Transcript 2014 IHP+ Monitoring - International Health Partnership

2014 Round of Monitoring
Development Effectiveness
in Health
Summary of Findings
(to be validated)
02 December 2014
2014 IHP+ monitoring: December 2014
Key findings
The seven behaviours
1
2
3
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6
7
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.
Resource inputs recorded on budget and in line with national priorities
Financial management systems harmonized and aligned; requisite capacity building done
or underway, and country systems strengthened and used.
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.
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.
Opportunities for systematic learning between countries developed and supported by
agencies (south-south/triangular cooperation).
Provision of strategically planned and well-coordinated technical support.
2014 IHP+ monitoring: December 2014
Measured in the 2014
IHP+ Monitoring
√
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×
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×
×
Slide 1
1.
2.
3.
4.
5.
6.
Key messages
IHP+ membership is associated with better country performance
Performance by governments and development partners are correlated
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
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
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
UP
the country results framework
Support to CSOs for participation in health policy processes
UP
Participation in mutual assessment of progress in implementing health commitments
LEVEL
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
2014 IHP+ monitoring: December 2014
Slide 2
Performance of
24 partner countries
2014 IHP+ monitoring: December 2014
Slide 3
Brief overview of
participating countries
Per capita health expenditure (current USD, 2012)
300
250
200
150
100
50
0
% Domestic vs External funding
100
80
60
40
20
0
% domestic funding
2014 IHP+ monitoring: December 2014
% external funding
4
Slide 4
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
88%
71%
U
P
53%
Figure 2: Number of countries with
CSO involvement in each of the five
health policy processes
2014 IHP+ monitoring: December 2014
2005/07
(9/17)
LEVEL
2010/11
(12/17)
2013
(15/17)
Partner countries continue to deliver on commitments to establish
health sector strategies, measure results and strengthen
accountability (2)
Figure 3: Proportion of countries
with jointly assessed national health
strategies
94%
U
P
59%
59%
2005/07
(10/17)
2010/11
(10/17)
Figure 4: % of countries that have
established mutual accountability
processes (N=24)
LEVEL
2014 IHP+ monitoring: December 2014
6
2013
(16/17)
Partner countries continue to deliver on commitments to establish
health sector strategies, measure results and strengthen
accountability (3)
Figure 6: Aggregate scores of participating countries on 4 accountability
indicators
5
Median number of years since joining IHP+ = 5
Median number of years since
joining IHP+ = 2.5
4
3
2
1
2014 IHP+ monitoring: December 2014
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7
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
15%
15%
13%
da
et
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m
ali
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an
M
ia
oz
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M
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C
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Ca
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Co
e
te
d'I
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ire
5%
U
P
7%
7%
6%
Ug
an
8%
11%
10% 10% 11%
10% 10%
To
go
7%
9%
r
Ni
ge
r ia
Se
ne
ga
Sie
l
rra
Le
on
e
Su
da
n
7%
10%
Ni
ge
7%
8%
Ne
pa
l
7%
9%
Vi
11%
11%
Figure 8: Government health sector budget execution in 2013
100%
86%
104% 100%
96% 93%
60%
100% 94% 92%
95% 97% 88%
69%
78%
91%
95%
85%
77%
52%
97%
Target 90%
2014 IHP+ monitoring: December 2014
ali
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oz
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i
Ca
m
bo
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Ca
m
er
oo
Ca
n
pe
Ve
rd
Co
e
te
d'I
vo
i re
28%
8
U
P
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
4
Mean level of external health sector funding = 30%
3
Mean level of external health sector
funding = 16%
2
1
2014 IHP+ monitoring: December 2014
9
a
Gu
Gu
in
ea
in
ea
Bi
ss
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on
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as
o
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C
au
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Vi
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na
m
Ni
ge
ri a
0
Partner countries continue to chart progress towards meeting
commitments for effective development cooperation. Progress,
however, is not uniformly shared by all countries (1)
8
Development Effec veness Score
Figure 10: Country score on 7
development effectiveness indicators
by year of IHP+ membership
R² = 0.54345
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6
5
4
3
2
1
0
0
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3
4
5
Years with IHP+
6
7
8
8
Development Effec veness Score
Figure 11: Country score on 7
development effectiveness indicators
by % of external health financing
1
R² = 0.34813
7
6
5
4
3
2
1
0
0
2014 IHP+ monitoring: December 2014
10
20
30
40
% External Funding
10
50
60
The performance of 37
development partners
2014 IHP+ monitoring: December 2014
Slide 11
Brief overview of
Development Partners
Total Health Aid in USD (million) (ODA 2012)
8000
7000
6000
5000
4000
3000
2000
1000
0
Proportion of aid spent on health (% ODA)
100.0%
80.0%
60.0%
40.0%
20.0%
0.0%
2014 IHP+ monitoring: December 2014
Slide 12
Development partners continue to participate in processes for
accountability at the country level (1)
World Bank
Figure 12: Proportion of development
funds disbursed through a mechanism
aligned with the Country Results
Frameworks
98%
USA
93%
UNICEF
93%
UK
90%
Germany
88%
Belgium
87%
UNFPA
82%
Canada
79%
EC
76%
Netherlands
65%
France
56%
GAVI
Figure 13: Proportion of development
partners in selected countries that are
aligned with the Country Results
Frameworks
52%
Global Fund
50%
WHO
50%
UNAIDS
U
P
34%
100%
80%
60%
U
P
40%
20%
0%
Benin
Burkina Faso
Burundi
DRC
Ethiopia
Mali
2005/7
2014 IHP+ monitoring: December 2014
Mozambique
2010/11
Nepal
Nigeria
Senegal
2013
13
Uganda
Development partners continue to participate in processes for
accountability at the country level (2)
Figure 14: % of countries where development partners reported at least
one type of CSO support
100%
100%
100%
100%
86%
83%
83%
81%
80%
80%
73%
71%
71%
67%
57%
AI
DS
(N
Ne
=8
th
)
er
lan
ds
(N
=5
)
GA
VI
(N
=2
2)
Ge
rm
an
y
(N
=7
)
Be
l gi
um
(N
=7
)
W
HO
(N
=2
3)
UN
IC
EF
(N
=1
6)
US
A
(N
=5
)
UN
FP
A
(N
=1
5)
EC
(N
=1
1)
Fr
an
ce
(N
Gl
ob
=7
)
al
Fu
nd
(N
=2
4)
Ca
na
da
(N
=4
)
Sp
ain
(N
W
=7
or
ld
)
Ba
nk
(N
=1
5)
UN
UK
(N
=5
)
47%
U
P
Figure 15: Development partner participation in mutual health sector
assessments in selected countries
100%
80%
60%
40%
20%
0%
Benin
DRC
El Salvador
Ethiopia
2005/7
2014 IHP+ monitoring: December 2014
Mozambique
2010/11
Nepal
Niger
Senegal
Togo
2013 (comparable)
14
Uganda
LEVEL
Development partners continue to participate in processes for
accountability at the country level (3)
Figure 16: Scores of development partners on 3 accountability indicators
2014 IHP+ monitoring: December 2014
15
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
na
m
da
Vi
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Ug
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To
go
M
nia
oz
am
biq
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Ne
pa
l
Ni
ge
r
Ni
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r ia
Se
ne
ga
Sie
l
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Le
on
e
Su
da
n
ali
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a
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alv
a
El
S
Be
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Bu
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Ca
m
bo
dia
Ca
m
er
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Ca
n
pe
Ve
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Co
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d'I
vo
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66%
99%
94% 90% 100% 91% 92%
88% 89% 82%
82%
79%
76%
76%
63%
Target 90%
au
78% 73%
M
98%
98% 92%
90% 91% 96%
do
r
Et
hio
pia
Gu
Gu
ine
ine
a
aB
iss
au
84%
Figure 18: Combined government/development partner health sector budget
execution in 2013
ali
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nd
a(
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no
Su
d
da
at
a)
n(
no
da
ta
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Ca
m
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n
100% 98% 94% 94% 92% 92% 91% 91% 91%
89% 88% 88% 87% 87% 85% 84% 84% 83%
75% 74% 67%
59%
2014 IHP+ monitoring: December 2014
16
D
O
W
N
Performance of development partners on financing and financial
management is weaker, despite improvements in financing by
partner countries (2)
Figure 19: Development partner
forward expenditure estimates
available to MOH
Figure 21: % of aid on budget by
development partner
D
O
W
N
86%
54%
34%
2015
2016
LEVEL
2017
Figure 20: % of total aid on
budget
Target
85%
81%
72%
71%
LEVEL
2005/07
2010/11
2013
2014 IHP+ monitoring: December 2014
17
Performance of development partners on financing and financial
management is weaker, despite improvements in financing by partner
countries (3)
Figure 22: % of partner funds using
national PFM system
Target
80%
D
O
W
N
65%
42%
41%
2005/07
2010/11
2013
Figure 23: % of partners using PFM process in countries with
CPIA≥3.5 (N = # partners/country)
90%
88%
D
O
W
N
80%
70%
56%
Ethiopia Burkina Faso Mozambique Cape Verde
(N=10)
(N=8)
(N=10)
(N=10)
2014 IHP+ monitoring: December 2014
Mali
(N=9)
53%
Vietnam
(N=15)
50%
Niger
(N=6)
50%
43%
Sierra Leone Senegal
(N=6)
(N=7)
40%
Burundi
(N=10)
18
11%
7%
Benin
(N=9)
Cambodia
(N=14)
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
3.12
2.54
2.49
2.41
2.20
2.18
2.16
2.13
2.03
1.91
1.90
1.77
1.52
1.48
1.24
Ca
na
da
(N
=4
UN
)
ICE
F(
N=
16
)
UK
(N
=5
)
EC
(N
Ne
=1
the
1)
rla
nd
s(
N=
5)
Be
lgi
um
Glo
(N
=6
ba
)
lF
un
d(
N=
W
or
24
ld
)
Ba
nk
(N
=1
5)
UN
FP
A(
N=
15
)
W
HO
(N
=2
3)
Fra
nc
e(
N=
7)
US
A(
N=
5)
Sp
ain
(N
=7
UN
)
AID
S(
N=
Ge
8)
rm
an
y(
N=
7)
GA
VI
(N
=2
2)
2.54
2014 IHP+ monitoring: December 2014
19
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
4.54
4.45
4.39
4.34
4.29
4.14
3.83
ID
S(
N=
8)
US
A
Gl
(N
ob
=5
al
)
fu
nd
(N
=2
Ge
4)
rm
an
y(
N=
7)
Fr
an
ce
(N
=7
)
Sp
ai
n
(N
=7
)
GA
VI
(N
=2
2)
4.52
UN
A
k(
N=
15
)
Ba
n
(N
=1
5)
W
or
ld
(N
=2
3)
4.83
UN
FP
A
HO
(N
=6
)
W
giu
Be
l
4.85
Ne
th
e
4.87
m
(N
=5
)
5.16
rla
nd
s
(N
=1
1)
5.21
EC
(N
=5
)
5.54
UK
N=
16
)
5.54
IC
EF
(
UN
Ca
n
ad
a
(N
=4
)
5.79
Figure 26: Correlation between
the scores of partners at
country level
Development Partner Score
7
6
5
4
3
2
1
R² = 0,52
0
0
1
2
3
4
Country Score
2014 IHP+ monitoring: December 2014
20
5
6
7
6 Take home messages
1. 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
2014 IHP+ monitoring: December 2014
Slide 21
6 Take home messages
4. 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.
2014 IHP+ monitoring: December 2014
Slide 22
“As in any partnership, it is likely the
interaction between both partners
that is responsible for the outcome”
Thank you for your kind attention
Leo Devillé
2014 IHP+ monitoring: December 2014