This year, training participants have been carefully selected from among those who are actually involved with the day-to-day financial management, so that they gain most benefit from each two and half-day training. Under the guidance of MOHS, we put more emphasis on the practical aspects of the training and less on the theory.

Inclusive township health planning was included as one section this year, and every participant should know this, as it is the basis of the overall programme implementation. Procurement is also very important, as it involves many aspects: from renovation of drug stores, to store management and procurement of drugs.

I had the chance to take part in a question and answer session after the procurement presentation, and I found that all participants including Township Medical Officers (TMO) (who have our delegation of authority) were very actively asking a lot of questions. It is our duty as facilitators to clarify and give feedback on the spot.

All township focal persons should know about the SOPs. I would say it is therefore a highly cost-effective training, benefiting the whole national healthcare system. I would like to thank the Global Fund for the funding and PR-UNOPS for their support to hold the training successfully.

This is the fifth training that we have organized since the Global Fund programme started in Myanmar. Based on the challenges encountered in implementation, this year we put less emphasis on technical aspects and more on the operational part.

The training has been improved based on previous experience and its contents were simplified and presented in a format that was easier for basic health staff (BHS) to understand. Our health staff are already familiar with the government financial rules and regulations, but they need to familiarize themselves with rules and regulations for management of the international funding.

Participants are medical officers and BHS who are involved with day-to-day field implementation. Group-work exercises with case scenarios gave them an opportunity to practise, share experiences, ask questions and get clarifications on the spot. We will organize a Training of Trainers (TOT) at the central level for the state/regional focal persons, who will then organize multiplier trainings for the health staff in their respective states/regions. I would like to thank the Global Fund for the funding and PR-UNOPS for its support in organizing this successful training.

Financial management is important for any organization—not only for MOHS—but also for the whole country, as accountability, transparency and being auditable become increasingly important globally. In this fifth training, we have expanded the scope to be more comprehensive and include the government financial rules and procurement, which are very important and linked to financial management.

As front-line soldiers need strong logistics support to win battles, health staff delivering services on the ground need efficient procurement and logistics management—which is again linked to financial management—to win the battle against diseases, deliver healthcare services effectively, and achieve great results and impact.

There were 200,000 malaria cases nationwide in 2015, which was halved to around 100,000 malaria cases in 2016. Such a remarkable achievement in malaria control received recognition and appreciation, even by the State Counsellor, Daw Aung San Suu Kyi.

As a facilitator, I am very satisfied with the participants’ motivation and active participation, as learning is a lifelong process. In line with the guidance of the Union Minister, a focus group discussion is held after each training. These are not monologue or dialogue presentations, but actual large-scale discussion forums. The training will definitely enhance participants’ capabilities with improved efficiency.

I have been involved as a facilitator for three years. Participating health staff know best about their respective areas and the health needs of its people.

As a facilitator, I find that participants are very interested in the group work and practical exercises, which have been developed to be close to their real-time on-the-ground field scenarios so that they gain the practical skills that will support faster, easier and more efficient implementation. As they also have the chance to practise computer-based group work, it will help to prepare them for future involvement in e-health. We allow more time for the group-work exercises because these are like a team building and knowledge sharing session.

I would like to thank MOHS for their strong support in all aspects of the training—finalizing the invitation list, sending out invitations, choosing the training venue, arranging the facilitators, finalizing the presentations line by line, coordination, holding meetings even on weekends, and requesting the honourable Union Minister to actually attend one batch (the third) of the training. The ownership lies with MOHS.

In my own experience in the last five years, I find this scheme, and the whole system, is very much appreciated by MOHS. In each quarter, there are around 6,000–7,000 activities planned and often executed in the country. Close to 6 million dollars per quarter are distributed through this scheme, and that is not an easy undertaking. This can only happen in the MOHS, at both central and peripheral levels—state/regional, district/township, and village level—they have adopted it and absorbed it. They are applying, accepting and following the SOPs. Nearly 150,000 activities have been completed in the last six years. Millions of dollars have been distributed, and we have not as yet received a single audit objection or observation on the scheme. This is what we are proud of. This has never happened globally and we can present it to the whole world. This is an example of what the Global Fund, MOHS, DOPH and UNOPS can present to the entire globe. I am very happy and proud to be part of the scheme.

This is the first time that I attend the training on planning and budgeting. Previously, we managed based on what we learnt or had handed over from our senior colleagues. Now, after the training, I believe I will be able to do financial management more systematically, as accountability and transparency are very important. Everyone should know the SOPs. This will greatly support our efforts towards achieving Universal Health Coverage. We got much support from the facilitators.

This is the first time I attend the training. It has given me an overview of how to present the results more systematically, what constitutes a workplan, and how to review whether an activity has been carried out according to the workplan. As Township Medical Officer (TMO), I am responsible for managing all aspects and activities of a township health department team, which includes medical care, public health and overall management work, etc.

The training improved our financial management skills. We greatly need support from the township finance and procurement focal persons for a more efficient and faster implementation process. For example, in situations like the outpatient department, I may be occupied with patient care and at the same time I may need to approve financial and procurement paperwork. In those situations, support from our Branch Clerk or Field Finance Assistant is very helpful, as there is a time constraint and I cannot go through each and every detail. As TMO, I can oversee management and at the same time be efficient in performing my other duties in public health and medical care.

Although this is the first time I attend the training, I am already familiar with these forms and formats as I am involved daily with financial management. This has been a chance for me to brush up on my skills for more systematic and effective financial management. Some other colleagues may be quite new, so group work is also a knowledge and experience sharing session for us.

This is the first time I attend training that includes budgeting. Any healthcare programme implementation is based on planning, which is linked to budgeting. Group work gives us a chance to practise workplan development and prepare eligible claims. The training also includes procurement, which is new to us. We learnt about procurement rules and principles, preparation of a procurement plan, requests, etc. It would be better to have more two-way discussion sessions.

I have been in the service for 24 years. I have attended trainings on microplanning twice. This is the first time I attend training that links microplanning with budgeting, so it is very practical and useful for us at the township level of implementation. We used to develop microplanning based on monitoring and evaluation findings on weak and strong points. The training will benefit the whole healthcare system.

I understood all the training contents very well. The sessions on inclusive township health planning and quarterly workplan development were really helpful and gave us an overview. The training should allow more time for group discussions, which help us remember more. The question and answer sessions gave me a chance to clarify areas that I needed to know; for example, on how the 20 per cent flexibility in budget ceiling in the workplan development works.

I have been in service for 28 years and this is the first time that I attend this kind of training. It will greatly benefit my township-level day-to-day work: reporting to state/region/district, as well as coordinating with, managing and leading midwives at the rural health centres and sub-centres, further down in implementation.

I will be retiring in five years’ time and there is not much time left for me in the service. With my years of experience and seniority, I want to be a role model for my junior colleagues, to whom I would like to pass on the spirit of strong determination, professionalism, skills and knowledge. It all starts with an efficient bottom-up planning from the sub-centres down at the village level for the whole country healthcare system to benefit.

I have been in the service for 22 years and this is the first time that I attend this kind of financial management training. The financial management skills that I have gained from the training will greatly benefit the people of Chin State, which is a hard-to-reach place, through reduced morbidity and mortality for AIDS, TB and malaria.

I attended the previous training in 2016, so this is my second time. The training has greatly improved in all aspects compared to last year and is becoming more interesting. I am daily involved with financial management and familiar with computer work. I find the group-work exercises very useful as these are based on real implementation.

In our session on monitoring and evaluation (M&E) at this year’s MCF training, we wish to highlight that M&E starts with planning. During the bottom-up work planning process at the township level, periodic target setting and detail plans of M&E activities can be developed in a coordinated manner. This will then be followed by implementation, evaluation, with continuous monitoring provided throughout the whole process. Reflecting the diversity of some 900 participants for this year’s training, we also aim to articulate roles and responsibilities in M&E that different positions may have in their day-to-day work. This interactive training is an opportunity for us to understand the capacity areas in which we could assist for further improvement.

This year, there is a particular emphasis on the importance of evaluation of the effectiveness of the workshop. Two types of evaluations are in place – a knowledge test conducted in the beginning and the end of the workshop and a questionnaire administered to capture qualitative information provided by the participants. They will provide us with a good perspective on trainee satisfaction, the knowledge gaps that still exist, and how we could improve our future training.

There was also a new initiative, Focus Group Discussion (FGD), led by the Health Literacy Promotion Unit of DOPH, MOHS in identifying training needs and how the workshop could be improved.  In the first two batches of the training, two FGDs were organized with selected participants.  In-depth assessment and recommendations made by the FGDs on training agenda, methods and supporting materials were immediately adopted by us and a modified training module was implemented for the remaining 4 batches. This experience brings UNOPS and our national partners together in working towards the capacity building central to the health systems strengthening.   

We have had regular internal and external coordination meetings. Ownership, budgeting and decision-making lies with DOPH, MOHS, and we would like to thank them for their strong support and guidance for the whole training package (agenda, logistics, contents, presentations, venue, etc.). This year we have had more group work and interactive discussions, and fewer lectures. The training will benefit the whole health system. Attendance has been nearly 90 per cent, which shows the trainees’ strong participation and motivation.

Procurement group work benefits both those who are new and those who already have experience. It gives them a chance to share experiences and knowledge and practise their skills, both as a procurement practitioner and as a reviewer. They also become familiar with forms, formats and principles.

Procurement is a specialized subject, and for any effective procurement, we need to deliver the right product to right place at the right time, at the right cost and in the right quality and quantity. This is even more important in the procurement of medicines, health products and equipment, where quality is of paramount importance in order to be able to deliver quality healthcare services.

As the Managed Cash Flow SOP is a living document, it has been improved every year, based on the challenges and the needs of the field-level on-the-ground implementation. We need to find ways to best support the programme, not only in a strictly financial role. We need to balance between flexibility and control so that we can best support the programme.

The group work gave participants the chance to familiarize themselves with and review all areas of an eligible claim: workplan, budget, D1 form, D2 form, authorization, need for a national registration number of an authorized person, etc. As facilitators, we see the participants’ spirit of team work and motivation in these group work sessions. I am most satisfied as we get the chance to show the whole workplan and budget for AIDS, TB and malaria activities.

Managed Cash Flow SOPs - Nov 2017 

Managed Cash Flow SOPs - Nov 2017 (compressed)

Managed Cash Flow SOPs - Training materials

Training agenda

Pre-test and Post-test questionnaires

Pre-test and Post-test results