Memorandum of Understanding for Joint Working by Ministry of Health and Sanitation, Ministry of Information and Communication on the Government of Sierra Leone ehealth Coordination Hub Dated 3 rd of November 2017 MEMORANDUM OF UNDERSTANDING SIERRA LEONE NATIONAL ehealth COORDINATION HUB Between MINISTRY OF HEALTH AND SANITATION, SIERRA LEONE and MINISTRY OF INFORMATION AND COMMUNICATION, SIERRA LEONE 1
CONTENTS 1. Background... 3 2. Key Objectives for the ehealth Hub... 3 4. Governance of National ehealth Coordination Hub... 4 4.1 Overview... 4 4.2 Guiding principles... 4 4.3 National ehealth Steering Committee... 4 4.4 ehealth Strategy Team... 4 4.5 Technical Advisory Groups... 4 4.6 National ehealth Working Group... 5 4.7 Reporting... 5 5. Roles and Responsibilities... 5 6. Escalation... 6 7. Term and Termination... 6 8. Variation... 6 9. Status... 6 ANNEX ANNEX A. ANNEX B. ANNEX C. ANNEX D. ANNEX E. THE NATIONAL ehealth COORDINATION HUB... STEERING COMMITTEE TERMS OF REFERENCE ehealth STRATEGY TEAM.. TECHNICAL ADVISORY GROUP. NATIONAL ehealth WORKING GROUP... 2
THIS AGREEMENT is dated 3 rd November, 2017 Parties (1) Ministry of Health and Sanitation (MOHS), Sierra Leone (2) Ministry of Information and Communication (MIC), Sierra Leone 1. BACKGROUND 1.1 MOHS and MIC have agreed to work together on the Government of Sierra Leone National ehealth Coordination Hub (National ehealth Hub) detailed in Annex A 2. KEY OBJECTIVES FOR THE NATIONAL ehealth HUB 2.1 The parties shall support the National ehealth Hub to achieve the key objectives set out in Annex A to this MoU (Key Objectives). 2.2 The parties acknowledge that the current position with regard to the National ehealth Hub and the contributions already made are as detailed in Annex A to this MOU. 3. PRINCIPLES OF COLLABORATION The parties agree to adopt the following principles when managing the National ehealth Hub (Principles): (a) collaborate and co-operate. Establish and adhere to the governance structure set out in this MoU to ensure that activities are delivered and actions taken as required; (b) be accountable. Take on, manage and account to each other for performance of the respective roles and responsibilities set out in this MoU; (c) be open. Communicate openly about major concerns, issues or opportunities relating to the National ehealth Hub; (d) learn, develop and seek to achieve full potential. Share information, experience, materials and skills to learn from each other and develop effective working practices, work collaboratively to identify solutions, eliminate duplication of effort, mitigate risk and reduce cost; (e) adopt a positive outlook. Behave in a positive, proactive manner; (f) adhere to statutory requirements and best practice. In particular, the parties agree to freely share information related to the National ehealth Hub; (g) act in a timely manner. Recognise the time-critical nature of the National ehealth Hub and respond accordingly to requests for support; (h) manage stakeholders effectively; (i) deploy appropriate resources. Ensure sufficient and appropriately qualified resources are available and authorised to fulfil the responsibilities set out in this MoU. (j) act in good faith to support achievement of the Key Objectives and compliance with these Principles. 3
4. GOVERNANCE OF NATIONAL EHEALTH COORDINATION HUB 4.1 Overview The governance structure defined below provides a structure for the establishment and functioning of the National ehealth Hub. 4.2 Guiding principles The following guiding principles are agreed. The National ehealth Hub s governance will: (a) provide strategic oversight and direction; (b) be based on clearly defined roles and responsibilities at organisation, group and, where necessary, individual level; (c) align decision-making authority with the criticality of the decisions required; (d) be aligned with National ehealth Hub scope; (e) leverage existing organisational, group and user interfaces; (f) provide coherent, timely and efficient decision-making; and (g) correspond with the key features of the National ehealth Hub governance arrangement set out in this MoU. 4.3 National ehealth Steering Committee (a) The National ehealth Steering Committee will provide the overall leadership and governance oversight for the development, adoption and drive the implementation of a national ehealth agenda. (b) The National ehealth Steering Committee shall be managed in accordance with the terms of reference set out in Annex B to this MoU. 4.4 ehealth Strategy Team (a) The ehealth Strategy Team Serves as the coordinating secretariat for the National ehealth Coordination Hub. The Strategy Team oversees and coordinates the execution of the ehealth implementation plan. The group will carry out functions focused on strategy development, execution of the implementation plan, and driving standards development and ehealth solutions compliance monitoring. (b) The coordinating secretariat shall be overseen and governed by the National ehealth Steering Committee. (c) The ehealth Strategy Team shall be managed in accordance with the terms of reference set out in Annex C to this MoU. 4.5 Technical Advisory Groups (a) Technical Advisory Groups will be constituted based on need and technical expertise required. They will advise and support the ehealth strategy team and ehealth working group by providing technical guidance on the development and implementation of the national ehealth vision and deployment of ehealth initiatives. Technical Advisory Groups will not be directly involved in decision-making but will play a significant role in guiding the coordinating secretariat based on their acknowledged technical and programmatic expertise and in their role as advisers. They will link with the wider ehealth working group comprised of all relevant stakeholders, including all MOHS programmes and directorates, and partners working on ehealth initiatives in the country. (b) Technical Advisory Groups shall be managed in accordance with the terms of reference set out in Annex D to this MoU. 4
4.6 National ehealth Working Group (a) The National ehealth Working Group will include representation from key stakeholders involved in the ehealth ecosystem in Sierra Leone. The group will be chaired by the Research and Publications Specialist, and he will report to the Steering Committee. The ICT Manager will deputise. The working group may want to set up technical subcommittees, working groups or technical advisory groups to address/work on specific issues as the need arises. (b) The National ehealth Working Group shall be managed in accordance with the terms of reference set out in Annex E to this MoU 4.7 Reporting Reporting shall be undertaken by all groups. (a) Steering Committee: Minutes and actions will be recorded for each Steering Committee meeting. Any additional reporting requirement shall be at the discretion of the Steering Committee. (b) Technical Advisory Groups: Reporting shall be based on the specific issues being addressed; technical assistance provided and technical recommendations ensuing from reviews, and progress planned for the next period and/or aligned with the frequency of the working group meetings. (c) ehealth Strategy Team: Reporting shall be monthly, based on the minutes from the monthly meetings, highlighting: Progress this period; issues being managed; issues requiring help (that is, escalations to the Steering Committee) and progress planned next period and/or aligned with the frequency of the Steering Committee meetings (d) National ehealth Working Group: Reporting shall be quarterly, highlighting: Progress this period; issues being managed; issues requiring help (that is, escalations to a Technical Advisory Group, ehealth Strategic Team or Steering Committee) and progress planned next period and/or aligned with the frequency of the Steering Committee meetings. 5. ROLES AND RESPONSIBILITIES 5.1 The respective Ministries shall undertake the following roles and responsibilities in promoting the objectives of the National ehealth Coordination Hub: Activity MOHS MIC ehealth Strategy Development Lead Assure Lead, coordinate and implement Lead Assure Resource Mobilisation Lead Assure Development of ehealth Standards and Protocols Lead Assure Development of ehealth Security Protocols Assure Lead IT technical advice Assure Lead ICT Infrastructure Development Assure Lead 5
5.2 For the purposes of the table above: (a) Lead: the party that has principal responsibility for undertaking the particular task, and that will be authorised to determine how to undertake the task. The Lead must act in compliance with the Objectives and Principles at all times, and consult with the other party(ies) in advance if they are identified as having a role to Assure the relevant activity; (b) Assure: the party that will defer to the Lead on a particular task, but will have the opportunity to review and provide input to the Lead before they take a final decision on any activity. All assurance must be provided in a timely manner. Any derogations raised must be limited to raising issues that relate to specific needs that have not been adequately addressed by the Lead and/or concerns regarding compliance with the Key Objectives and Principles. 6. ESCALATION 6.1 If any party has any issues, concerns or complaints about the National ehealth Hub, or any matter in this MoU, that party shall notify the other parties and the parties shall then seek to resolve the issue by a process of consultation. If the issue cannot be resolved within a reasonable period of time, the matter shall be escalated to the Steering Committee, which shall decide on the appropriate course of action to take. If the matter cannot be resolved by the Steering Committee within 21 days, the matter may be escalated to the respective ministries for resolution. 6.2 If either party receives any formal inquiry, complaint, claim or threat of action from a third party in relation to the National ehealth Hub, the matter shall be promptly referred to the Steering Committee (or its nominated representatives). No action shall be taken in response to any such inquiry, complaint, claim or action, to the extent that such response would adversely affect the National ehealth Hub, without the prior approval of the Steering Committee (or its nominated representatives). 7. TERM AND TERMINATION This MoU shall commence on the date of signature by all parties, and shall expire as mutually agreed by all the parties. 8. VARIATION This MoU, including the Annexes, may only be varied by written agreement of the Steering Committee. 9. STATUS 10.1 This MoU is not intended to be legally binding, and no legal obligations or legal rights shall arise between the parties from this MoU. The parties enter into the MoU intending to honour all their obligations. 10.2 Nothing in this MoU is intended to, or shall be deemed to, establish any partnership or joint venture between the parties, constitute either party as the agent of the other party, nor authorise either of the parties to make or enter into any commitments for or on behalf of the other party. 6
7
CONTACT POINTS Ministry of Health and Sanitation Name:... Office Address:... Tel No:... E-mail Address:... Ministry of Communication and Information Name:... Office Address:... Tel No:... E-mail Address:... 8
ANNEX A THE NATIONAL EHEALTH COORDINATION HUB Overview The overall goal of the National ehealth Coordination Hub is to provide leadership and guidance from within the MOHS, to promote the development and deployment of ehealth initiatives; and to serve as a forum for discussion, decision making and consensus building on national ehealth-related issues, as well as sharing knowledge, experiences and lessons learned in implementing ehealth initiatives in Sierra Leone. The Directorate of Policy, Planning and Information will be responsible for convening and coordinating the participating stakeholder groups. The Key Objectives: To coordinate and regulate ehealth initiatives deployed in the country and ensure that ehealth initiatives meet the needs of the MOHS. To facilitate the potential integration/interoperability of other existing ehealth systems. To support IT infrastructure improvement efforts of the MOHS. To set and establish standards and guidelines for ehealth deployment To review and approve relevant SOPs for the generation of digital data and its utilisation. To promote innovative ehealth applications and identify new use cases for ehealth applications. To expand on the existing use of and provide support on the deployment of innovative and sustainable mhealth initiatives for improved health outcomes; an example of such a system is RapidPro/mHero for sending and receiving health messages, queries, and feedback to and from health workers. To share knowledge, experiences and lessons learned and facilitate the scaling of promising practices in ehealth initiative deployed across the country. 9
ANNEX B NATIONAL EHEALTH STEERING COMMITTEE TERMS OF REFERENCE The Steering Committee will provide the overall leadership and governance oversight for the development, adoption and drive the implementation of a national ehealth agenda. 1. Roles and Responsibilities a. Provides political support and strategic oversight for the adoption of ehealth in the country. b. Approves and endorses the national ehealth vision, drives the ehealth agenda and assists in addressing risks and resolving issues that may arise. c. Provides strategic leadership and guidance for development of national ehealth Strategy and Policy. d. Oversees the functioning of the ehealth strategy team and technical advisory groups. e. Provides high level oversight for the execution of national ehealth plans, standards, and all ehealth related projects. Oversees overall progress, and approves changes to scope or approach. f. Supports resource mobilization and leveraging of existing investments to promote the National ehealth agenda. 2. Membership a. Chief Medical Officer (MOHS), Chair b. Director, DPPI (MOHS), Secretary c. Director of Communications (MIC) d. Director of Information (MIC) e. Director of Primary Health Care (MOHS) f. Director, Human Resources for Health (MOHS) 3. Meetings a. The committee shall meet quarterly or at the call of the chairperson with three business days notice. b. A simple majority of members in attendance at a properly constituted meeting, shall constitute a quorum. Meetings may be held in person or via electronic connections that allow two-way involvement of all participants. c. One week s notice shall be given to each member of the time, date and location of the meeting. 4. Decision making a. The National ehealth Steering Committee shall make decisions by majority vote. In the event of a tie, the Chair shall have the casting vote. b. Decision making will be based simple majority of those members in attendance to resolve or approve any issues requiring a vote. 10
ANNEX C EHEALTH STRATEGY TEAM The ehealth Strategy Team Serves as the coordinating secretariat for the ehealth Coordination Hub. The Strategy Team oversees and coordinates the execution of the ehealth implementation plan. The group will carry out functions focused on strategy development, execution of the implementation plan, and driving standards development and ehealth solutions compliance monitoring. The coordinating secretariat shall be overseen and governed by the National ehealth Steering Committee. 1. Roles and Responsibilities a. Maps and assesses existing and subsequent ehealth projects. b. Reviews and approves ehealth projects proposed by working group subcommittees and partners. c. Conducts stakeholder research and consultation, information gathering, analysis and drafting of the national ehealth vision. d. Coordinates the development of a national ehealth Policy & Strategy, Implementation plan and Monitoring framework, standards and guidelines. e. Coordinates development of SOPs and guidelines f. Provides guidance for development of new use cases, establishes criteria for identification and selection of ehealth initiatives. g. Sets and prioritizes ehealth-related projects h. Identifies opportunities for collaboration with key national and international ehealth partners. i. Promotes and champions ehealth initiatives at national, regional, and district levels. j. Proposes best practices for supporting the national ehealth agenda and document lessons learned. 2. Membership a. Research and Publications Specialist (MOHS/DPPI) Chair; b. MOHS/DHRH Representative Deputy Chair; c. ICT Manager Deputy Chair; d. HMIS Specialist, DPPI e. WHO rep f. UNICEF Rep g. 3-4 partner reps. 3. Meetings a. A simple majority of members in attendance at a properly constituted meeting, shall constitute a quorum. Meetings may be held in person or via electronic connections that allow two-way involvement of all participants. b. The secretariat shall meet fortnightly or at the call of the chairperson with three business days notice. 4. Decision Making a. The ehealth Strategy Team shall make decisions by majority vote. In the event of a tie, the Chair shall have the casting vote. b. Decision making will be based on simple majority of those members in attendance to resolve or approve any issues requiring a vote. 11
ANNEX D TECHNICAL ADVISORY GROUPS The Technical Advisory Groups will be constituted based on the required technical expertise and support needed. They will advise and support the ehealth strategy team and the ehealth working group by providing technical guidance on the development and implementation of the national ehealth vision and deployment of ehealth initiatives. They will not be directly involved in decisionmaking but will play a significant role in guiding the coordinating secretariat based on their acknowledged technical and programmatic expertise and in their role as advisers. They will link with the wider ehealth working group comprised of all relevant stakeholders including, MOHS programmes and directorates, and partners working on ehealth initiatives in the country. It may form sub-groups. 1. Roles and Responsibilities a. Provide guidance and recommendations, and support development of national ehealth vision and outcomes. b. Assist in identifying existing or planned ehealth initiatives and applications. c. Provide input into the development of a national ehealth agenda, as well as ehealth strategic plan and policy. d. Provide technical inputs and recommendations for the stakeholder groups on various ehealth components. e. Review and provide feedback on findings, conclusions, and draft deliverables. 2. Membership: To be determined based by the ehealth strategy team based on required technical expertise. 3. Meetings a. The committee shall meet quarterly or at the call of the chairperson of the ehealth Strategy team with three business days notice. 4. Decision Making a. A simple majority of members in attendance at a properly constituted meeting, shall constitute a quorum. Meetings may be held in person or via electronic connections that allow two-way involvement of all participants. b. Decision making will be based simple majority of those members in attendance to resolve or approve any issues requiring a vote. 12
ANNEX E NATIONAL ehealth WORKING GROUP TERMS OF REFERENCE The National ehealth Working Group will include representation from key stakeholders involved in the ehealth ecosystem in Sierra Leone. The group will be chaired by the Research and Publications Specialist, and he will report to the Steering Committee. The ICT manager will be Deputy Chair. The working group may want to set up technical sub-committees or working groups to address/work on specific issues as the need arises. 1. Roles and Responsibilities a. Provide support to the national ehealth Coordinating secretariat as needed. b. Serve as a forum for ehealth partner coordination and information sharing. c. Provide input to the development of the national ehealth vision, strategy, implementation plan, investment and monitoring framework. d. Share experiences, successes, challenges and lessons learned. e. Provide feedback on deliverables and outcomes that have been achieved. 2. Membership a. MOHS Directorates - DPPI, ICT, DPC, DHRH, DDMS, RCH, DFN, DEHS; and Programmes: TB/Leprosy, Malaria, Reproductive and Family Health, EPI/Child Health, HIV/AIDS, CHW/PHC, Teenage Pregnancy and DHMTs. b. Development partners working in the ehealth space in Sierra Leone c. Representatives from multilateral and bilateral donor agencies d. Private sector stakeholders 3. Meetings a. The ehealth working group will meet monthly on a date that will be agreed on by the group. The secretary will be responsible for circulating meeting minutes, which shall be distributed to group members, no later than 10 days following each meeting. Presentations/papers will be circulated at least 3 working days prior to a meeting. 4. Decision Making a. A simple majority of members in attendance at a properly constituted meeting, shall constitute a quorum. Meetings may be held in person or via electronic connections that allow two-way involvement of all participants. b. Decision making will be based simple majority of those members in attendance to resolve or approve any issues requiring a vote. 13