2014 IHP+ monitoring: December 2014 2014 Round of Monitoring Development Effectiveness in Health Summary of Findings (being validated) 12 December 2014.
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2014 IHP+ monitoring: December 2014
2014 Round of Monitoring Development Effectiveness
in Health
Summary of Findings(being validated)12 December 2014
2014 IHP+ monitoring: December 2014 Slide 2
Key findings The seven behaviours Measured in the 2014
IHP+ Monitoring
1 Agreement on priorities that are reflected in a single national health strategy and underpinning sub-sector strategies, through a process of inclusive development and joint assessment, and a reduction in separate exercises.
√ 2 Resource inputs recorded on budget and in line with national priorities √ 3 Financial management systems harmonized and aligned; requisite capacity building done
or underway, and country systems strengthened and used. √ 4 Procurement/supply systems harmonized and aligned, parallel systems phased out,
country systems strengthened and used with a focus on best value for money. National ownership can include benefiting from global procurement.
× 5 Joint monitoring of process and results is based on one information and accountability
platform including joint annual reviews that define actions that are implemented and reinforce mutual accountability.
√ 6 Opportunities for systematic learning between countries developed and supported by
agencies (south-south/triangular cooperation). × 7 Provision of strategically planned and well-coordinated technical support. ×
2014 IHP+ monitoring: December 2014 Slide 3
Key messages 1. IHP+ membership is associated with better country performance 2. Performance by governments and development partners are correlated 3. Partner countries continue to deliver on commitments to establish health sector strategies, measure
results and strengthen accountability Establishing a country results framework UP Engagement of civil society in health policy and planning LEVEL Joint assessment of national strategy including targets and budgets UP Implementation of policies and procedures for mutual accountability LEVEL 4. Partner countries have improved the financing and to some extent financial management of the health
sector Proportion of budget allocated to health and level of budget execution UP Predictability of health funding over next 3 years through rolling budget or MTEF UP Public financial management strength according to CPIA LEVEL 5. Development partners continue to participate in accountability processes at country level Support for and use of country results framework and proportion of funds monitored using
the country results framework UP
Support to CSOs for participation in health policy processes UP Participation in mutual assessment of progress in implementing health commitments LEVEL 6. Performance of development partners on financing and financial management has stagnated Level of health sector support budget execution in 2013 DOWN Proportion of support to government registered in national health budget LEVEL Predictability of funding communicated to government for 2015-17 DOWN Proportion of support using national financial management procedures DOWN
2014 IHP+ monitoring: December 2014 Slide 4
Performance of 24 partner countries
2014 IHP+ monitoring: December 2014 Slide 5
Brief overview of participating countries
5
El Salv
ador
Cape V
erde
Vietnam
Sierra
Leone
Nigeria
Cote d'Iv
oire
Camero
on
Maurita
nia
Cambodia
Senega
l
Uganda
MaliTo
go
Burkina
Mozambique
Nepal
Benin
Guinea
Guinea Biss
auNige
r
Burundi
Ethiopia
DRC Su
dan0
50100150200250300
Per capita health expenditure (current USD, 2012)
El Salv
ador
Vietnam
Nigeria
Maurita
nia
Cote d'Iv
oire
Camero
onGuinea
Sierra
Leone
Cambodia
Togo
Nepal
Senega
lNige
r
Cape V
erde
Uganda
Mali
Burkina
Benin
Guinea Biss
au
Burundi
Ethiopia
DRC
Mozambique
Sudan
0
20
40
60
80
100
% Domestic vs External funding
% domestic funding % external funding
2014 IHP+ monitoring: December 2014
Partner countries continue to deliver on commitments to establish health sector strategies, measure results and strengthen accountability (1)
Figure 1: Proportion of countries with Country Results Frameworks
Figure 2: Number of countries with CSO involvement in each of the five health policy processes
UP
LEVEL
2014 IHP+ monitoring: December 2014 7
Partner countries continue to deliver on commitments to establish health sector strategies, measure results and strengthen accountability (2)
Figure 3: Proportion of countries with jointly assessed national health strategies
Figure 4: % of countries that have established mutual accountability processes (N=24)
UP
LEVEL
2014 IHP+ monitoring: December 2014 8
Partner countries continue to deliver on commitments to establish health sector strategies, measure results and strengthen accountability (3)
Figure 5: % countries with at least 4 mutual accountability processes (N=17)
Figure 6: Aggregate scores of participating countries on 4 accountability indicators
LEVEL
2014 IHP+ monitoring: December 2014 9
Partner countries have improved the financing and to some extent financial management in the health sector (1)
Figure 7: Proportion of national budget allocated to health in 2013
Figure 8: Government health sector budget execution in 2013
UP
UP
2014 IHP+ monitoring: December 2014 10
Partner countries have improved the financing and to some extent financial management in the health sector (2)
Figure 9: Average scores of participating countries on 3 financing indicators
2014 IHP+ monitoring: December 2014 11
Partner countries continue to chart progress towards meeting commitments for effective development cooperation. Progress, however, is not uniformly shared by all countries (1)
Figure 10: Country score on 7 development effectiveness indicators by year of IHP+ membership
Figure 11: Country score on 7 development effectiveness indicators by % of external health financing
2014 IHP+ monitoring: December 2014 Slide 12
The performance of 37 development partners
2014 IHP+ monitoring: December 2014 Slide 13
Brief overview of Development Partners
United St
ates
Japan
World Ban
k
GFATM EC
German
y UKFra
nce
Netherl
ands
GAVI
Australi
a
Canad
a
Swed
enWHO
UNFPA
UNICEF
UNAIDS
Belgium
Spain
Irelan
dIta
ly
Luxembourg
Portuga
lUNDP
AfDBAsD
B0
10002000300040005000600070008000
Total Health Aid in USD (million) (ODA 2012)
GFATM
UNFPA
WHOGAVI
UNAIDS
United St
ates
Netherl
ands UK
Luxembourg
Canad
aJap
an
World Ban
k
Irelan
d
UNICEF
German
y
Australia
Swed
enSp
ain
Belgium
France EC Ita
lyAfDB
Portuga
lUNDP
AsDB
0.0%20.0%40.0%60.0%80.0%
100.0%
Proportion of aid spent on health (% ODA)
2014 IHP+ monitoring: December 2014 14
Development partners continue to participate in processes for accountability at the country level (1)
Figure 12: Proportion of development funds disbursed through a mechanism aligned with the Country Results Frameworks
Figure 13: Proportion of development partners in selected countries that are aligned with the Country Results Frameworks
UP
UP
2014 IHP+ monitoring: December 2014 15
Development partners continue to participate in processes for accountability at the country level (2)
Figure 14: % of countries where development partners reported at least one type of CSO support
Figure 15: Development partner participation in mutual health sector assessments in selected countries
UP
LEVEL
Benin DRC El Salvador Ethiopia Mozambique Nepal Niger Senegal Togo Uganda0%
10%20%30%40%50%60%70%80%90%
100%
2005/7 2010/11 2013 (comparable)
2014 IHP+ monitoring: December 2014 16
Development partners continue to participate in processes for accountability at the country level (3)
Figure 16: Scores of development partners on 3 accountability indicators
2014 IHP+ monitoring: December 2014 17
Performance of development partners on financing and financial management is weaker, despite improvements in financing by partner countries (1)
Figure 17: Development partner health sector budget execution in 2013
Figure 18: Combined government/development partner health sector budget execution in 2013
DOWN
2014 IHP+ monitoring: December 2014 18
Performance of development partners on financing and financial management is weaker, despite improvements in financing by partner countries (2)
Figure 19: Development partner forward expenditure estimates available to MOH
Figure 20: % of total aid on budget
Figure 21: % of aid on budget by development partner
DOWN
LEVEL
LEVEL
2014 IHP+ monitoring: December 2014 19
Performance of development partners on financing and financial management is weaker, despite improvements in financing by partner countries (3)
Figure 22: % of partner funds using national PFM system
Figure 23: % of partners using PFM process in countries with CPIA≥3.5 (N = # partners/country)
DOWN
DOWN
2014 IHP+ monitoring: December 2014 20
The performance of developing partners on financial management of assistance has stagnated despite improvements of financial management in partner countries (4)
Figure 24: Scores of development partners on 4 financial cooperation indicators
2014 IHP+ monitoring: December 2014 21
The overall performance of development partners on meeting their commitments to effective cooperation is lower than that of partner countries, but at the country level the scores obtained by both partners are correlated
Figure 25: Overall score of development partners on 7 indicators
Figure 26: Correlation between the scores of partners at country level
0 1 2 3 4 5 6 70
1
2
3
4
5
6
7
f(x) = 0.376014381214161 x + 1.69035274179052R² = 0.525536693412663
Country Score
Deve
lopm
ent P
artn
er S
core
2014 IHP+ monitoring: December 2014 Slide 22
6 Take home messages1. There is some correlation between the length
of stay in the partnership and overall score on development effectiveness for countries
2. Performance by governments and development partners are correlated
3. Countries have generally made progress in meeting commitments, particularly in the area of developing tools for accountability and engaging CSOs, although there is wide variation in country performance and CSOs have a different view
2014 IHP+ monitoring: December 2014 Slide 23
6 Take home messages4. Many countries have increased their domestic
funding for health and developed medium term forecasts, but there has been limited progress on improving financial management systems.
5. Compared with 2012, some DPs score worse particularly on the financing indicators; again there is variation in performance
6. Need to use the findings from this monitoring especially at country level, as a tool for accountability - some experience already this year.
2014 IHP+ monitoring: December 2014
“As in any partnership, it is likely the interaction between both partners that is responsible for the outcome”
Thank you for your attention
Leo Devillé
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