PLANNING AND FINANCE
Proper planning and finance management enables value for money in Government expenditures. The Planning and Finance unit is responsible for the sound monitoring of measures as announced in the Government Programme 2020-2024 and budget measures which fall under the purview of the Ministry of Health and Wellness.
The Planning and Finance Section consists of the following:
Some of the main activities at the Planning and Finance Section are:
Health Sector Strategic Plan 2020-2024
The Budget Speech 2020-2021 made mention of the formulation of a new Five-year Health Sector Strategic Plan (HSSP) 2020-2024 to ensure that the national health services can cope with new challenges such as the growing burden of Non-Communicable Diseases (NCDs), the complex health needs of the ageing population, the growth of personalised medicine and rising expectations of patients for more patient-centred and improved quality of care.
The HSSP 2020-24 provides concrete strategies and interventions to address major health challenges across the lifespan of all citizens by providing a coherent framework that will guide policymakers, stakeholders and partners in health development.
The HSSP 2020-24 incorporates the strategies framed in line with the priorities of the Government as outlined in Vision 2030, Government Programme 2020-2024, Budget Speech 2019-2020, Budget Speech 2020-2021 as well as Global and Regional Commitments on Health endorsed by Mauritius, therefore, seeking to fulfil Mauritius's commitment to the implementation of the Sustainable Development Goals' agenda, more specifically, Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages.
The Health Sector Strategic Plan 2020-2024 (HSSP 2020-2024) was launched by the Honourable Prime Minister on 12 August 2020 followed by different dissemination workshops.
As at 16 August 2021, out of the 603 activities identified in the plan, some 19.7% were completed, 50.1% were either initiated or in-progress and 30.2% were planned for subsequent Financial Years.
Digital Health and Computerisation
The Government of Mauritius aspires to implement Digital Technologies to ensure efficiencies in service delivery and system processes. With the same vision, the Ministry of Health and Wellness envisages to implement a National e-Health Project in Mauritius and Rodrigues to improve the quality and responsiveness of health care services.
After the detection of the first cases of COVID-19 in Mauritius, the Government of Mauritius entrusted the United Nations Development Programme with a cost sharing Agreement to the tune of USD 1,190,000 to implement a Laboratory Information Management System (LIMS) through technical assistance from the University of Washington (Department of Global Health).
The COVID-19 module of the LIMS has been deployed in all the Flu Clinics at the Regional Hospitals and a launching ceremony was held with the Ministry of Information Technology, Communication and Innovation, the Embassy of Japan in Mauritius and the United Nations Development Programme on 27 October 2021. The other services of the Central Health Laboratory of the Ministry of Health and Wellness such as the biochemistry, bacteriology and haematology departments would be integrated into a National LIMS. This would be followed by connectivity to the different laboratories of the Regional Hospitals and Queen Elizabeth Hospital in Rodrigues would be equipped with the LIMS by July 2022.
The National LIMS would be extended to the major health institutions namely Souillac Hospital, the Moka Eye Hospital, the Cancer Hospital, the ENT Hospital and the Brown Sequard Mental Health Care Centre. The overall deployment of the LIMS is expected to be completed by December 2022.
In parallel with the implementation of the COVID-19 LIMS, as Mauritius planned its opening of borders to travellers, there was a pressing need to digitalise the passenger sanitary checks at the airport for diseases control at the port of entry of the country. The Airport Health Laboratory was set up for this purpose in 2020 and a Digital Embarkation/Disembarkation Platform is being developed as an extension of the COVID-19 LIMS. This would ensure that the customer experience at the Airport is paperless and quick by adhering to all COVID-19 sanitary protocols.
SORMAS, which is an open-source digital software solution for digital health surveillance for epidemics worldwide, was made available to the Ministry of Health and Wellness through procurement by the United Nations Development Programme and would be integrated in the LIMS. The SORMAS includes disease specific process models for many high priority epidemic prone disease such as COVID-19, dengue fever, ebola virus disease, influenza, malaria, meningitis (CSM), poliomyelitis, and yellow fever.
In terms of digitalisation of all laboratory services, the National Blood Transfusion Service (NBTS) was digitalised in 2008. The application is hosted at the National Blood Transfusion Service, Candos, and replicated at all Regional Hospitals. It is a blood banking system that caters for the registration, collection, and processing of blood. It also provides an updated inventory of actual stock of blood by groups throughout the country. The Ministry of Health and Wellness is currently working towards the upgrading of the NBTS system. The Government Analyst Division (GAD), which falls under the ambit of the Ministry of Health and Wellness, is also finalising its requirements for the digitalisation of its processes with regard to analysis of Food, Toxicological Samples, Water and Pharmaceuticals.
The United Nations Development Programme is also supporting the Ministry with the legal drafting of a Digital Health Law so as to provide the legal and institutional framework for Digital Health. This is in line with Strategic Goal 18 of the Health Sector Strategic Plan 2020-2024 which is to generate sound and reliable information at all levels of the health system with a holistic approach for better decision making. The Digital Health Law would enable the Ministry to implement a robust and integrated National e-Health Project with the objectives of improving the services provided to all citizens at the different public health institutions as well as strengthening governance for data collection and management.
Mauritius is ranked 52nd out of 132 countries in the Global Innovation Index (GII) Report 2021 which was released on 20 September 2021. Mauritius is also 1st in Africa according to the GII. The GII report is co-published annually by the World Intellectual Property Organisation (WIPO), a specialised agency of the United Nations, Cornell University of New York and Institut Européen d'Administration des Affaires (INSEAD). The report established that Mauritius has been classified among high income countries whose innovation performance is in line with its level of development and has also ranked highest in the Sub-Saharan region in three pillars (Institutions, Infrastructure and Creative outputs) out of seven.
Implementing Digital technologies would enable Mauritius to improve on the GII ranking through improved use of ICT and business reengineering leading to efficiencies in service delivery and systems processes. The Ministry of Health and Wellness has identified around 40 e-Health modules in its National e-Health Project, of which the LIMS and the Public Health Border Control are essential components.
The Ministry of Health and Wellness is now envisaging to implement the Patient Administration System (PAS) which is the first point of contact for patients at Public Hospitals. The PAS is intended to ensure that the Ministry of Health and Wellness establishes a digital patient database to which the other modules can be connected and integrated.
The Ministry of Health and Wellness aims to improve the quality of healthcare delivery to increase patient satisfaction and enhance social equity by providing a broader range of health services to the whole population. Public health services in Mauritius are provided free of cost and the budget for the Ministry for the Financial Year 2021-2022 is around MUR 13.1 billion, representing around 7% of Government expenditure. For the year 2020, there were around 8 million visits in public hospitals for a population of 1.2 million people which represents around 75% of healthcare needs of the population. The Government dispenses its health services through primary, secondary and tertiary healthcare.
For the period 2021-2024, the Ministry has for strategic directions:
National Health Accounts
Health spending is one of the fundamentals which influences health outcomes. The implementation of the Health Sector Strategic Plan 2020-2024 hinges on healthcare spending in the country and the cost-effective prioritisation and allocation of financial resources. National Health Accounts (NHA) enable the Ministry and other stakeholders to understand the source, magnitude and flow of funds from both the public and private sectors and provide useful insights on healthcare spending which are used to formulate and implement health financing policy.
According to the latest NHA Report (2018), the estimated Total Health Expenditure for the Republic of Mauritius, including the island of Rodrigues, amounted to MUR 25.91 billion (approx. USD 745 million). Government Health Expenditure was MUR 12.04 billion whereas Private Health Expenditure was MUR 13.87 billion. The per capita spending on health increased from MUR 20,023 in 2016 to 20,483 in 2017. The Total Health Expenditure as a percentage of the Gross Domestic Product was 5.67% in 2017.
Higher per capita spending on health contributes towards improvement in the general health status of a population. The current health expenditure per capita in Singapore is more than USD 2,500 whereas the per capita spending in Mauritius is below USD 800. In 2017, the Infant Mortality Rate (IMR) and under-five mortality rate per thousand live births in Singapore were 2.20 and 2.80 respectively while in Mauritius, these were 12.20 and 14.30 respectively. Likewise, in 2017, Singapore recorded 8 maternal deaths per 100,000 live births while Mauritius recorded a maternal death rate of 74 per 100,000 live births.
National AIDS Spending Assessment
The NASA is an internationally standardised framework developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS) based on a system of classification and guidelines to track the resources spent on the HIV/AIDS response from all sources to beneficiary populations in a given year. The NASA Resource Tracking Tool (RTT) 2018 software developed by the UNAIDS was used for the development of the NASA Report 2018.
The Report tracks national healthcare spending on HIV and AIDS. Previous spending reports were carried out for the years 2010, 2012 and 2018.
Health Statistics Report
The Health Statistics Reports of the Ministry are prepared on an annual basis and contain information on population and vital statistics, health infrastructures, health personnel, maternal and child health, notifiable diseases, private health institutions, morbidity, infant and child mortality, mortality (all ages), and other services for the monitoring of the health of the population which will enable improvement of service delivery.
EU REHSIMUS Budgetary Support
In the context of the response to the COVID-19 pandemic, the European Union is providing a budget support to the tune of EUR 7.8 million for the project “Reinforcing the Health Sector in Mauritius" – REHSIMUS which aims at reinforcing the national health systems including the response to challenges posed by the COVID-19 pandemic and to any other pandemic and public health emergency that may emerge in the future to reinforce the resilience and the efficiency of the health systems.
Japan's Grant Aid – Economic and Social Development Programme
The Government of Japan is providing medical equipment in the context of the COVID-19 measures to the Ministry of Health and Wellness under the Japan's Grant Aid “the Economic and Social Development Programme". The Grant Aid is to the tune of JPY 300 million.