District Health Management Team Reform Activity Lesotho Health and Horticulture Compact - Health Systems Strengthening (HSS) Project - District Health Management Team Reform Activity; This Activity focuses on improving the capacity of Lesotho's local-level healthcare management units, known as District Health Management Teams (DHMTs), to address local priorities and deliver high quality PHC services to the populations they serve. To accomplish this, the Activity supports expanding DHMT health financial systems and management capacity and bolstering the institutional support DHMTs receive from national and central level entities. The Parties expect that with adequate central-level support and resources, better trained DHMT staff, and the ability and autonomy to manage financial resources, DHMTs can provide a significantly higher quality of PHC. Specifically, the Activity provides funding for:

(A) capacity building for local training institutions to provide management and skills training to DHMT staff in areas such as annual planning, financial management, personnel and equipment management, and data analysis;

(B) technical assistance to support MOH staff (central and DHMT) management capacity through on-the-job training and mentoring;

(C) technical assistance to Government ministry professionals and other health sector stakeholders in forming multi-disciplinary teams and/or technical working groups to identify administrative, managerial, and/or clinical problems in their respective practices and execute solutions;

(D) support to the Ministry of Finance (MOF) and MOH to extend financial management systems to the DHMT level, enabling district-level decision-makers to access funding and financial data in a timely manner, and better target expenditures by tracking finances and services delivered, as well as disease incidence and prevalence;

(E) an assessment of the interoperability of the DHMT financial and health information systems to determine how financial and health service data can be most efficiently accessed and analyzed for preparing and adjusting the annual operating plans (AOPs) of the DHMTs;

(F) technical assistance to strengthen DHMT capacity to involve stakeholders and partners in the planning and evaluation of programs, services, and comprehensive AOPs, ncluding an operations budget that is assessed and adjusted quarterly, allowing the measurement of district-level PHC service delivery, including GBV services, against targets;

(G) technical assistance to the MOH and MOF to establish an annual budgetary process for determining the annual budget and resource needs of the DHMTs, and allocating funds and resources in a timely manner based on the approved budget and plan in order to increase DHMT planning and financial autonomy;

(H) grants to DHMTs meeting established key performance indicators as a means of incentivizing financial reforms and improved PHC service delivery, including GBV services;

(I) technical assistance to support DHMTs to produce quarterly data and the MOH to revitalize the Annual Joint Review to measure performance against targets;

(J) technical assistance to support the MOH in tracking and managing health care worker training; and

(K) technical assistance to support the MOH in defining PHC staffing structures, roles and processes from the community to district levels, including GBV.