Health

9USAID-Tarabot worked with the Ministry of Health to implement administrative reforms through capacity building, institutional changes, and process reengineering to enhance the ministry’s capabilities in service delivery. Sustainability was foundational to USAID-Tarabot’s training of ministry staff in project management and providing technical assistance to support the application of engineers’ new skills and knowledge on a pilot project. Tarabot introduced standardized procurement practices that support the building of much needed medical facilities, and equipped ministry staff with planning methods that ensure capital investment projects are in line with national development goals. To illustrate its ownership of these initiatives and ensure the sustainability of Tarabot’s work, the Government of Iraq allocated $274,000 in cost share funding to support USAID-Tarabot’s activities with the Ministry of Health.

Project Management

USAID-Tarabot, in partnership with COMSEC, strengthened the capacity of the Ministry of Health by training 46 engineers on modern project management techniques using Project Management Institute (PMI) standards. Training was provided to engineers in PMI processes, estimation techniques and MS Project, feasibility studies, and earned value management. With Tarabot’s assistance, engineers were able to apply their new skills on a project for the construction of a four-story primary healthcare center in Baghdad, budgeted at $1million.

Tarabot advisors helped the ministry’s project management team in the planning phase to develop a project charter, scope the project, and identify stakeholders–valuable inputs for the realistic costing and scheduling of the project. These tools were clear improvements upon the ministry’s old project planning techniques, which did not have clear requirements for documentation, milestones, and deliverables and resulted in a lack of control over time slippage and budgeting. The healthcare center is under construction using improved techniques introduced by Tarabot and will support a staff of 75 medical professionals and provide medical services for more than 10,000 Iraqis.

Tarabot also supported 26 ministry engineers to prepare them for certification as Project Management Professionals (PMP) through a 35-hour training course, a pre-requisite for registering with the PMI and to take the PMP exam, and simulation exercises. Engineers are equipped with the techniques, skills, and knowledge required for certification, ensuring the anchoring of sound project management practices within the Ministry of Health.  

Project Planning

USAID-Tarabot worked in partnership with the Government of Iraq to improve capital investment planning through capacity building and institutional reform measures. With the assistance of Tarabot, ministries are better equipped to select and plan investment projects that maximize value and impact in service delivery, and ensure that local projects are coordinated with national priorities as outlined in the National Development Plan 2013–2017.

USAID-Tarabot’s efforts with the Ministry of Health focused on the development of criteria for the selection of projects based on cost-benefit analyses of economic, social, financial, spatial, and environmental factors with due consideration for development goals, risk levels, and direct and indirect impacts. To this end, a series of capacity building workshops and on-the-job trainings were held for 88 staff members from the Ministry of Health to enable them to use project selection criteria in project planning. The capacity building process consists of three phases: 1) assessing current planning processes, 2) aligning project selection with National Development Plan goals and developing selection criteria, and 3) applying selection criteria in the development of project plans.

To support the management of the ministry’s projects, USAID-Tarabot assisted the Ministry of Health to operate the Iraq Development Management System, an online software package for overseeing the ministry’s capital investment cycle. Tarabot provided 14 ministry staff members with training on the system’s initiation and maintenance, including how to update and enter project information into the system, query it for information, and generate reports on projects and their implementation progress.

Public Procurement

USAID-Tarabot, in partnership with the Ministry of Planning, is working with the Government of Iraq to execute its investment budget through fair and transparent procurement systems, enabling a favorable environment for international and domestic businesses and better services for the Iraqi people.

USAID-Tarabot worked with the Ministry of Health to reform its public procurement practices to be in compliance with Ministry of Planning requirements and international best practices. This support included the development and adoption of standardized procurement processes, standard bidding documents, and procedures and mechanisms for procurement planning. While equipping ministry staff with this knowledge and these tools, Tarabot also worked alongside them to help design terms of reference and evaluate requests for proposals for three tenders: 1) the design of a 100-bed hospital in Baghdad, 2) the design of a 100-bed hospital in Najaf, and 3) the design and construction of a 300-bed hospital in Baghdad. The preparation of these tenders enabled ministry staff to apply standardized procurement practices on actual public works contracts. The tendering of these contracts is pending the passage of the Iraqi budget.

Tarabot developed a ministry procurement webpage for the issuing of tenders and helped the ministry subscribe to dgMarket, an international open access web portal for the announcement of tenders, enabling a wide range of firms to bid on public works contracts with the Ministry of Health. These tools will also enable the ministry to advertise contracts in a fair, transparent, and consistent manner.

Tarabot also assisted the ministry in completing its 2012, 2013, and 2014 procurement plans to guide the ministry’s procurement activities; and the drafting of a sustainability plan to ensure the anchoring of sound procurement reforms achieved with Tarabot.

Regulatory Reform

Many countries in transition face the challenge of broadening the enabling environment to reform and stimulate economic growth and create jobs. Outdated and unnecessary laws and regulations impose efficiency costs on economic activity, while promoting corruption and reducing the government’s ability to deliver services. Tarabot worked to review legislation and regulations and made recommendations for their reform or elimination through an inclusive and transparent process built on extensive stakeholder input.

The Ministry of Health reviewed six business-related regulations that affect its ability to deliver services with the assistance of USAID-Tarabot’s Iraq Solution for Regulatory and Administrative Reform (ISRAR) initiative. Legislations reviewed include the “General Corporation Law of Health Insurance and Rural Health No. 211 of 1975” and the “General Law of Pharmaceuticals and Medical Supplies No. 9 for the year 1983.” In partnership with the Ministry of Health, Tarabot identified and reviewed outdated laws and regulations that impose efficiency costs on the ministry’s performance in providing health services to the Iraqi people, and set forth recommendations for their elimination or reform.

Center of Excellence

The Iraq Center for Excellence in Government (ICEG), formed under COMSEC, is the culmination of years of effort by USAID-Tarabot and its predecessor, Tatweer, to improve the performance of Iraqi government entities. It is a public entity that encourages leadership and innovation in service delivery by providing frameworks and guidelines for organizational management and institutional capacity development through the application of the Excellence model, which consists of seven criteria in the areas of leadership, people, knowledge, strategy, resources, processes, and results. The Excellence model provides a holistic view of an entity and how these elements relate to one another to affect organizational performance and results achieved.

With the assistance of USAID-Tarabot, assessments were made of all capacity development initiatives accomplished with the Ministry of Health’s Imamein Al Kadimayah Hospital in the areas of quality management and organizational development to support their adoption of the Excellence model. Ongoing technical support was provided in the documentation and review of organizational processes to implement short term, high impact plans in service delivery along established Excellence guidelines. Tarabot recommended two services–patient reception and consultancy in the surgical department, and patient reception in the surgical operation room–for process reengineering to enable efficiency in receiving and assisting patients. To enable ministry staff to identify opportunities and gaps in organizational development and service delivery, Tarabot trained 53 staff members on the application of the Excellence model.

In February 2014, the ministry used $39,000 of its cost share funds to send its Excellence unit to the King Abdullah Excellence Center in Jordan for a ten-day study tour to learn about Center of Excellence processes and mechanisms. With this knowledge, the ministry is better positioned to reengineer its internal work processes for greater efficiency and functionality, and to implement core ICEG components that will facilitate improved service delivery.