Transcript Lessons learned on Aid Effectiveness

Lessons learned on Aid
Effectiveness
Angelo Stefanini
Guiding principles (OECD – Principles for
Good International Engagement in Fragile States, 2008)
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Ensure activities do no harm
Take context as the starting point
Focus on state building as the central objective
Recognize links between political, security and
development objectives
• Align with local priorities in different contexts
• Agree on practical coordination mechanisms
between international actors
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Initial assessment
• Health sector very fragmented / high
number of players / shortage of ‘system
know how’
• National counterpart favoring bilateral
deals / more inclined to generous donors
• Development partners’ agendas / trapped
in a “moral blackmail” / hostages of
political developments
• Ineffective coordination structure (HSWG)
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Strategy
• Partners (MoH+Donors) to agree on basic
principles of partnership
• Strengthen key functions within MoH, e.g.
planning process, ICD dept.
• Pro-active role for the Shepherd
• Focus on Capacity
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If Capacity elements are defined as…
Then interventions focus on…
RESOURCES
(who has what)
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Material and equipment
Infrastructures, physical facilities
Budget support
Dedicated funding (trust funds etc.)
SKILLS AND KNOWLEDGE
(who knows what)
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Training
Scholarships
Technical Assistance
Technology transfer
ORGANIZATION
(who can manage what)
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Management systems development
Restructuring
Decentralization
POLITICS AND POWER
(who can get what)
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Community empowerment
Civil society advocacy development
Legislative strengthening
Political party development
Discouraging faction/ethnic-based politics
INCENTIVES
(who wants to do what and why)
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Sector policy reforms (e.g. social safety nets,
fiscal policy, health sector reform)
Encouraging civic dialogue, social compacts and
consensus building
Democratic elections
Strengthening accountability structures and
procedures
Improved rule of law
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(Adapted from Brinkerhoff, 2010)
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Levels of Capacities
Health Worker
Health Facility
MoH / Communities / NGOs
National Gvt / International Donors
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Obstacles/Challenges
• The risk of "Incapacity building" or "Capacity
destruction"
• The issues of
– Donors as PLAYERS vs payers
– MoH as STEWARD vs service provider
– HSWG to exchange VIEWS vs news
• The gap / inconsistency between Diplomatic and
Technical Offices
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Lessons Learned
• “A Perfection of Means and Confusion of
Aims” (i.e. Doing well the wrong things)
• The need for a shared Capacity
Framework
• “Pessimism of the Mind, Optimism of the
Will” (A. Gramsci)
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