MTSS as a Panacea for Effective Planning and Development
If you fail to plan, you have invariable planned to fail.
This technical brief focusses on how Medium Term Sector Strategy and Operational plans implementation have become the backbone of planning and development of the health sector in the states and federal. A full understanding of the annual budget planning and MTSS preparation system is essential, not just to derive expenditure projections and development but to be able to advise policymakers on the feasibility and desirability of specific budget proposals, from a macroeconomic or microeconomic perspective and how such proposals align to goal and objectives of the sector. Budget planning and preparation are (or should be) at the heart of good public expenditure management because it is much easier to control government expenditures at the "upstream" point of budget preparation than later during the execution of the budget. For MTSS/AOP to be fully effective, state and federal public expenditure management systems should have a structure that addresses the following principles. 1.
Planning within budget envelops: A system that the state controls aggregate expenditure of the MDAs to ensure affordability; that is, consistency with the macroeconomic constraints; 2.
Policy documents / policy to guide expenditure: There is an effective means for achieving a resource allocation that reflects expenditure policy priorities. In the case of the health sector all plans developed are geared towards the achievements of the SHDP or the MDGs 3.
Efficient delivery of public services (productive efficiency); comprehensiveness of budget, Transparency and realistic budget process, and implementing the budget in a very transparent manner. 4.
Enhancing budget efficiency: Minimization of the financial costs of budgetary management i.e., efficient budget execution and cash and debt management practices. 5.
Reinforces linkages with gains/performances of past plans (Annual performance review) for continuity in policy implementation. 6.
The process through strategy sessions enhances effective stakeholder’s participation, transparency, ownership and accountability. 7.
Costing of proposed initiatives and process documentation in an open and transparent manner. The Planning Cycle: The planning cycle describes how long term plans are broken down into midterm and annual plans for implementation. The National Strategic development plan 2010-2015 outlines the strategies and activities to deal with the main problems identified in the strategic plan. The strategic plan is organized into 8 thematic areas, basically fashioned along the 6 health building blocks. The eight thematic area include Leadership and Governance, Health Care Service Delivery, Health Financing, Human Resources for health, Health management Information system, Community Participation and Research For health. Because of the long term nature of the NSHDP, MTSS was developed to break the long term plan into a mid-term (three years) rolling costed plan (MTSS) the latest being the annual operational plan / Budget. This paper looks at how the MTSS serves as a conduit for good planning and development in the health sector. The graph below shows the complementarity of the long term, mid-term and annual plans.
This is the model adopted by both the Federal (FMOH) and five PATHS 2 states, Kwara, Cross River and Oyo states are at various level of developing the MTSS. FMOH are encouraging other states to adopt the model. MTSS: As part of the Public Financial Management Reforms, the Fiscal Responsibility Act provides that governments at all levels must articulate a medium term expenditure framework as the basis of their annual budget. The Medium Term Expenditure Framework (MTEF) and the Medium Term Sector Strategies (MTSS) are seen as central to improved public sector performance and are expected to enhance the accountability and transparency of government policy...
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