In the run-up to the establishment of the PSO, issues where policy action is required and possible have been pre-identified and configured as “PSO Projects”. Each “PSO Project” is a concrete and organized effort to take advantage of a perceived opportunity to deal with a circumscribed policy issue or challenge. Each PSO Project has a beginning and an end, is expected to produce direct deliverables and to contribute to improved capacity for health sector governance. PSO Projects are assigned to teams that include relevant MoPH staff and PSO. The configuration through which PSO runs a Project can vary as appropriate: PSO Core staff as such; PSO Core staff reinforced by external experts (contracted or rotated between academia and MoPH); or PSO managing a contract with an academic or civil society organisation that brings the necessary expertise and manpower.
In the selection of policy issues to be addressed through PSO Projects trade-offs had to be made:
the policy issue that is addressed must be policy relevant and of strategic interest to the sector: it has to address a health sector issue or challenge where advances can be made that would contribute to improving health and health equity, moving towards universal coverage, and strengthen the institutional base for governing the health sector in the public interest.
dealing with this issue in a Project format has to bring a potential for capacity building and creation of alliances with key sector stakeholders. This is key to ensure that the Project contributes to sustaining effective, collaborative, and information and evidence-based governance of the health sector.
the policy issue has to be amenable to treatment in a project format and offer perspectives of translation into implementation within the country’s context and resources. This means building on Lebanon’s experience with incremental reform, where one moves forward where political and technical opportunities for doing so exist, and does not waste energy on issues where political or resource constraints make change an illusion.
There are consequences to these trade-offs. First, it means the selected Projects do not constitute a comprehensive reform plan (though most would no doubt be included in such a plan): this is because the selection of Projects had to balance the needs for change with the capacity and opportunities to move forward. Second, it means the list of PSO Projects that make up the Work Programme has to be seen as dynamic: it may change as new challenges and opportunities arise or avenues for change are closed. It behoves the PSO Guiding Committee, with its representation of MoPH, WHO and AUB to monitor the need to adapt the Work Programme over time.
The PSO Projects are grouped in four broad categories, according to the manner in which they are to support decision making and facilitate sector governance and organisation processes. These four broad categories are:
I: Building MoPH & PSO readiness (2 PSO Projects);
II: Modernising health care provision for Universal Health Coverage with People-centred care (11 PSO Projects);
III: Generating strategic intelligence to guide sector governance (5 PSO Projects); and
IV: Organising the policy dialogue on the health sector and its future (5 PSO Projects).