should also receive this kind of financial management training. I am glad that they are included this time.

Post-training assessment should be conducted one month, six months and a year after the training – at least by mail – to know what participants have retained. Then, not only output but also outcome could be assessed.

This is the first time that I have attended the training, which I think is very useful for us. As medical doctors, we are not used to financial management and budgets, for these were not part of our training at the university. From the training, we now know what needs to be planned, how the cash flows and whom to report to. We also learned about the government financial system, rules and regulations.

It also gives us an opportunity to learn about updates and revisions, especially for our colleagues stationed at health posts in distant and hard to reach places.

I am very new to public health. I was appointed as TMO only five months ago and this is the first time that I attended this training. I am very eager to use the skills that I have gained from this training back in my practical management work as TMO. My predecessor gained a lot from this kind of training and I too came full of hope to improve my financial management skills. I know more about the importance of proper planning, budgeting and how to implement according to the workplan within the given timeframe. Group work also allowed me to practise and perfect my skills, and I think we should include more in future sessions.

I once attended the financial management training organized by the World Bank. As medical doctors, we are not very familiar with financial management and the training will be very useful. I came with great hopes and I think these were 99% fulfilled, as I now know how to do controls. We should allow more time for this kind of two-day training. Overall, this kind of large-scale training gives us a chance to meet with other health staff from across the country, and share our experiences with improved networking for future communication, coordination and collaboration.

Overall the training will improve our skills and make accounts and fund management more effective and efficient. The group work is an example of our teamwork and we can point out common mistakes and share our experiences with improved networking among the health staff from various townships across the country. Procurement principles were explained well, and Daw Khaing Khaing Kyi, Director, Budget Division, DOPH, MOHS, also explained well the government financial rules and regulations. 

Previously I attended financial training by the World Bank. This is the first time I have attended this training. We are used to filling UNICEF U1 and U2 forms, and now I know about D1 and D2 forms for Global Fund supported activities. We learned about the nominated drawer, receipts, invoices, how to fill in the form and where to sign, and the importance for the claims to be accurate and eligible.

I have been in service for two years and the training has been very helpful for me to improve my skills in handling cash. At the duty station I cannot learn that much. All teaching materials were appropriate for me and I am thankful for this chance to improve my skills.

The training will improve efficiency in the delivery of healthcare services. It also helps in enhancing the controls around the cash that we disburse to the Government. It will also help the newly inducted staff on the management of cash and funds that we channel through the Managed Cash Flow Unit (MCFU). I have seen a lot of motivation and participation, and ownership of the whole process by the national programmes under the leadership of MOHS. We are grateful to them for all their inputs, involvement, participation, proposal of areas that we need to cover in the training, and in the development of SOPs. I am sure this is one big thing that I will take home about the training.

This training has been successful due to our collaboration and teamwork between UNOPS and MOHS, DOPH, Disease Control Unit appointed focal points and, most importantly, the full participation, motivation and commitment of participating health staff from various townships across the country. Their voices are important in programme implementation.

We provided suggestion boxes in each session and future trainings will be improved based on the feedback we received.

We used pre- and post-training tests to assess the knowledge gain through the training. We have been very encouraged by participants’ motivation and 100% attendance. We made it flexible so that anyone who could not attend the designated batch could come on other dates. 

The training not only gives the chance to learn and share experiences of the Global Fund supported implementation but also of the government financial rules and regulations. We have reinforced the training with more facilitators so that we could give more time to each individual in group work. We improved the method in group work, giving more attention to the staff who had never received the training before. There was at least one facilitator for every three participants in group work. Participants now know more about the criteria for an eligible claim.

Participants are very motivated and share their real-life experiences with each other. In the group work, they get the chance to practise based on real implementation scenarios and check and correct each other’s work. In that way, they realize what are the common mistakes and remember how to avoid these. Common mistakes seen during group work exercises were failing to get the signature from the Delegated Authority, and not being aware of who has the authority to make changes to workplans.

I am overwhelmed to have seen more participation, ownership and full attendance. Participants can also share SOPs with colleagues who have not received the training. The contact details of our 48 FFAs and our Yangon PR-UNOPS focal points were shared in case there were any further questions — they are most welcome to contact us with any queries anytime they need to. Our FFAs can also provide on-site training. We have seen improvements every year since the start of the programme. For me, this training has felt more like a discussion forum in which we are all learning from each other.

This is the third time this kind of training has been held. From this year, financial personnel practically involved with fund management have been included in the training, such as the Upper Division Clerk, Lower Division Clerk, Branch Clerk and Superintendent. We are very pleased with the 100% attendance, and have found that everyone participated fully and with motivation. Group-work based on field scenarios has helped them to improve their skills and learn about common mistakes through practice. They also had the chance to network and share their experiences and challenges in implementation in their respective State/Region and district/township. Though our Field Finance Assistants have been constantly in touch with them, our central MCFU staff  have only been in contact by phone. This training has given us a chance to meet them in person and explain more fully the things they need to know.

Managed Cash Flow SOPs - Nov 2016

Training agenda

Training materials

Pre-test/Post-test questions

Training assessment