What gets measured, gets managed

Health Partners' Forum - Fostering convergence, maximizing synergies

The Uttar Pradesh Health Partners' Forum (UPHPF) has clearly established its credibility as an informal consortium of partners convened around a common mission and purpose set forth by the state leadership of the National Health Mission/SIFPSA. The HPF has emerged as an example of a 'promising practice' for public health program management. The decentralization and scaling up of these learnings through formation of Divisional HPFs and District HPFs by SIFPSA along with other partners, covering the entire state, has clearly set the ball rolling towards accomplishing the National Health Mission objectives.

A plethora of development agencies in a resource-scarce setting, each pre-occupied in fulfilling their own agendas, is a familiar scenario in public health programmes. The uncoordinated nature of the interventions often leads to confusion at the field level, also increasing the burden on local health officials, who expend scarce human resources in interacting with each and trying to meet their requirements. Uttar Pradesh was no exception, with several national and international development sector organizations implementing health and research interventions/projects in the state with little or no formal coordination among themselves or with the government, barring those working on polio eradication program.

This was the precise ask from the senior leadership at the National Health Mission and the Ministry of Health & Family Welfare in the state which led to garnering of a momentum in 2006 when several development partners and some local NGOs that work on maternal, new-born and child health and nutrition collectively formed a Health Partners' Forum (HPF) in order to identify ways of working together, advocate and share knowledge with the government of Uttar Pradesh. This informal consortium of partners, initially named MNCHN Technical Advisory Group (MNCHN-TAG) and later Sanjhi Sehat in 2007 by the then Principal Secretary MoHFW, was formally rechristened as Uttar Pradesh Health Partners' Forum (UP-HPF) by NHM, Uttar Pradesh.

An entirely voluntary platform, the UP-HPF has sustained itself over a decade through a system of rotating responsibilities and shared leadership. Realizing the strength of this informal consortium of development partners, each bringing in a unique set of technical capabilities and knowhow, the leadership at the National Health Mission/SIFPSA and Government of Uttar Pradesh were swift in recognising the potential use of this forum in providing the required momentum to the mission projects, both in terms of technical assistance at state level in project design and development and at the field level for implementation support and independent monitoring and feedback. With all the member agencies having their own committed financial support from various donors, the key highlight of the entire HPF is its non-financial engagement and no burden on exchequer.

On its part, the government of Uttar Pradesh formally recognized the HPF through a government order and further streamlined the process of engagement by forming various thematic support groups (TSGs). Formed within the HPF, these sub groups focus on various technical-thematic areas like Maternal, New Born and Child Health, Family Planning, Nutrition, Adolescent Health, BCC, PCPNDT, Improving Program Management including Logistics Management and other National Programs. The TSGs are co-chaired by the technical leads from the Directorate of Family Welfare and NHM for each theme. The TSGs report out their progress and output to the UP-HPF. The purpose of the TSGs was to foster technical collaboration and partnerships, including coordination between the government and various partners in achieving NHM goals and to serve as a platform for sharing lessons from partner agencies and the Government and facilitate documentation. The TSGs are also expected to assist NHM/GoUP with strategy development, based on evidence of what works including standardization of IEC/ BCC, job aids and support materials developed in the state and distributed through HPF network in the field. The TSGs are expected to meet at least once in every quarter and more frequently if needed.

Over the years the UP-HPF has evolved into a self-sustaining model which is co-owned by the development partners and the Government. In order to maintain the true spirit of partnership, the model of shared leadership under HPF is fostered in a way wherein the responsibility of convening the meeting is assumed every time by one of the development partners and the same is voluntarily rotated every time amongst all partners. The HPF which is co-chaired by the Principal Secretary MoHFW and the Mission Director NHM/Executive Director SIFPSA, is a vibrant body providing a common platform for discussion, dialogue and partnership between the health department represented by the senior leadership from the Ministry of Health, National Health Mission, Directorate of Family Welfare, SIFPSA and senior representatives of over 25 international and national level development agencies working in Uttar Pradesh.

Considering the success of the Health Partners' Forum at the state level, SIFPSA took the onus of facilitating creation of a similar health partners' forum at the district level (dHPF) to provide technical assistance and implementation support to the District Health Society, and at the divisional level, to strengthen the review and coordination system through the divisional health partners forum (dvHPF). The system of two tier health partners' forum is expected to help in better coordination in program implementation and optimal utilization of existing resources and technical knowhow. The divisional health partners' forum (dvHPF) and the district health partners' forum (dHPF) are envisioned to provide a common platform to meet NHM objectives through concerted efforts, shared learning, feedback and progress tracking by the concerned partners and government representatives.

Activities like community mobilization for health services, handholding and capacity building of front line workers, setting up an independent program monitoring and feedback mechanism, support in training and workshops and program documentation are some of the areas that are likely to get strengthened. The dvHPF and dHPF are chaired by the Divisional Commissioner and the District Magistrate respectively. While the dvHPF is expected to meet, at least, every six months, dHPF will be convened on a bi-monthly basis. The development partners and local NGOs present in the concerned divisions and districts have been invited to be part of the dvHPFs and dHPFs. Efforts are being made to identify and notify one development partner in each district as the nodal partner for supporting the District Project Management Unit of NHM in convening the dHPF on bi-monthly basis. SIFPSA serving as the nodal body at the state level, provides constant support and guidance to the dHPFs and dvHPFs.

Today the UP-HPF in Uttar Pradesh has clearly established its presence and credibility as an informal consortium of partners convened around a common mission and purpose set forth by the state leadership of the National Health Mission/SIFPSA. The HPF has emerged as an example of a 'promising practice' for public health program management. The decentralization and scaling up of these learnings through formation of dvHPFs and dHPFs by SIFPSA, along with other partners, garnering similar synergistic support at each level, district and division, in the state has clearly set the ball rolling towards accomplishing the objectives of the National Health Mission.

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