I am involved as a training facilitator. The aim is to train all Township Medical Officers (TMOs) and Senior Finance Clerks working in financial management of GFATM funding. At least two staff members were invited from each township/health station for the training.

Participation in this training can improve financial management skills for managing GFATM funding. It will also help maintain programme and financial management skills in preparation for the transition when the Ministry of Health takes over the role of PR-GFATM in Myanmar from UNOPS in 2017.

It was not possible to invite all health officers from the 330 townships across Myanmar at once, so the trainings were conducted in nine batches of two days with 90–100 participants per batch for 18 days. This year there have been twice as many participants, as township Senior Finance Clerks have also been included. A similar training was organized in 2013, but this year there were some additions.

The ‘advance payment’ modality has been added to the existing disbursement mechanisms of reimbursement and direct payment. Also, U Win Oo, Deputy Finance Director, presented the government financial rules and regulations. The training thus provided a platform to assimilate the similarities in the implementation of the Global Fund grants under the Managed Cash Flow SOPs and government budget/financial management rules.

The government financial rules and regulations, keeping accounts and maintaining ledgers, current steps in planning and budgeting, implementation, preparation and assessment before implementation These and other things participants should know about the government financial rules and regulations were discussed and presented during the training.

The World Bank has loaned $100 million and this will enter directly into the government accounts. We are preparing how best to implement with the World Bank funding in a cost-effective manner to get the best value for money for the benefit of the people of Myanmar.

We are developing guidelines and principles for use of funding from the World Bank. We need to further discuss with all implementing front-line health officers on separate reporting guidelines and forms for use of World Bank funding, and will arrange future training on this.

We have found that all participants are very motivated and actively involved in the discussion. March is the budget closing month for MOH, and although they are very busy, they took the time to come here and participate in the discussion. We greatly appreciate this and we are very happy to know of their commitment and motivation to serve people in need.

We have also informed them that they can come to us or contact us for any clarifications they need. They are always more than welcome to come any time they face challenges or bottlenecks in implementation related to financial management, as we are here to help them and provide clarifications on government financial rules.

We will calculate budget based on the detailed workplan developed after active discussion and coordination with local implementing partner agencies. In this way, we will be better able to budget, plan and implement with improved capacity to deliver high quality health services in an efficient manner. 

When I get involved with front-line heath officers, I realize that some of them still do not know about workplans. However, now they come to relate the workplan with what they are actually implementing. The Global Fund’s financial rules are stricter than the Government’s, so from the start we try to determine the real needs in populations. We also review and discuss this regularly every three months and adapt the plan as we discover needs based on frequent assessment and monitoring. We contact UNOPS office so that it can be instantly followed up and solved.

After three years of implementation, the Managed Flow SOPs have become more flexible. For example, previously, travel allowances were paid based on the standard regional rate set by UNICEF, but now these are paid based on the actual cost with proper claims. Now that the Global Fund has introduced this payment method, we would like other funding sources such as the World Bank to follow this example. We should have fruitful discussions among us regarding the management of funds from different sources, which will greatly benefit our country.

This third round of trainings has greatly improved compared to the first in 2011 and the second in 2013.

As a National Programme, we have to plan and supervise activities for implementation at the field level. Sometimes what we have expected and planned differs from what is actually implemented on the ground; therefore, there have been bottlenecks in actual implementation.

However, if the planning is bottom-up and if all health staff implementing at the ground level know about detailed work planning and develop bottom-up microplanning, detailed programme and financial management will become more efficient.

From this training, participants will become familiar with the financial SOPs and will be able to develop their own workplan, requiring the national programmes to provide supervision only.

Previously it was difficult to understand the real needs for implementation at ground level and what must be supported at the points involved in health service delivery and implementation.

We need to know their actual needs and cannot guess these from the central level.This training has opened the gate for the central-level AIDS, TB and malaria National Programmes to collaborate more with the responsible health persons from all other levels further down in implementation management.

The training has also allowed us to meet together and discuss more openly to gain a deeper understanding of the actual challenges and share experiences. This is not only a training, but also a workshop for open discussion and collaboration. The National Programmes come to know how better to support implementation at front-line health service delivery points and can make recommendations on how best to support them from behind so that they can implement more efficiently and effectively. We are very satisfied with their active participation, which motivates us to move forward and also allows us to know their capabilities. 

The participants mainly included the implementing health staff from various townships across the country—Township Medical Officers and those under their supervision.

It is not very often that the responsible heath officers can meet, and this was a chance for them to discuss their experiences and challenges in implementation. They came to know about the Managed Cash Flow Standard Operating Procedures and improve their financial management skills. I found that everyone had been actively involved in the group work and discussions. It is for the benefit of the whole Ministry of Health, so I am very happy and proud.

This training has significantly improved compared to that in 2013, as the SOPs and all training materials have been translated into Myanmar and we had all materials including the SOPs book in advance so we could take notes more easily.

However, we would like to suggest for additional staff to be invited. For example, please kindly consult with those who are at the front line of implementation, as they know best.

Different townships have different conditions and different staff can be involved in the work. Some of the participants may not be directly involved with implementation. 

In future, if we could invite those that are directly involved with implementation, all participants would gain solid, 100 per cent benefit.

We have learnt more about financial management principles and processes so that we can conduct financial management more efficiently and effectively.

Concerning monitoring and evaluation, it would be very useful for us if the checklist shared with us by UNOPS [in the Monitoring and Evaluation section of the training] could be further modified, integrated with other activities under MOH for use at the national level.

As practising medical doctors, involved day to day with medical care, we have not had much experience in financial management or the essential skills needed of a manager, so I am sure the training greatly benefit us.

We have learnt about procurement principles, as we are now involved with this, and also about budget rules. However there might still be bottlenecks in implementation related to the time we receive the budget and the actual time left for implementation.

While we are used to implementing a top-down plan, now we are to develop our own workplan. Although I thought that it might be difficult to develop one on my own, when I did the exercise on workplan development, I actually found that it meant proper planning of our current activities.

I found this group work really useful. We would also like the public health sector leaders from the townships like the Township Health Nurses and Health Assistants to be invited in addition to the township Senior Finance Clerks. 

It took nearly two months preparation to organize the training. We had to prepare the list of health officers to be invited in collaboration with the National Programmes. We also did detailed planning for the logistics and administrative needs.

We formed a training preparation team within PR and met every week to catch up on progress against a check-list. The result of this collaboration and detailed planning effort is that we could invite all participants from various townships across the country in time. Around 1,000 participants took part in the trainings and attendance was more than 90 per cent.

The training is very important because this year we train more than 900 mid- and senior-level managers in management planning and budgeting. Also, we included an M&E section in the training this year for the first time.

We cover basic concepts of what Monitoring and Evaluation is and why it is important, and also give participants hands-on training on how to do data quality auditing. So this is a very good opportunity to sensitize all officers from various levels of management in Monitoring and Evaluation (M&E) work. M&E will become increasingly important as there will be a growing amount of funding coming to public health from the Government and from international partners.

M&E also is a health system strengthening activity – one of the six building blocks of WHO Health System Strengthening – and is needed in order to have good information. 

The previous training in 2013 did not include Monitoring & Evaluation (M&E) section. An M&E section has been included as a module in the training starting this year as it is important to link how M&E relates to the day to day work of the health officers.

 The Global Fund’s funding decision is performance-based using M&E results, so M&E and Managed Cash Flow are related. Funding decisions are made based on the results of M&E, and funds flow according to the Managed Cash Flow.

We plan to include an M&E section in future trainings and we are sure the data quality in recording and reporting for all three diseases will improve.

I have been involved as a training facilitator. We included two group-work exercises in this training. The first was concerned with making eligible claims and differentiating between good and bad claims.

The group-work exercise gave participants a chance to see what is needed for eligible complete claims, what makes good claims, and also to look at bad claims. In the exercises, participants had to identify which were the good and bad claims, and explain what made these good or bad. All participants were very motivated and enthusiastic.

The second group-work exercise was on how to develop a workplan through the process of bottom-up consolidated workplanning. This is important as it is the starting point for the Managed Cash Flow. They were very eager and actively participated in the group work. Most participants did know how to develop workplans.

Managed Cash Flow SOPs - Jan 2015

Training Materials DVDs

Training Assessment

Pre-test/Post-test Questions

Opening Speech - (English)

Opening Speech - (Myanmar)

Watch Video: Together For A Better Future

Read Traning NewsLetter

See some photos of the training