Lessons from Health Sector Performance Reporting & Monitoring Strengthening Accountability to Achieve the Health MDGs Geneva, 5 th October 2012.

Lessons from Lessons from Health Sector Health Sector Performance Performance Reporting & Reporting & MonitoringMonitoring

Strengthening Accountability to Achieve the Health MDGs

Geneva, 5th October 2012

Results Framework Performance Monitoring & Evaluation of

the IHP+

AVAILABILITYAVAILABILITY

COLLECTIONCOLLECTION UTILIZATIONUTILIZATION

DEMANDDEMAND

HEALTH RESULTSTHROUGH

STRENGTHENED HEALTH SYSTEMS

HEALTH RESULTSTHROUGH

STRENGTHENED HEALTH SYSTEMS

Why monitor?2. Transparent Information from

Performance Reporting & Monitoring 3. Mutual

Accountability Processes with

Forum for Discussion

1. Mechanism for Participation, based on IHP+ Global and Country Compacts

Reflecting on 5 Years of Monitoring

August 2008 May 2010 April 2011 October 2012

GOVERNMENTS OF:Cambodia, Cameroon, Cape Verde, Chad, Côte d’Ivoire, Gambia, Guinea, Kenya, Madagascar,

Pakistan, Vietnam, Zambia.

DEVELOPMENT PARTNERS: Canada, Finland, France, Italy, Portugal,

International Labour Organisation (ILO), Bill & Melinda Gates

Foundation .

GOVERNMENTS OF:

DEVELOPMENT PARTNERS:

NOT YET PARTICIPATING IN IHP+RESULTS FOR ANNUAL PERFORMANCE REPORTING OR SELF REPORTING & ACCOUNTABILITY

PARTICIPATING IN IHP+RESULTS

TAKING STEPS TO USE IHP+RESULTS REPORTING TO STRENGTHEN MUTUAL ACCOUNTABILITY

1 2

3ENSURING HEALTH SECTOR AID EFFECTIVENESS COMMITMENTS ARE SYSTEMATICALLY AND ROUTINELY MONITORED

4

This represents the end goal of a virtuous cycle.

1. Mechanism for Participation, based on IHP+ Global and Country Compacts

2. Transparent Information from

Performance Reporting & Monitoring

How information has been collected & managed

MAR - JUL 2010Developed and/or agreed by IHP+ signatories.

Reviewed in July 2011. FEB - APR 2012

Questionnaire based on Standard Performance Measures. Data collected and used as basis for ratings.

MAY - JUL 2012Draft scorecards discussed with participating

signatories.

IHP+GLOBAL

COMPACT

STANDARDPERFORMANCE

MEASURES QUESTIONNAIRE RATING

SCORECARD

How this Information has

been used (or not!) Development

agenciesHQ-level reviews; Country sector reviews

National governments

Govt Reviews; Country sector reviews; Compact Reviews

Civil SocietyParliamentarians (Nigeria); IHP+ Civil

Society Consultative Group; Busan side-event.

The IHP+ network Key contributor to TT HATS (Busan)

Accountability meetings

Southern Civil Society Forum (Ghana, Feb 2011), Action for Global Health (Paris, May 2011; Madrid, June 2011)

ResearchersCenter for Global Development paper on QuoDAH (May, 2011); Globalization & Health paper (July 2012)

General Public Lancet article and letter.

3. Mutual Accountability Processes with

Forum for Discussion

What change has IHP+Results contributed to

Some evidence of increasing cooperation to deliver more effective aid (but not yet at level of collaboration)

Information is now available

Voluntary Participation is increasing

Greater Transparency with Performance Reports, Scorecards and Web Data

Discussions are being had about aid in the health sector (some country-led), with power shift in conversations

Other: Conceptual positioning of IHP+ as an aid effectiveness intervention; Sectoral perspective on aid effectiveness (TTHATS); Alignment for COIA etc

What have been the challenges?

➔ Lack of appropriate use of the IHP+Results mechanism and information products, to improve coordination or to inform collaborations between partners

➔ Not collecting and reporting the right Information at the right time

➔ Participation for the wrong reasons (cooperative compliance rather than learning) and incentives are not compelling

➔ Transparency without data integrity because information is not systematically validated, or being questioned

➔ Discussions not taking place at the right levels, with the right people (mutual accountability and review mechanisms are not in place or being routinely used)

➔ Lack of capacity within partner institutions?

What we have learnedMEASURES

(TRANSPARENCY)1. Paris Indicators a good

strategic choice2. Some indicators need

attention: not appropriate, not useful (procurement, PBAs, capacity building)

3. Some definitions need attention (‘active’)

4. Lack of qualitative information weakens potential for learning & improvement

5. Framework needs to be able to detect & report unanticipated changes

6. Targets need to be better defined (lowest common denominator vs aspiration?)

7. IAG

PROCESS (PARTICIPATION):

1.Voluntary participation seems to work

2.Some sense of compliance (cooperation) driving participation, rather than learning

3.Transaction costs are heavy and will continue to be if reporting has value

4.Triangulation is important for credibility, but how important – can we ever reach truth?

5.Locating the process at country level remains the aspiration

6.NB: Monitoring must adapt and evolve

USE (FORUM FOR DISCUSSION)

1.Limited discussion of reports and scorecards

2.Prospects for use in 2012/13 are better – key to future demand for monitoring

3.Civil society role in promoting use is important – IHP+ needs to better resource CSOs to engage

4.Important to articulate the value of monitoring aid effectiveness to health results

5.Use and accessibility are connected – scorecards have been valuable in this regard

AVAILABILITYAVAILABILITY

COLLECTIONCOLLECTION UTILIZATIONUTILIZATION

DEMANDDEMAND

HEALTH RESULTSTHROUGH

STRENGTHENED HEALTH SYSTEMS

HEALTH RESULTSTHROUGH

STRENGTHENED HEALTH SYSTEMS

How to improve?2. Transparent Information from

Performance Reporting & Monitoring 3. Mutual

Accountability Processes with

Forum for Discussion

1. Mechanism for Participation, based on IHP+ Global and Country Compacts

Questions on Future Monitoring

1) What needs to be done to stimulate demand for future monitoring?

2) How should specific technical issues relating to information relevance, validity & availability be addressed (and by whom?)

3) How can better use be made of the information – especially through collaborative discussions & by country level decision-makers?