Technical Risk Assessment Table A4.1: Technical risks and mitigation strategies Issue Approach Impact Probability Risk General Difficulties of Moderate Moderate Moderate Selection of issues that both MoF and coordination, and line ministries have an incentive to solve management of performance as the basis for program design; based allocations Reinforcement of collective incentives (particularly flow of funds to through the choice of DLIs; implementing units) Bank support for timely recruitment of PCT Ongoing Bank support across sectors to facilitate dialogue Challenges in recruiting, Moderate Moderate Moderate Bank supports DNT to develop ToRs, training and deploying identify and recruit high-quality national staff to provide international TA for training and ongoing ongoing public sector QA of national staff management capacity Staff identified within public sector development and support institutions centrally and provincially (deployment issue) Incentives insufficient or Substantial Moderate Substantial Annual review of performance poorly targeted to offset allocations, and capacity development potential shifts required in Annual discussion of supporting formal/informal benefits of interventions in sector dialogue existing institutional arrangements Medicines Supply Chain Funding constraints for Moderate Moderate Moderate Two availability indicators focus on medicines purchase impact medicines with different financing on tracer medicines streams availability (DLI# 1 and 4) DLI medicines (HIV and maternal and reproductive health) are high-priorities for both GoM and health partners (particularly, US Government and GFATM) DLI pricing commensurate with level of government control Sector level performance based allocations support gap-filling purchase of low cost essential primary health care medicines (which are often neglected by vertical funding sources). Allocations of up to US$ 9.6 million are available over the period of the Program, representing approximately 20% of costs for medicines included in primary health
Technical Risk Assessment Table A4.1: Technical risks and mitigation strategies Issue Approach Impact Probability Risk General Difficulties of coordination, and management of performance based allocations (particularly flow of funds to implementing units) Selection of issues that both MoF and line ministries have an incentive to solve as the basis for program design; Reinforcement of collective incentives through the choice of DLIs; Bank support for timely recruitment of PCT Ongoing Bank support across sectors to facilitate dialogue Moderate Moderate Moderate Challenges in recruiting, training and deploying national staff to provide ongoing public sector management capacity development and support Bank supports DNT to develop ToRs, identify and recruit high-quality international TA for training and ongoing QA of national staff Staff identified within public sector institutions centrally and provincially (deployment issue) Moderate Moderate Moderate Incentives insufficient or poorly targeted to offset potential shifts required in formal/informal benefits of existing institutional arrangements Annual review of performance allocations, and capacity development Annual discussion of supporting interventions in sector dialogue Substantial Moderate Substantial Medicines Supply Chain Funding constraints for medicines purchase impact on tracer medicines availability (DLI# 1 and 4) Two availability indicators focus on medicines with different financing streams DLI medicines (HIV and maternal and reproductive health) are high-priorities for both GoM and health partners (particularly, US Government and GFATM) DLI pricing commensurate with level of government control Sector level performance based allocations support gap-filling purchase of low cost essential primary health care medicines (which are often neglected by vertical funding sources). Allocations of up to US$ 9.6 million are available over the period of the Program, representing approximately 20% of costs for medicines included in primary health Moderate Moderate Moderate
892910WP0P12460echnical0Assessment.docx