Innovations for Enhanced Aid Harmonization and Aid Effectiveness

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Innovations for Enhanced Aid Harmonization and Coordination A case study of Nepal Bjorn-Soren Gigler, World Bank Institute [email protected] October 7, 2011

description

This presentation focuses on a case study of Nepal on how to use innovative approaches to enhance aid harmonization and aid effectiveness. the presentation provides (i) an overview about the important challenges of aid effectiveness in Nepal, (ii) an analysis and lessons learned form the Sector-Wide Approach in Health, and (iii) innovations in technology to improve aid transparency, donor harmonization and development effectiveness.

Transcript of Innovations for Enhanced Aid Harmonization and Aid Effectiveness

Page 1: Innovations for Enhanced Aid Harmonization and Aid Effectiveness

Innovations for Enhanced Aid Harmonization and Coordination A case study of Nepal

Bjorn-Soren Gigler, World Bank [email protected] 7, 2011

Page 2: Innovations for Enhanced Aid Harmonization and Aid Effectiveness

1) Background 2) Challenges & Lessons

3) Open Aid Map

AGENDA

1. Overview 2. Key Challenges 1) Aid Effectiveness 2) Aid Harmonization 3) Civil Society

Organization

3. Lessons Learnt

1.

2.

3.

1. Health in Nepal

2. Aid in Nepal

3. SWAp

4. SWAp in Health Sector

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Nepal

Landlocked, diverse country with an average $470 (GDP per capita)

• Population (million) : 29.3 • GDP per capita : $470 (South Asian average: $1,082)• Poverty : 31% below poverty line• HDI :• Culturally, ethnically and religiously diverse • Political transition in 2006

Source: World Bank (2011)

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Nepal

Source: UNDP (2011)

Human Development Index : Trend 1980 – present

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Nepal – Health Sector

Highest Infant Mortality and HIV prevalence in South Asia

• Wide disparity in health conditions. • HIV infection : 0.49% (ages 15-49) • Life expectancy (years) : 67 • Infant Mortality : 39• Under-five mortality : 48 (per 1,000) • Under-five Child malnutrition : 38.8% • Birth attended by skilled health staff : 19%• Access to an improved water source : 88• Progress in nutrition remains limited.

Source: World Bank (2011) & UNGASS (2008)

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KEY REGIONAL DIFFERENCES IN TERMS OF POVERTY

Data available

IndicatorPoverty

incidence

Time period 2001

Source CBS

MAP: POVERTY INCIDENCE (DARKER COLOR HIGHER POVERTY)

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Aid in Nepal

52.80%

34%

* country programmable aid as a % of total gov expenditure (Action Aid 2011)

Aid dependency *

• ODA has been increased greatly from 1960 ($8.2M) to 2009 ($994M)• Highest aid dependent county in Asia

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SWAp

SWAp

$ millions 2004 2005 2006 2007 2008 2009

All 726.0 528.7 528.3 817.8 736.4 994.8

DAC countries 378.9 369.5 345.3 260.5 491.5 598.5

AusAID 3.2 1.1 5.5 1.7 12.6 10.8

DFID 114.3 104.7 58.2 50.8 51.3 140.3

GTZ 30.9 47.6 26.8 64.0 44.5 43.2

USAID 47.7 55.5 57.9 77.1 105.9 79.4

JICA 37.9 110.8 67.8 35.7 58.1 77.0

SDC 12.0 12.8 24.9 16.2 40.1 27.7

Finland 19.3 6.4 20.8 14.6 17.8 39.6

DANIDA 40.1 5.8 32.8 12.1 47.3 45.5

NORAD 65.4 8.1 31.0 52.1 33.6 66.2

Multilateral 347.2 159.2 183.0 457.3 244.9 396.3

IDA (WB) 215.8 35.0 25.0 330.8 158.0 284.2

UNICEF 6.5 5.5 6.4 7.7 6.0 7.4

UNFPA 3.3 4.8 3.9 4.3 5.6 4.4

ILO / WHO 0 0 0 0 0 0

AsDF (ADB) 80.0 73.9 97.2 0 0 25.1

25.3%

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Aid Flows to Nepal in Health Sector

Differences in Priority of Health Sectors (multi-lateral- bilaterals) • Health expenditure per capita : $ 25 • Public exp. of total health expenditure : 35.3%• Public exp. of total GDP : 5.8%

Energy only *

Transportation only*

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SWAp (Sector-Wide Approach)

• characterized by a set of operating principles rather than a specific package of

policies or activities.

• involves movement over time under government leadership towards: - broadening policy dialogue - developing a single sector policy (that addresses private and public sector issues) and a common realistic expenditure program - common monitoring arrangements - more coordinated procedures for funding and procurement.

World Health Organization, World Health Report (2000 )

An approach to international development that brings together governments, donors and other stakeholders within any sector

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SWAp for Health in Nepal

Statement of intent to guide the partnership in health sector in Nepal(initiated in Feb, 2004)

• To reduce transaction cost to the government by aligning external support with Nepal government’s sector plan by strengthening harmonization among the development partners in the health sector

Sector Wide Approach in H

ealth

Donor Country(5)

International Organization

(6)

• Australian Development Agency (AusAID)• British Department for International Development

(DFID) • German cooperation agency (GTZ)• U.S. Agency for International Development (USAID)• Japan International Cooperation Agency (JICA) • Swiss development agency (SDC)

• The World Bank• International Labour Organization (ILO)• UN children’s fund (UNICEF)• UN Population Fund (UNFPA)• World Health Organization (WHO)

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• December 2003 : Health Sector Strategy: An Agenda for Reform• February 2004 : SWAp • July 2004 : Letter of sector development policy by GoN • August 2004 : Nepal Health Sector Programme- Implementation Plan (2004-2010)• March 2005 : Signing of Joint Financing Arrangement (JFA) - GoN, DFID and World

Bank • June 2009 : Signing of JFA by AusAid as third partner to provide health sector budget

Progress

Pool Partner Non-signatory Signatory - Project Support

Nepal Government

• AusAid• DFID • The World

Bank

• ILO • UNAIDS • UNFPA • UNICEF • WHO

• AusAid• DFID • The World

Bank

• GAVI • GFATM • NLRA • Others

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• Launched to support developing countries in achieving health sector MDGs through health system strengthening, supporting national health plans and donor coordination (September 2007)

• In first phase eight countries including Nepal selected for IHP+ • ‘Nepal Health Development Partnership Compact’ signed in February 2009 by

Ministry of Health & Population and eight health sector development partners and it further commits to strengthen the SWAP in health sector

International Health Partnerships +

IHP+

Donor Country(2)

International Organization

(6)

• Australian Development Agency (AusAID)• British Department for International Development

(DFID)

• The World Bank• UN Children’s fund (UNICEF)• UN Population Fund (UNFPA)• World Health Organization (WHO)• UNAIDS • GDC

IHP+ Signatory

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• Every year two Joint Annual Reviews (JAR) are held one for annual work plan and budget and another for review of sector performance and till date nine JARs completed successful

• ‘Health sector development partners forum’ chaired by health secretary as agreed in statement of intent signed in 2004 & IHP+ national compact in 2009

• All major issues are duly discussed in the above two forums

Major Coordination with SWAp in Health

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1) Background 2) Challenges & Lessons

3) Open Aid Map

AGENDA

1. Progress and Achievements

2. Key Challenges 1) Aid Effectiveness 2) Aid Harmonization 3) Civil Society

Organization

3. Lessons Learnt

1.

2.

3.

1. Health in Nepal

2. Aid in Nepal

3. SWAp

4. SWAp in Health Sector

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Key Achievements

some key words

• Improved health outcomes and increased capacity on financial expenditure led to availability of more funds and vice-versa

• Availability of pool fund in significant percentage and joint planning and programming through JAR helped to prepare more realistic and comprehensive health work plan & budget

• The government financial & procurement system is gradually improving as SWAP promotes national system

• Availability of more funds in health sector also helped to address the constitutional provision of basic health as a fundamental right of the citizens and as an effort to remove the financial barrier and reach to all citizens with a universally available essential health care package, free health care scheme launched and users fees removed from primary health care system

• SWAP implemented at district level with merging of many program heads into one as “integrated district health program”

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Key Challenges for Aid Effectiveness

Aid Effectiveness …

• Governance and accountability• Financial management and financial flows• Frequent changes in government• Lack of effective private sector integration and regulation• Continued off-budget support in health sector (non-governmental)• Higher aid dependency for Nepal Government • In sufficient information systems specially financial, procurement, vital

registration, physical assets and human resource management

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Key Challenges for Aid Harmonization

• Donor efforts at monitoring and evaluation are fragmented• China and India are big partners in health sector with significant contribution, but

refused to coordinate so that still alignment and harmonization is a problem• Lack of open Information• HIV is almost completely segregated from the rest of the health sector.

Aid Harmonization …

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Key Challenges for Civil Society Participation

• Limited Information about the role of CSOs in Health sector

• Lack of coordination of national civil society• Political affiliation of civil society organizations• Selective engagement of very few organizations that

are not necessarily representative of people on the ground

• Civil society is not systematically involved in sector meetings

Limited CSO’s Participation …

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• Health sector SWAP has increased ownership, harmonization and aid alignment in general.

• The capacity of health sector in context of managing big program such as SWAP or health sector program is gradually increasing

• However, there are still needs for partners to have better coordination on the matter of communications, monitoring and evaluation system and geographical strategy.

• It is necessary to upgrade the national systems such as financial management, audit of financial expenditures and information management and inter-agency coordination.

• Technical assistance and information system with open data is crucial. • It is necessary to engage CSOs and citizens more for better monitoring aid

flows and projects at the local level. • It would be great to establish inter-agency linkage with other SWAPs

beyond health sector (i.e. education, environment) and try to coordinate & address the SWAP related common issues.

Lessons Learnt

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1) Background 2) Challenges & Lessons

3) Open Aid Map

AGENDA

1. Progress and Achievements

2. Key Challenges 1) Aid Effectiveness 2) Aid Harmonization 3) Civil Society

Organization

3. Lessons Learnt

1.

2.

3.

1. Health in Nepal

2. Aid in Nepal

3. SWAp

4. SWAp in Health Sector

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World Bank Projects in Nepal

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World Bank Projects in Nepal

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Projects by Population Density

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Enhance Poverty Targeting

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15. SECOND RURAL WATER SUPPLY & SANITATION PROJECT (RWSS)

Data available

Number of districts

73

Total observations

2,902

MappingLocation VDC,

Ward, Settlement

Status ?

Time period 2002-2006 (?)

Source RWSSP

Mismatched 224 VDCs

MAP: LOCATION OF WSS AT VDC

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17. SECOND HEALTH SUPPORT PROGRAM (HSSP II)Data available

Number of districts

75

Total observations

4,161

MappingHealth center location at the

VDC

Status ?

Time period ?

Source Bert

Mismatched 62 VDCs

MAP: HEALTH CENTERS LOCATION AT VDC