GUIDELINES FOR COMITE DE PILOTAGE MEETINGS 070524 1 BACKGROUND

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Guidelines for Comite de Pilotage Meetings

Guidelines

For Comite de Pilotage Meetings

070524

1. Background

The Rwandan national performance-based financing (PBF) model for health centers and the national PBF model for district hospitals have been created using a participatory process during the first half of 2006. The national PBF model for health centers was designed during a three-day participatory workshop in February 2006, in which all stakeholders were present.^¹ The process is also described in the international literature through a paper for the Global Development Working Group on Performance Based Incentives,^² and in the 2007 MfDR- Managing for Developments Results- Sourcebook publication.^³ Contracts between different levels are part of this model. The district PBF steering committee (Comite de Pilotage) forms a crucial part of this new institutional set-up. A contract between the Mayor and the district PBF steering committee creates the framework for the decentralized governance of performance-based financing.^⁴

2. Main Roles and Responsibilities of the Comite de Pilotage

To ensure that the Quantity control is carried out
To ensure that the Hospital carries out its Quality Regulatory work in a timely manner
To ensure timely data entry (data have been entered at least 24 hours prior to the Comite de Pilotage meeting), and to compare and certify the Quantity and Quality data that have been entered in the PBF BDD with the original paper invoices
To organize, respecting the timelines, the regular quarterly Comite de Pilotage meetings
To transfer, without undue delay, the minutes of the Comite de Pilotage meetings, and the consolidated quarterly PMA and HIV district invoices to the MOH PBF department (CAAC), and eventual donors.

3. The Budget for the Comite de Pilotage

The Comite de Pilotage budget (which is the same as the quarterly budget made available to the districts), should be used according to available official guidelines on spending government resources. This budget will be transferred to districts on a performance base. The performance base is stipulated in point 4 below.

This budget is meant to pay for:

Organizing the Comite de Pilotage meetings
Data entry of the Quantity and Quality indicators in the PBF BDD (http://www.pbfrwanda.org.rw)
Field trips by USF personnel, for activities related to performance-based financing.

4. The Performance Base for the Comite de Pilotage

The two most important deliverables for the Comite de Pilotage are the Timely Delivery of Minutes of the Comite de Pilotage meetings and the Quarterly Consolidated District Invoices. The minutes of these Comite de Pilotage meetings should be conform the format and lay-out of such minutes (see annexes 2 and 3) and the Quarterly Consolidated District Invoices produced by the PBF BDD, which, after having been ratified by the Comite de Pilotage, should be signed by both the Director of Health/President of the Comite de Pilotage and the Mayor. These deliverables should be submitted to the CAAC and donors according to the following timetable:

For the first Quarter: before May 5^th of the current year
For the second Quarter: before 5^th August of the current year
For the third Quarter: before the 5^th November of the current year
For the fourth Quarter: before the 5^th February of the following year

The performance base for receiving the Quarterly Comite de Pilotage budget allocation is:

The PMA and HIV indicators have been collected timely (five days prior to the planned date of the Comite de Pilotage meeting)

When these data have not been collected within the stipulated timeframe, the Comite de Pilotage will lose its entire quarterly budget allocation

Data entry, for both the Quantity and the Quality data, should be complete at least 24 hours prior to the planned date of the Comite de Pilotage meeting

In case these data have not been entered as above, the Comite de Pilotage will be penalized by a 50% reduction of its Quarterly budget allocation

Timely transmission of the two deliverables (as stipulated above) of the Consolidated Quarterly District Invoices, drawn from the PBF BDD, and signed by the Mayor, with the Minutes of the Comite de Pilotage meeting, transmitted to the CAAC and donors, according to the following timelines:

Each day delay will be penalized by a 10% reduction of the quarterly Comite de Pilotage budget

Adherence to the Terms of Reference of the Comite de Pilotage meetings

Minutes that do not follow the Terms of Reference and Guidance on agenda, content and format as stipulated in the annexes 2 and 3, will be penalized by a 25% reduction in the quarterly Comite de Pilotage budget.

iv: The Actual Meeting:

Typical meeting lasts from 9 am to 1 pm (maximum); 3hrs minimum. Chair – director USF, in absentia the director of the Hospital- ; Secretary and Timekeeper designated.
Draft Minutes should be circulated by email within 2 days after the meeting.
Previous minutes should be discussed and approved in each meeting.

v: Agenda Template and Time Limits: see Annex 2.

vi: Minutes Template and Format: see Annex 3.

Annex 1: Guide and Formats for the Comite de Pilotage Meetings

(A) Participants and Quorum

Participants are those that have been listed in the contract between the Mayor and the Comite de Pilotage. They consist of:

The director of Health (director of the USF)
The PBF focal point (from the USF, frequently the ‘responsable Sante’)
The Hospital Director
A representative of the Hospital Supervisors
CDLS representative
Mutuelle district representative
FBO representative
Public Health Facility representative
NGOs involved in PFB

The minimum QUORUM^⁵ consists of at least one representative from three different agencies: (i) the USF, (ii) the District Hospital and (iii) the donor/NGO involved in PBF.

(B) Timing

Meetings are held at least four times per year as a routine, but can be more frequently depending on local arrangements. Each obligatory quarterly meeting should be held before the 5^th of the 5^th month. i.e.: before the 5^th May (first Quarter data), before the 5^th August (2^nd Quarter data), before the 5^th November (3^rd Quarter data) and before the 5^th of February (4^th Quarter data).

(C) Procedures

i: The one calling the meeting: the Director of Health/USF; the meeting should be called at least five working days before the actual meeting.

ii : Data entry in the PBF BDD: final responsible is the Director of USF (who can delegate responsibility). Data need to be in the PBF BDD at least 24 hours prior to the actual Comite de Pilotage meeting. Both Quantity and Quality data need to have been entered.

iii: Sending out draft minutes of the last meeting: responsible is the Director of the USF, who sends out these draft minutes by email, together with the invitation to the Comite de Pilotage members, to the CAAC, donors and NGOs, and other invitees. A few paper copies should be made for those that do not have routine email access (i.e. the health center participants).

iv: The Actual Meeting:

Typical meeting lasts from 9 am to 1 pm (maximum); 3hrs minimum. Chair – director USF, in absentia the director of the Hospital- ; Secretary and Timekeeper designated.
Draft Minutes should be circulated by email within 2 days after the meeting.
Previous minutes should be discussed and approved in each meeting.

v: Agenda Template and Time Limits: see Annex 2.

vi: Minutes Template and Format: see Annex 3.

Annex 2: Agenda Template and Time Limits of Agenda Items

Agenda

Agenda ITEM	Time allocated
Opening	5 min
Approval of previous meeting minutes.	15 min
Follow up on action points decided during previous meeting.	30 min
USF presents report on Quantity control activities	15 min
DH presents report on Quality Regulatory activities	15 min
Facture PMA trimestrielle consolidee presented and discussed; compared with actual physical monthly provisory invoices, and amended eventually. Keep note of discrepancies for later amendment.	30 min
Facture VIH trimestrielle consolidee as above.	30 min
Discuss indicator trends	15
Discuss activities for next quarter	30-45 min
Advanced strategies/QA
Verification of Quality and Quantity data
Etc.
Recap activities/decisions.	5 min
Closure and tentative date of next meeting.	5 min

Annex 3: Template and Format for Minutes of Comite de Pilotage Meeting

Template and Format

Draft Minutes should be in Word, Final Approved Minutes in Adobe.
Filename should follow the convention: [yrmonthdate_DistrictName_ctteePilotage] for instance, 070516_Nyaruguru_cteeePilotage

Comite de Pilotage de [District Name -Times New Roman font 14 Bold Centralized]

070517 [Date –Times New Roman font 12 Bold]

Meeting start and end time [Times New Roman font 12]

Chair: [name]

Secretary: [name]

Timekeeper: [name]

List of Participants [Times New Roman font 12]

No	Name	Agency	email	mobile
1	A
2	B
etc

Agenda

Agenda ITEM	Time allocated
Opening	5 min
Approval of previous meeting minutes.	15 min
Follow up on action points decided during previous meeting.	30 min
USF presents report on Quantity control activities	15 min
DH presents report on Quality Regulatory activities	15 min
Facture PMA trimestrielle consolidee presented and discussed; compared with actual physical monthly provisory invoices, and amended eventually. Keep note of discrepancies for later amendment.	30 min
Facture VIH trimestrielle consolidee as above.	30 min
Discuss indicator trends	15
Discuss activities for next quarter	30-45 min
Advanced strategies/QA
Verification of Quality and Quantity data
Etc.
Recap activities/decisions.	5 min
Closure and tentative date of next meeting.	5 min

[report]
[report]
[etc]

1 ‘Performance Based Financing for Health Services in Rwanda: Development of a National PBF Model’, Proceedings of a three-day workshop February 16, 17 and 18, 2006, MiniSante, 1 March 06

2 ‘Rwanda Performance Based Financing for Health’, Miriam Schneidman and Louis Rusa, 20 October 2006, page 20.

3 ‘Rwanda: Performance-Based Financing in Health’, Louis Rusa and Gyuri Fritsche, published during the third round table in Vietnam February 2007, http://www.mfdr.org/Sourcebook/index.html (accessed 20 April 07)

4 See for instance the « Contrat Régissant le Comite de Pilotage et les Formations Sanitaires pour la Stratégie de Financement du Niveau Décentralise sur Base de leur Performance » signed by the Mayor of Gicumbi District on 19 May 2006.

5 “In law, a quorum is the minimum number of members of a deliberative body necessary to conduct the business of that group. Ordinarily, this is a majority of the people expected to be there, although many bodies may have a lower or higher quorum” definition from Wikipedia, http://en.wikipedia.org/wiki/Quorum, accessed 17 May 2007

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