 So today I will talk, as I said, about budgeting and what you need to think about when you're budgeting and each has two projects, why it is important. The key areas that you need to think about when to that requires funding and a bit of a checklist of what you should look for in a budget and exercise at the end. So why is this budgeting process important sometimes it can seem a bit sort of, oh, it's the financial department they should do that right. I'm a technical person I shouldn't think about money. But it's really important. So it's one of my favorite budgeting pictures here. You know your clients, your Ministry of Health they want these super nice skyscrapers but they give you money to put like two pieces of corn with a toothpick instead. That's what you have money for. So, doing a good budgeting exercise. It sort of sets expectations for the project because when you know what kind of money is on the table. If you are good at budgeting you can also say that this money will take you this far. So don't expect us to deliver this super advanced thing in every health facility in all of the country data entry real time. If you give me enough money to buy five computers and hire one person 20% it will not work. So, a good budgeting process is important to ensure that the available resources are spent at the appropriate domains in your system. So it's not just to say that you have X amount of dollars for your project but also you say a little bit about we will spend half of it on this and 25% percent of it on this and 25% percent of it on this. So it forces you to plan a bit more because you are allocating resources. And as I say it sets the scope and expectation of the project. You can have some minimize as we call them in Norway or you can have a skyscraper. The budget also should ensure that you have money for a maintenance phase or for a long term phase. So, having the money on the table or a good budget in place. It will show that you don't just need funding for year one. It doesn't help that somebody says oh here is $100,000 go ahead. And it sounds like the project is a success. Because if you can show in a good budget that you will need money also for year two and three and four and five. That you have a more sustainable project. If you don't have an idea whether funding will be available in year two, three, four and five. Maybe you shouldn't start because it will be a waste of money that money for year one could maybe be used for something more useful. So who should do the budgeting work for DHS to and how should it be done. So it depends of course on the country the capacity. But the goal is that the country teams should do as much of this budgeting work as possible. I mean, I am capable of making a DHS to budget and my colleagues are so many people can make a good budget but it really should be the country team that does it. And so his bio like the global DHS to team or the his network they can absolutely help you to guide you in the process or help you to review what you have done. We're happy to do that we do that all the time, but it should be led by the country in the ministry ideally. So you should plan for some technical assistance for supervision and quality assurance in this process and we also have some tools available that you can use that we will link to in moodle afterwards some Excel templates that can be useful with the key categories etc. We showed this picture yesterday I hope you remember this the foundational domains of the highest to I will not spend time on the details of it again. This is just to show that all the things on the bottom line here the foundational areas they also need some money. And having this good one plan with proper budget it's it will also help you to get your work funded and to a lot align the different people who will chip in. It can be different donors, it can be different departments in the ministry. It doesn't have to be outside money can also be within government money but to align around one plan. So some key sort of categories or areas that need some funding that you need to think about when you're making your budget is firstly local personnel costs. So this is your core team, they need to get paid somehow. So you need to think about what does it cost to pay the salary of person ABC and D that will take care of your DHS to system over time. So they don't only need to get paid but they also need some money to build their capacity to maybe be sent to academies like this, maybe a more technical Academy to learn etc. And technical assistance costs so that is typically costs associated with having the his groups or other external consultants that know DHS too well to have them come and help you out especially in the beginning. And then there is a big cost, a chunk of money that is local operational costs so that is everything that costs money in your country. Buying devices, paying for internet, making sure your end users are trained, paying the bill to the hosting company, etc. So you could say maybe in the beginning of the DHS to project it's really this DHS to strengthening the core team, it's a big cost. You need to invest in that. And then overall and I'll get back to that. You can also see if you're doing a couple of budget examples you will see that the cost of end user training and devices are really what drives it up. It's a very big difference doing a project with data entry at 10 district offices versus in a country where you're doing facility data entry at 5000 clinics, because you have to train those 5000 clinics to buy them devices, and you have to pay their internet every month. So everybody remember this ship that got stuck. So this big ship is your 20 years of public health data and their program silos. So you know sometimes somebody comes and I have $20,000 this will help you so yeah, maybe it won't really help you so having a good budget will illustrate how far you can go with your money. A colleague of mine sent me this I thought it was a bit funny. So some general budgeting considerations so depending on the state of your core team or the maturity of the country your nature of assistance from the outside will change so you can sort of think that you have your core team skills starting very small in the beginning. It's all new everybody's new to this. They don't know what to do. So you will need a lot of outside help. And then as your team's expertise grows over the years, you will need less and less help from the outside. Another thing to remember in terms of budgeting is that most of the costs in your budget are what we call recurring costs. This means that it's costs that will not be paid once, but it will come again and again and again and again. So for example, if your project requires infrastructure it requires that you buy 1000 tablets for example to support health workers to collect data. You could say maybe on average 20 to 25% of those tablets needs to be replaced every year. This is because a tablet does not last forever. When they get broken people lose them in the river when they're crossing somewhere somebody steals it takes it home, you lose the charger. So it's not like you have bought your 1000 tablets and you are finished. So, next year, you have to have in your budget that you need to buy 250 new tablets, or two. Yeah, depends the number is next act but you get the picture right you need to pay for for things again and again. The same with repair maintenance hosting you need to pay that hosting bill every year or every month connectivity you need to pay that every month, etc. I think I covered this so I will skip this one. So for the core team what you need to think about for budgeting for the core team you need salary, you need salaries people need to get paid. So we see core teams in countries where you you speak to them, and you ask, oh what is your biggest challenge is like yeah I don't really have a pay job. I'm here because I think it's very interesting or it's a volunteer position that's not good. You need to make sure they have salaries and set aside some money for them to go to academies like this to build their network and to build their skills. And also some regional visits from from the his groups, some TA days. In some countries and I don't know this region enough so I'm not sure if this is the, this is the same, but we have this saying that sometimes you need to create some stickiness in the core team, we want core teams that stay for a while. Sometimes you see that government positions are not very well paid. So what you need to think about are there ways that you can incentivize your core team to stay on for for several years to build that, build that capacity it can be maybe some scholarships it can be some contribution to have them get some education. Again sending them to academies etc various options. It's different from country to countries I won't say what you should do but think about it. And then I will just discuss now as some things that you need to think about when you're building your budget. There are some hidden things that you don't necessarily think about. Have you set aside time for orientation meetings, gathering people to start it you need to rent your venues you need to buy your coffee and tea. Have you set aside time for requirements gathering visiting clinics to understand what are their problems, having users travel to your ministry for example. Time for DHS to configuration and testing. And of course training and refresher training. I want to say a little bit about tracker or individual level data collection. Overall, this is much more expensive than doing aggregate data collection. You can think why. Why is that more expensive. Anyone. Why is it more expensive to do individual level data collection than to select aggregated data. It's more personnel more training more infrastructure. Exactly. More personnel more devices more training. And also if you're building a tracker program so if I want to build an immunization registry in my country, I want to track every child that gets vaccinated. This is something that is really part of the health workers work process. So doing an aggregate form you can relatively easily do from the, the capital, the, the ministry of health you have a form looking like this and you just build it. But if you're building a tool that a nurse will use every day in the clinic. You know, in their everyday work practice, you need to set aside time to understand that work practice because you don't want to introduce a tool. That breaks their day. I guess if you want to, you can talk to Palestine team, they know how to make systems that will be for health workers right you have to speak to them spend time with them and get their feedback. And also set aside time so that it's field tested in realistic settings you build something you budget for time to take and try it out in the clinic for a month, sit with them for some weeks understand is it working. Go back readjust. I think I covered this. So we have a tool, a budget tool that we will upload on the moodle platform. We will have an exercise just now in the next couple of minutes. Are you ready to hand out some stuff. Sure. And we will give you a very simplified version of this tool now for the exercise but we have a more advanced tool on our on our pages that you can also review but for the sake of the exercise now which I just cut it down a bit. So again to summarize budgeting details to implementations it's important to establish the scope of the project ensure that you have resources over time. The maturity profile can help you to identify areas that need more money. You need to budget for core team technical assistance and local operational costs. Most costs are recurring recurring they come again and again. And you need to budget for the foundational domains and tracker is more expensive than aggregates. So now we will have a short exercise it maybe it will feel like you are back in math class in primary school. So it's a little case describing a country, fictional country, and their implementation so it's one page with a case. And there is two budget sheets. The first budget sheets is budgeting for year one. And the second budget sheet is budgeting for year two. So year one and year two. So there are some dark. Can you give me an example of the other the budget of a budget sheets. So it looks a little bit like this but it's a simplified version I just want to show you that on the on the paper that you will be handed out. There are some dark yellow fields. This is where you can add your numbers. Okay. Thank you. If you have any questions please raise your hand. It doesn't matter for me if you get like 100% correct answer but it's for you to think and read the case. We have 40 minutes for this exercise. Yeah, you all have this this paper here very soon. This is the budget you want I want you to write in. If you are not very good in math in your head you might need the the. calculator in English calculator. Yeah, you might need your calculator on your phone to make some multiplications. Okay, good luck. I think I will slowly try to go through how I have been thinking in this exercise now. Was it difficult. It was okay. Yeah, good. It's not complicated math, but it's sort of thinking through your implementation. How many people should we train how many devices do we need etc. So first thing I want to say is that there is not 100% a clear answer here. I have some different numbers but I will try to explain how I have been thinking. Is it easy to see or is it too difficult to see. I will try to assume, hold on better. Okay. So let's take the easy numbers first. We know, for example, that the people in the core team should have one training each. That's easy. But they say they need 60 days 60 days of TA from the his groups that's also easy number that's here. But then training of the end users. How many who did you think you have to train. It's a new data set. The health facilities have not seen this health, this data set before. We did have the question and we went to your team and they told us that they don't train the paper base so we did half of the health facilities. And they asked them about the paper base. Okay. So would you have the half of the number of the health centers and that's a number of the hospitals in the district. Okay, that's fine. There are many answers to this you have to think in your implementation. How well trained are the staff in the facilities will it be for them to just have a new data set or is it fine. So here in this example, I said that everybody should get trained, because it's a new data set but we could debate that if that is correct. Maybe you would put in that only the people who are starting to use the tries to use the technology will get trained. There's no right or wrong answer, but, but you had the discussion which is good. Okay. The server ends. I think that's an easy question. Yes, one question. You said that the hospitals is 37. And in your high, you're saying two hospitals per district, right. Oh, oh God, I'm sorry. Yeah, that is actually very correct. Yeah. Correct, correct. This one's too quick. 74 let me just write 74. That is absolutely correct, which means now I haven't done this properly with formulas. So it won't reflect. But for devices, you would need devices for 50% of the health facilities, because the hospitals have devices. So you need to buy devices for the 50% of the health facilities. Now the end numbers here will be wrong because I miscalculated so don't think about that I will talk how I think for connectivity. Budget for connectivity also for district office also for hospital and health facility. But maybe in your country you know that the internet in the hospital it's covered by another departments. Someone else is paying for that I don't need to budget for that. Again, it's up to you and your country so in this example I say we have to pay for internet for hospitals and district offices. But maybe it's not the same in your country for supervision miss it visits. I budgeted here that every health facility and hospital should get a supervision miss it visit. And the reason for that is that if it's a new data set we all saw yesterday how difficult it was to add get the data quality right. So I'm thinking every health facility, they might need some help not just the ones using the highest to because you are just as dependent on good data quality coming from the paper based facilities. Again, there is no correct answer or wrong answer here. But think about it. It's not just the people using the technology that needs help with health data. It's also the ones writing on paper. Okay, if we go to the maintenance budget. Of course now it's less, less users that need training, there was a percentage so you don't need to train everybody on your tube but you need to train some because some people will, some people will retire, they're getting older there. Some people will quit their jobs. You have some new hires, and these people they never got trained in year one. So you have to think they have to get trained as well when they join. So it's good to budget for some retraining. The 10% number is just what the ministry in this la la lands, estimated that their turnover of health staff is. Different in your country. Maybe your country has very high turnover of health staff, or it's very stable. But in any case, it's good to plan for some sort of retraining, because people we all forget what we learned last year. Maybe we, we forget a little bit. The core team, they still need training there are a lot of skills they need to learn. So it's not like if you train them a little bit in year one, they're finished. Maybe the team would like to expand so in year one they do aggregate now the ministry is saying, we want to integrate with these five systems in our country, we want to have individual level data collection for disease a bmc. The core team they need to build their skills every year. So but for them to train every year, not just when you are starting. We see that the core team. Now the country is more they are better in the highest to they don't need so much help anymore, but they need a little bit help. So now they are better at the highest to configuration training material everything. So they're starting with something more advanced. They want to clean up some of the mistakes they did in year one. So everybody needs help, even very advanced countries you know sometimes you get outside help. The hosting costs. It's the same it's not getting less in year two, you have to pay the same every year, or maybe more if inflation is going up devices, you replace some devices 25% and in this case they know from experience them the department of planning or infrastructure they say, we know that a laptop is lasting for X number of years. So you need to plan for that connectivity costs still the same. It's not getting less in year two, you have to pay the same every year, or maybe more or maybe less. The core team salaries. It's the same in year two, maybe more if you have negotiated a pay raise I don't know. Maybe you are expanding the team because you need you see that you need more help so maybe you need to adjust this as well you're getting more people on the team for example, supervision visits. Okay, you should visit your health facilities, I would say, once a year from the data on data use, visit them and say, how is it going, are you collecting. And if you're not visiting everybody then look at the data quality coming from the different facilities visit the ones with the most trouble. I don't know. Again, there is no correct answer here. In my assignment it said that they should get the same one visit each every year. Maybe in your country you would do a subset and you would target the ones with that has most challenges, I don't know it's up to you, but you should budget and plan for that. So I think with that we will end this exercise I hope it was useful to have you think a bit and reflect. So two lines under a correct answer here so don't worry if you don't have exact the same numbers, but I hope you discussed, yes. Thank you I think we need to add the license and the security certificates also. Yes, so I want to say the example that you have here. It's quite a simplified budget because we don't have so much time so I just added few key lines. We have this budget guide that can also help you plan. We did this for for Ministry of Health in Iraq, who love and myself, last year. They said, Oh, we want this implementation where we want to do a facility level data entry. We want four people in every facility to be trained on the highest to we want everybody to have devices, because it sounds very good right. So that's what a country with ambition would like to do. So we help them to budget. And you see, like we will never get this amount of money. So then you need to scale down your implementation plan. And we also calculated how long will it take to train all these end users, if you estimate that a training is three days. Maybe 20 qualified trainers, they cannot train everybody the same week. So you need to spread it out in time. And then suddenly with the proposed implementation plan there. It would, I can't remember now, but it would take like two years to train everybody. But if you scaled it down to two people per facility to receive training. You could start your project before like there are so many considerations you need to think about. So budgeting is also planning. It's not just the numbers. It's also how will you run your projects. What kind of project do you want. It's not just the cash. So I hope this was useful. And now I think we have a 15 minute tea break. And we will be back quarter to 11. Thank you. Good work to everybody.