Getting Everyone on the Same Page
Over a dozen development partners are supporting the Government of Bangladesh’s health reform strategy; getting a comprehensive overview of who’s doing what used to be quite a challenge. Now it’s become easier: since GIZ helped to create a knowledge management platform, communication within the Development Partners Consortium has been streamlined and its work has become more transparent, both for its members and for the interested public.
A massive effort to improve health
Over the period 2011-2016, Bangladesh’s Ministry of Health and Family Welfare is implementing an ambitious strategy to improve priority health services for the country’s 156 million residents and to strengthen the performance of its health system in line with the Millennium Development Goals. At a total cost of USD 7.7 billion, the Health, Population and Nutrition Sector Development Program (HPNSDP) is one of the largest health reform programmes in the world.
Dhaka - Bangladesh © Thomas Kelly
The current five-year programme is the third in a series of such approaches, the first of which was introduced in 1998 as a way to bring order to an increasingly complex and inefficient development assistance landscape. Since Bangladesh’s independence in 1971, non-governmental organisations (NGOs) and international development partners have played an enormous role in the evolution of the country’s health system. Stand-alone projects and vertical programmes proliferated and were successful in reducing morbidity, mortality and the total fertility rate in the country. However they were poorly coordinated, leading to duplication and financial waste.
Although the health sector landscape in Bangladesh is still fragmented and pluralistic, the global push to make development assistance more harmonised and efficient is beginning to bear fruit. At present, a core group of 17 development partners – including, on behalf of Germany’s Federal Ministry for Economic Cooperation and Development (BMZ), the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) and KfW Entwicklungsbank – is aligning its support for the health sector with the strategy developed by the Government of Bangladesh.
Navigating a crowded playing field
Aligning development assistance with an agreed strategy may sound straightforward, but in practice it is far from simple. Bangladesh’s national health reform strategy is dauntingly complex, with 32 separate operational plans – one for each of the Ministry of Health and Family Welfare’s 32 line directorates – and an overarching project implementation plan which runs to more than 300 pages.
For development partners like GIZ – which provides technical assistance and doesn’t contribute to the pooled fund, as many larger development partners do – it is particularly important to be aware of what others are doing and to take into account lessons which have been learned from previous efforts. Unfortunately, however, institutional memory tends to be short in Bangladesh, due in part to the regular turnover of personnel in the Ministry of Health and Family Welfare, as well as within development organisations. As a result, it is not uncommon for research to be commissioned on questions which have been studied before, or for ‘pilot’ approaches to be introduced which have already been attempted in a similar form elsewhere.
In order to direct their contributions to greatest effect, development partners need up-to-date, comprehensive information about the major initiatives being undertaken in the health sector – and access to the main results and outputs from these efforts. But for Kelvin Hui, a technical advisor with GIZ’s Support to the Health Sector Programme, it was exactly this which was missing when he arrived in Bangladesh in 2011.
Bangladesh is a popular setting for pilot projects and research studies, but has lacked a central clearinghouse for information about the results of these varied initiatives © GIZ
Internet searches yielded thousands of research studies, evaluation reports and programme documents about health in Bangladesh, but there was no central repository of information to which he could turn. ‘The only formal resource was the Ministry of Health and Family Welfare’s website,’ Hui recently recalled, ‘and the information available there was limited in scope.’ He needed to quickly get the lay of the land, but instead spent a lot of time locating important strategic documents, piecing together the history of earlier health reform strategies in the country, and coming up with an overview of the work of various development partners by visiting their individual web pages.
A one-stop resource for the Bangladesh health sector
Hui and his colleague Karsten van der Oord, a technical advisor on knowledge management, saw an opportunity to address this gap through GIZ’s engagement with the Development Partners Consortium, a coordinating mechanism established to improve coordination and harmonisation of development assistance for health. They proposed to lead the development of an online knowledge management platform – modelled on a similar tool they had developed for GIZ in Indonesia some years earlier – and to provide technical backstopping for the project until June 2014.
‘This was an exciting project for us,’ says Mobasser Hussain, the chairman of Zanala Bangladesh, a Dhaka-based software development company which created the site. ‘The moment we heard about it we were immediately convinced. To our knowledge there had never been a platform like this before in Bangladesh.’
Hussain and his colleagues worked closely with GIZ and small task team of interested Consortium members to build a simple, user-friendly site where the content would be managed by the Consortium members themselves. The goal was to bring together and make public all relevant information about the health reform programme, including the many outputs and publications which had been produced under its auspices, but which were now languishing in obscurity.
The homepage of the Development Partners Consortium website www.hpnconsortium.org © GIZ
Because the Consortium members themselves would be responsible for uploading relevant material to the site, it was essential that the user interface be easy to understand. If they didn’t embrace the website and use it regularly, the resource could quickly become out of date and lose credibility. To avoid this trap, Zanala kept the backend as simple as possible and provided easy-to-follow user manuals to representatives of all the member organisations and to site administrators as part of the training process.
The resulting site – www.hpnconsortium.org – has a clean look and is easy to navigate. A toolbar on the left-hand side of the page directs visitors to pages with information on:
- The current health sector reform programme as a whole, including its goals, strategic plan and implementation plan;
- The work of the individual development partners, including publications and reports which they have produced;
- Management of the health sector reform programme, including operational plans and reports from thematic task teams;
- The implementation and results of the annual programme review which assesses the programme’s progress against more than 40 indicators;
- Background resources on Bangladesh’s health sector, searchable by theme and keyword;
- Health-related legislation in Bangladesh; and
- Upcoming events and events, organised through a calendar function.
All of these materials are publicly available; another section of the site, which contains internal information pertaining to the Consortium and its members, such as meeting minutes, is password protected.
Since November 2013 an automatically-generated bi-weekly newsletter informs registered users about any changes, new links, or uploaded files – a development which has also increased traffic to the site.
25,000 page views and counting...
The Consortium website went live in early 2013; by July 2014 it had racked up more than 25,000 page views. The number of users has grown steadily (see figure) and more than half the visitors to the site are new users.
Very quickly the site became an indispensable resource. ‘It’s one of the first places I look for materials when I am writing briefing notes or reports on the health sector programme in Bangladesh,’ says Keiko Tsunekawa, who works for the Japan International Cooperation Agency (JICA). She notes that it is very helpful to be able to direct consultants to relevant background materials on the site, instead of sending them large documents by email prior to their visits. ‘Many people find it useful to have a site like this as there are a huge amount of data and materials for health in Bangladesh and they are not necessarily accessible.’
Source: Google Analytics
The website is absolutely essential for Foyzul Bari Himel, whose job is to coordinate development partners’ technical assistance contributions to the health reform programme on behalf of the Planning Wing of the Ministry of Health and Family Welfare.
‘I have to ensure that none of the technical assistance being requested by a line director duplicates work which has been conducted before,’ Himel explains. ‘After any request I go straight to the website to see what’s there.’ Recently, reports, strategic plans and feasibility studies which he found on the website helped him to better target technical assistance in areas as diverse as implementation of the country’s tribal health plan and improving processes for the procurement and maintenance of vehicles and medical equipment.
The site has also helped to streamline information flows. While the Consortium secretariat previously disseminated materials about the health programme through an email distribution list, now it simply uploads documents to the site, thereby allowing many more stakeholders access to useful information. Peggy Thorpe, who acted as chair of the Consortium from 2013-2014 on behalf of the Department of Foreign Affairs, Trade and Development Canada (DFATD), was instrumental in pushing the site front and center right from the start: ‘As chair, I made it clear that everything goes onto the site: documents, meeting minutes, everything.’
‘There’s little question that the creation of the website was a very valuable contribution from GIZ,’ says Thorpe. ‘There was nothing like this before for the health sector. If people need something, they know where to go.’
Tsunekawa, who was part of the website task team, credited GIZ for ‘seeing the process through and for bringing the right technical expertise to the job.’ While GIZ played a clear leadership role in creating the site, she observed that it succeeded in bringing all the development partners on board so that the resulting knowledge management platform is seen not as a GIZ product, but as something that belongs to everyone.