what has changed in 5 years ?
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What has changed in 5 years ?. 3 cycles of independent monitoring of the IHP+. Geneva, 4 th October 2012. Strengthening Accountability to Achieve the Health MDGs. Starting in 2007…. IHP+ Global Compact. - PowerPoint PPT PresentationTRANSCRIPT
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What haschanged in 5 years ?
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
Geneva, 4th October 2012
3 cycles of independent monitoring of the IHP+
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Starting in 2007…
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IHP+ Global Compact
Agreement to put the Paris Framework into practice in the health sector, for Health
Systems Strengthening
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What was expected to change?
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AVAILABILITY
COLLECTION UTILISATION
DEMAND
HEALTH RESULTSTHROUGH STRONGER
HEALTH SYSTEMS
IHP+Results2. 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
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Monitoring over 5 Years
August 2008 May 2010 April 2011 October 2012
Significant meetings: - Ministerial Review 2008- Country Health Sector Team meetings (Bamako June 2009; Brussels Dec 2010)- World Health Assembly side events: 2010, 2011, 2012.
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15 Development Partners
10 Countries
Baseline Data 2009 Data
10+12 Standard Performance Measures
4,000+ Data Points!
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17 Development Partners
19 Countries
Baseline Data 2009 Data
10+12 Standard Performance Measures
6,000+ Data Points!
2011 Data
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Transparent (and credible) picture of performance over time
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What is changing?Have a more informed picture of what is happeningBetter cooperation & coordination in most countriesSome collaboration between partners to manage
for results & to put in place mutual accountability
BUT
No significant (‘step-change’) improvements in the quality of Health aid delivered to IHP+
Partner Countries
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By 2011, Development Partners met only 3 of 12 targets (unchanged since 2009)
Least DP progress on measures of actual aid delivery: multi-year aid commitments, aid that is recorded on country budgets, and aid that uses country systems.
Partner Countries made less than expected progress on improving health budget allocations and disbursements
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Country Public Financial Management Systems
0.5
0.5
0.5
0.5
1.0
PARTICIPANTS IN 2010 & 2012 PARTICIPANTS ONLY IN 2012
0.5
1.0
0.50.5
1.0
0.5
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Aid flowing through country PFMs
[For 10 Countries with data for all 3 rounds]
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2DPa: Aggregate proportion of partner support reported on national budgets
Donors putting their money ‘on budget’ for health
52%
2007 2009 2011
79%52% 61%
2007 2009 2011
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Predictability of funding
3DP: health sector aid provided through multi-year commitments
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Changes in Health Systems
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Health Workforce
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Progress in ‘first 5’ countries All had the 4 pillars in place (Compact + National Health Plan +
Performance Assessment Frameworks + Mutual Accountability Process)
All received more external aid recorded on their national budgets from 2009 to 2011 (Target met in Nepal, Mali and Mozambique)
• A mixed picture on the extent of multi-year commitments by donors…
• …but trend towards increased levels of predictability in 4 countries (2 even had significantly more aid delivered than planned
for).
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Where to from here?The value of Performance Monitoring for Accountability
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
The end goal of a virtuous cycle.
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Recommendations
1. Do what’s necessary to actually deliver more effective health aid!
2. Make better use of Mutual Accountability mechanisms to drive this progress
3. Ensure future reporting & monitoring is fully owned by stakeholders
4. Continue monitoring & provide more real-time information that decision-makers need to know
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1. Is this information relevant, interesting and useful to improve investments into the health sector?
2. How can we make better use of this information?
?