2.6 Intersectorality

2.5.2 Health planning Planning and development of the MoH is coordinated by the Management Development and Planning Unit (MDPU) within the Ministry. Development of long-term, medium-term and annual plans for the government health-care delivery system is a core function of this unit. The medium-term and annual health plans for districts, and thereby provinces, are based on the broad strategic directions of the National Health Policy 2016–2025. The district annual plans are formulated based on the district health priorities and the provincial annual plans are formulated by consolidating the district plans. These, and the plans of line ministry directorates, institutes and special programmes are compiled to derive the annual plan of the Ministry of Health.

2.5.3 Role of development partners in policy and planning Development partners (DPs) refers to the lead technical agencies, donor agencies and international cooperation agencies based in a specific country. The influence of DPs on the policy and planning process is based on financial resources, technical expertise, and indirect financial and political incentives. Considering the policy formulation process in Sri Lanka to be principally nationally driven, the DPs, especially the lead technical agencies such as WHO, United Nations Children’s Fund (UNICEF), United Nations Population Fund (UNFPA) and, to a lesser extent, the International Organization for Migration (IOM), bring in best evidence, comparative information and standards on health from across the globe. For example, in the early stages of devolution of power in Sri Lanka when planning expertise at the provincial level was relatively weak, the DPs played a critical role in helping the government improve the planning capabilities of the provinces and districts. Further, these agencies may influence the policy and planning process through international conventions such as the Framework Convention on Tobacco Control (FCTC) and Sustainable Development Goals (SDGs). There are also instances where the policy and planning process, especially that of financial direction and fund allocation, is influenced by donor agencies. For example, the current PHC reorganization and the introduction of an essential services package have been facilitated by the World Bank and WHO.

2.6 Intersectorality

All major policy decisions on health are made collectively by the Cabinet of Ministers and cooperation is often sought between ministries and sectors on an ad hoc basis to deliver services. There is a parliamentary Sectoral Oversight Committee on Health to ensure “health in all policies”. A key strategy for intersectoral action and coordination at all levels is the establishment of the National Health Development Network, consisting of

the Health Development Committee (HDC) at the sectoral level, the National Health Development Committee (NHDC) and the ministerial National Health Council, viewed as the apex body.

The NHDC is established to ensure intersectoral coordination for health development activities. It is chaired by the Secretary Health, has relevant secretaries as members and is composed of technical focal points in ministries. The NHDC functions as a good platform to facilitate the coordination of health development efforts between the Ministry of Health, the provincial ministries and other health-related sectors and agencies.

National-level intersectoral committees have been set up under the DGHS to address major issues in communicable and noncommunicable disease control, prevention of injuries, school health, nutrition and other programmes. These committees, comprising relevant government and nongovernment agencies and development partners, meet on a regular basis to ensure intersectoral collaboration and policy harmonization.

Being the implementors of all national-level policy directives, many intersectoral communications take place at the provincial level. The Planning Division of the Province, headed by the Deputy Chief Secretary – Planning, convenes several meetings a year for planning and monitoring of activities within a holistic developmental approach. The Provincial Director and team represent the health sector.

The District Development Committee (DDC), operating at the district level under the political leadership of and coordinated by the District Secretary (government agent), is a forum for discussion involving many sectors. The health sector is represented by the Regional Director of Health Services.

The DDC operates at the divisional level under the political leadership of the division and is coordinated by the Divisional Secretary. The health sector is represented by the MOH of the area. The DDC carries out divisional-level multisectoral coordination.

The 17 SDGs highlight the interconnectedness and the importance of health in all goals and that achieving SDG 3 (ensure healthy lives and promote wellbeing for all at all ages) is the key to achieving many other SDGs, as it is essential to have a healthy population for economic productivity and national development.