Transcript Performance Reviews

Performance Reviews - ZAMBIA
Fifth IHP+ Country Health Teams Meeting
Aligning for better results in changing environments
2-5 December 2014, Sokha Angkor Resort, Siem Reap, Cambodia
C. Simoonga
W. Mwambazi
Y. Siame
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Background
• The Zambian Government thru MoH embarked on health sector
reforms in 1991 based on three guiding principles:
• Leadership
• Accountability
• Partnership.
• The LAP principle emphasized
a Platform of greater
harmonization and alignment between different stakeholders in
the sector.
• Sector Wide Approach (SWAp) institutionalised in 1992 as
mainstay in sector coordination and programming, including
mechanisms for joint sector performance reviews.
• First MoU signed in 2006 affirmed commitment of major
Cooperating Partners to SWAps, e.g. DfID, SIDA, DGIS, EU, The
World Bank, UN Agencies, etc
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Background continued
• The framework of the International Health Partnership
(IHP+), an addendum (Compact) to the MoU was
developed in 2008, which both widened the scope of
the agreement and the kind of stakeholders involved.
• However it was never signed due to the fiduciary
problems that were disclosed in May 2009 which
strained relations with development partners and the
Government, leading to withdrawal of traditional
bilateral partners from pooled and/or budget support.
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Background continued
• In response , the Government with its CPs developed a
Governance and Management Capacity Strengthening
Plan (GMCSP 2012-2016) which aims to strengthen
fiduciary controls, systems and structures in the MoH
with a view to rebuilding confidence in the health
Sector Wide Programming (SWAp) approach.
• Advanced implementation of the GMCSP by all
stakeholders (GRZ, CHAZ, CPs, etc);
• Signing of the second Memorandum of Understanding
between GRZ (MoH, MCDMCH), CPs (includes GFATM)
and NGOs, to reaffirm support to the NHSP 2011-16. 4
Zambian Health SWAp
• The Zambian health SWAp has been a culture of mutual
accountability, aimed at achieving better health
outcomes in a sustainable environment, but recognising
the mandates and policies of all stakeholders.
• Fundamentally this involves:
– Pooling of funds/resources for increased efficiency and
effectiveness
– Common planning and implementation coordination
framework
– Joint Performance Reviews (JARs, MTRs, ETRs), under One
monitoring and evaluation framework.
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Joint monitoring and evaluation
• This is done through: Joint Annual Reviews (JARs)
 Mid Term Reviews (MTRs)
 End Term Reviews (ETRs)
• The JAR which is done annually involves:
– Quantitative and Qualitative assessment of performance
– In-depth review of performance on sampled areas (Policies,
Themes, institutions, and health facilities) against key
indicators, including district-level service delivery
– Makes comparison of policies against thematic areas
– Key stakeholder participation, includes NGOs
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JARs: Advantages and Challenges
• Advantages
– Joint performance review against agreed set of indicators
and targets
– Enhancing mutual accountability for results
– Strengthens policy dialogue for sustaining gains
– External validation and Low sector transaction costs
• Challenges
– Projects and parallel funding (60% funding to NGOs, NHA
2013)
– Lob-sided dialogue (Partners with limited commitment at
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country level)
Summary
• The JARs in Zambia now in its ninth year (2012),
 (JAR-2013 replaced by MTR 2014 of the rNHSP 2011-2016)
• It has emerged as a shared platform for purposes of the
harmonisation of policies and systems
• It has also provided a common platform for a joint
assessment of health system development over the
preceding year as part of the enhanced effort of transparency
and accountability within the sector.
• JARs have great potential for mutual accountability and
strengthening policy dialogue for better health outcomes. 8
THANK YOU
Musi-oa-Tunya (Victoria Falls), Zambia
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