IHP+: introduction and ministerial review

IHP+: introduction and ministerial

reviewAction for Global Health Conference

S t r e n g t h e n i n g A c c o u n t a b i l i t y t o A c h i e v e t h e H e a l t h M D G s

Madrid, 7th June 2011

What is the International Health Partnership (IHP+)?

• A global partnership that puts the Paris and Accra principles on aid effectiveness into practice, with the aim of improving health services and health outcomes, particularly for the poor and vulnerable

• 52 signatories in 2011 (up from 27 in 2007): 27 developing countries, 13 bilateral donors, 12 international organisations.

www.internationalhealthpartnership.net

What is the impetus behind IHP+?

0

200

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1990 2008 MDG

Sub-Saharan Africa

MM

R pe

r 100

,000

live

birth

s

Donor Commitments for Health as % of Total Health Expenditure

0

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1997 1998 1999 2000 2001

Mauritania

Tanzania

Mali

Eritrea

What is the impetus behind IHP+?

Source: http://siteresources.worldbank.org/EXTPARLIAMENTARIANS/Resources/Debrework_Zewdie.pdf

IHP+: expected outcomes & mechanisms• Expected outcomes

– Better use of existing funds through improved partner coordination; increased investment in national health strategies

– Country ownership - Stronger government leadership in sector coordination– Reduced burden on developing countries, allowing increased focus on

implementing the national health strategy – ……and hence contribution to better results

• Mechanisms1. Support to national planning processes2. Joint assessment of national health strategies and plans3. Country compact development4. One results monitoring framework, to track strategy implementation5. Promoting mutual accountability by monitoring progress against compact

commitments

5. Promoting mutual accountability by monitoring progress against compact commitments

• Several avenues, at national and global level

– Nationally: through more inclusive health policy dialogue, sector performance monitoring mechanisms e.g. joint annual reviews (JARs)

– Independent monitoring of progress against partners' commitments in Global and Country Compacts – IHP+Results consortium scorecards and annual report

– Global platforms for discussion e.g. during World Health Assembly; Country Health Teams Meetings;

– Ministerial Review?

What results have been achieved? (1)

What results have been achieved? (2)

Our findings suggest that progress has been made in key areas:•Most governments and DPs have put in place the four policy pillars.•DPs have made progress in aligning their health aid financial aid and capacity building with national priorities.•Five governments have increased the proportion of their national budget allocated to health.•Three governments have strengthened their public financial management systems.•DPs are increasing their use of public financial management systems for their health aid•Civil society is seen to be engaging more in national health policy processes; governments appear to be involving them more Less progress has been reported on targets for responsible health financing and for strengthening and using country systems:•No African government had met the 15% Abuja target•DP performance on predictable financing has been mixed•Government performance in disbursing their health budgets was mixed.•DP use of country procurement systems appeared to have declined.•Civil society engagement in health sector policy processes could increase much further, and could be supported much more.•Countries allocated a lower proportion of funding to human resources for health, despite developing•HRH plans and beginning to integrate them into national health plans.

Establishing and supporting national plans

52% 79%

2007 2009

2DPa: Aggregate proportion of partner support reported on national budgets.

Aid reported on budget

Are DPs aligning health aid with national priorities?2DPb: support for capacity development that is coordinated and in line with national

strategies

Source DP data returns

0.5

0.5

0.5

0.5

0.5

Strength of country Public Financial Management Systems

Aggregate partner use of Country Public Financial

Management Systems

Mixed effect on Strengthening Systems

Figure 3.9: Proportion of the health sector budget spent on

Human Resources for Health (HRH)

Figure 3.10: Number of skilled medical personnel per 10,000 population

NATIONAL HRH PLAN

Health systems investments

Conclusion

• A growing partnership - increasing signs of country demand for and ownership of the IHP+

• Emergent signs of change – ripples rather than a sea • More information is available for mutual accountability• But more needs to be done, in particular:

• Ensuring meaningful involvement of civil society to progress towards real mutual accountability

• Ensuring stronger country ownership – developing mechanisms to institutionalize monitoring

• Encouraging more partners to participate• Continued focus on results• Ensuring support for aid effectiveness continues – at Busan and in

decisions about the future of the IHP+

Thank you

For more information on IHP+Results please visit

www.ihpresults.net

Additional slides

IHP+ and SWAps

• Building on SWAps (reinforcing, reinvigorating)• Linking to global level• Bringing in new partners• Accountability

EC data in 4 supported IHP+ Countries

Establishing and signing Compacts

Establishing and using national Performance Assessment Frameworks

Establishing and using common accountability mechanisms

Civil Society engagement in policy & planning processes