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

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. ×


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


Performance of 24 partner countries


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


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


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



Figure 5: % countries with at least 4 mutual accountability processes (N=17)

Figure 6: Aggregate scores of participating countries on 4 accountability indicators

LEVEL


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


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


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


The performance of 37 development partners


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)


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



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)



Figure 16: Scores of development partners on 3 accountability indicators


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



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



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


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


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


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


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.


“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

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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