The International The International Health Partnership (IHP+)Health Partnership (IHP+)

Presented by Marilyn EntwistlePresented by Marilyn EntwistlePAHO/WHO BelizePAHO/WHO Belize

17 May 201017 May 2010

2

OutlineOutline

What is IHP+? Who is part of it?What is IHP+? Who is part of it?

What was the impetus for IHP+?What was the impetus for IHP+?

What are some of the expected outcomes of What are some of the expected outcomes of IHP+?IHP+?

How will IHP+ achieve results?How will IHP+ achieve results?

IHP+ management arrangementsIHP+ management arrangements

3

What is IHP+?What is IHP+?

A global partnership that puts A global partnership that puts the Paris and Accra principles the Paris and Accra principles on aid effectiveness into on aid effectiveness into practice, with the aim of practice, with the aim of improving health services and improving health services and health outcomes, particularly for health outcomes, particularly for the poor and vulnerablethe poor and vulnerable

4

Who is part of IHP+?Who is part of IHP+?Current partners are:Current partners are:

Developing countriesDeveloping countriesBenin, Burundi, Burkina Faso, Cambodia, Djibouti, DR Congo, EthiBenin, Burundi, Burkina Faso, Cambodia, Djibouti, DR Congo, Ethiopia, Kenya, opia, Kenya, Madagascar, Mali, Mozambique, Nepal, Niger, Nigeria, Rwanda, SenMadagascar, Mali, Mozambique, Nepal, Niger, Nigeria, Rwanda, Senegal, Uganda, egal, Uganda, Zambia, Zambia,

Developed CountriesDeveloped CountriesAustralia, Canada, Finland, France, Germany, Italy, Portugal, NeAustralia, Canada, Finland, France, Germany, Italy, Portugal, Netherlands, Norway, therlands, Norway, Spain, Sweden, United Kingdom Spain, Sweden, United Kingdom

Civil Society OrganizationsCivil Society Organizations

Development partnersDevelopment partnersAfrican Development Bank, European Commission, GAVI, Global FundAfrican Development Bank, European Commission, GAVI, Global Fund, International , International Labor Organization, UNAIDS, UNDP, UNFPA, UNICEF, WHO, World BankLabor Organization, UNAIDS, UNDP, UNFPA, UNICEF, WHO, World Bank, Bill and , Bill and Melinda gates Foundation Melinda gates Foundation

Any country or organization willing to sign the Any country or organization willing to sign the ““IHP+ Global CompactIHP+ Global Compact”” can joincan join

5

What was the impetus for IHP+?What was the impetus for IHP+?

Progress towards the health MDGs remains Progress towards the health MDGs remains inadequateinadequate

Many health system constraints are Many health system constraints are unaddressedunaddressed

Global & domestic investment in health is Global & domestic investment in health is insufficientinsufficient

International funding is International funding is unpredictableunpredictable

Support to countries is Support to countries is inefficientinefficient –– rising numbers of rising numbers of partners; risks of fragmentation, duplicationpartners; risks of fragmentation, duplication

6

Many health system constraints Many health system constraints are unaddressedare unaddressed

Each year, 100 million people are impoverished as Each year, 100 million people are impoverished as a result of health spendinga result of health spending

Extreme shortage of health workers exist in 57 Extreme shortage of health workers exist in 57 countries countries –– 36 of these are in Africa36 of these are in Africa

An estimated 50% of medical equipment in An estimated 50% of medical equipment in developing countries is not used, either because developing countries is not used, either because of a lack of spare parts or maintenance, or of a lack of spare parts or maintenance, or because health workers do not know how to use itbecause health workers do not know how to use it

7

8

MOH WBADB

KHANA

ClintonHAI

SRCHNI

RHAC

RACHA

MSFBelgium

Global Fund to Fight ATM

GAVI

HMN

JICA

CDC

GTZ

AFD

BTC

KfW

DFID

EC

USAID

AusAid

WHO

UNFPA

UNAIDS

UNICEF UNDPWFPCARE

URC

HU

AECI

KOICA

KanthaBopha

MSFFrance

International Health Partnership

Catalytic Initiative

UNITAID

PMNCH

RBM

Stop TB

PEPFAR PMI

PSI

SC

Oxfam 100+ health partners

Health Partnerships in One CountryHealth Partnerships in One Country

9

What are the expected outcomes?What are the expected outcomes?

Reduced burden on developing countries, Reduced burden on developing countries, allowing increased focus on implementing the allowing increased focus on implementing the national health strategy and hence better national health strategy and hence better resultsresults

Better use of existing funds through improved Better use of existing funds through improved partner coordination; increased investment in partner coordination; increased investment in national health strategiesnational health strategies

Country ownership Country ownership –– Stronger government Stronger government leadership in sector coordinationleadership in sector coordination

10

How will IHP+ achieve this?How will IHP+ achieve this?

Increased support for Increased support for one national health strategyone national health strategy, , by supportingby supporting

National sector planning processesNational sector planning processesGreater partner confidence in the strategy, by Greater partner confidence in the strategy, by ““joint joint assessmentassessment””More unified partner support for the strategy More unified partner support for the strategy ––compactscompactsOne results monitoring frameworkOne results monitoring framework, to track strategy , to track strategy implementationimplementationGreater mutual accountability Greater mutual accountability –– by by monitoring monitoring compact commitmentscompact commitments

11

12

Ministry of HealthMinistry of Health

Health Agenda Health Agenda 2007 2007 -- 20112011

Strategic Plan Strategic Plan 20092009--20112011

13

Some Some Other Other PlansPlans

14

2. Joint assessment of national strategies2. Joint assessment of national strategies

A shared assessment of the national strategy, A shared assessment of the national strategy, accepted by multiple partners as basis for accepted by multiple partners as basis for technical & financial supporttechnical & financial support

Joint assessment tool & guidelinesJoint assessment tool & guidelines:: developed in developed in interinter--agency Working Group; drafts approved by IHP+ partners in agency Working Group; drafts approved by IHP+ partners in July 2009. Strong advice to move to rollJuly 2009. Strong advice to move to roll--out with interested countriesout with interested countries

Principles of joint assessment approachPrinciples of joint assessment approach::country based; aligned with incountry based; aligned with in--country processes; inclusive; with an country processes; inclusive; with an independent elementindependent element

15

16

Joint Assessment ToolJoint Assessment Tool

Deliberately generic setting out essential Deliberately generic setting out essential ““ingredientsingredients”” of any national strategyof any national strategy

Will Will notnot give a pass/fail or single scoring as its give a pass/fail or single scoring as its overall assessmentoverall assessment

Will highlight strengths, gaps & needs within 5 sets Will highlight strengths, gaps & needs within 5 sets of attributesof attributes

17

5 Groups of Attributes5 Groups of Attributes

Situation analysis & coherence of strategies/plan Situation analysis & coherence of strategies/plan with analysiswith analysis

Process through which plan/strategy developedProcess through which plan/strategy developed

Adequacy of financing projects/strategies & Adequacy of financing projects/strategies & arrangements for financial management & auditingarrangements for financial management & auditing

Implementation & management arrangements Implementation & management arrangements including for procurementincluding for procurement

Monitoring & evaluation plans & processes for Monitoring & evaluation plans & processes for using findingsusing findings

18

19

Uses & Potential Benefits Uses & Potential Benefits for Governmentsfor Governments

↑↑ quality of national health strategies/plans &quality of national health strategies/plans &congruence with national development frameworkcongruence with national development framework

↑↑ support by partners of national strategies rather than support by partners of national strategies rather than their own programstheir own programs

streamlined process of securing approved funding by streamlined process of securing approved funding by donors & Ministries of Financedonors & Ministries of Finance

↑↑ efficient use of available fundsefficient use of available funds

↑↑ use of shared reporting processesuse of shared reporting processes

20

For PartnersFor Partners

↑↑ transparent, systematic & inclusive review processtransparent, systematic & inclusive review process

↑↑ opportunity for partners to bring their experiences to opportunity for partners to bring their experiences to process & influence assessmentprocess & influence assessment

↑↑ partners results in partners results in ↓↓ transaction costs associated with transaction costs associated with multiple agencymultiple agency--specific assessments & reporting specific assessments & reporting processesprocesses

↑↑ opportunity for joint agreement by partners on ways to opportunity for joint agreement by partners on ways to address identified gaps and needs from assessmentaddress identified gaps and needs from assessment

21

Joint assessment challengesJoint assessment challenges

Balancing country Balancing country leadershipleadership with with independent independent elementelement

InclusivenessInclusiveness: how to engage civil society more : how to engage civil society more efficiently & effectivelyefficiently & effectively

Links to developments on Links to developments on financing financing –– must must avoid parallel processesavoid parallel processes

““One size does not fit all countriesOne size does not fit all countries”” –– adapt to adapt to country situationcountry situation

LearningLearning from experience from experience –– and from related and from related international exercises as wellinternational exercises as well

22

Timing of Joint AssessmentsTiming of Joint Assessments

Decided at country level & tailored to country needs, Decided at country level & tailored to country needs, processes & timetablesprocesses & timetables

May happen at different stages in cycle of development May happen at different stages in cycle of development and/or implementation of national strategy/plan and/or implementation of national strategy/plan depending on its prime purposedepending on its prime purpose

23

3.3. Supporting more unified systems Supporting more unified systems of partner support: compactsof partner support: compacts

Compacts: Compacts: negotiated agreements between partners negotiated agreements between partners –– government, government, civil society, development agencies civil society, development agencies –– on how they will support the on how they will support the national health strategynational health strategy

Dimensions Dimensions Government commitmentsGovernment commitmentsDevelopment partner & other signatory commitmentsDevelopment partner & other signatory commitmentsAid management modalitiesAid management modalitiesMonitoring arrangements & indicators for tracking progressMonitoring arrangements & indicators for tracking progress

Build on existing agreements, make more explicitBuild on existing agreements, make more explicit

Bring in new partners Bring in new partners –– new developmentnew developmentpartners, civil societypartners, civil society

24

25

4.4. Moving to a Moving to a common monitoring frameworkcommon monitoring framework

Indicator DomainsIndicator Domains:: inputs & processes, outputs, inputs & processes, outputs, outcomes, impactoutcomes, impact

Data Collections:Data Collections: Administrative sources, facility Administrative sources, facility assessments, populationassessments, population--based surveys, Belize Health based surveys, Belize Health Information System, etc.Information System, etc.

Analysis & SynthesisAnalysis & Synthesis:: Data quality assessment, Data quality assessment, estimates & projects, etc.estimates & projects, etc.

Communication & Use:Communication & Use: Targeted & Comprehensive Targeted & Comprehensive reported, regular country/review processes, global reportingreported, regular country/review processes, global reporting

26

5. Greater mutual accountability5. Greater mutual accountability

Several avenues, at national and global levelSeveral avenues, at national and global level

Nationally: through more inclusive health policy Nationally: through more inclusive health policy dialogue, sector performance monitoring dialogue, sector performance monitoring mechanismsmechanisms

By monitoring progress against partnersBy monitoring progress against partners’’commitments made in Global and Country commitments made in Global and Country Compacts, through an independent consortium Compacts, through an independent consortium (IHP+ Results)(IHP+ Results)

Global events such as the Health and Global events such as the Health and Development ForumDevelopment Forum

27

28

Looking aheadLooking ahead

Focus on resultsFocus on results

Focus on mobilizing more stakeholders to Focus on mobilizing more stakeholders to support national health strategies support national health strategies designed to achieve those resultsdesigned to achieve those results

Focus on harmonizing procedures & Focus on harmonizing procedures & better aligning with country strategies & better aligning with country strategies & processesprocesses

Focus on active engagement by all IHP+ Focus on active engagement by all IHP+ signatoriessignatories

Next Next StepsSteps

for for BelizeBelize

IHP+ websiteIHP+ websitehttp://www.internationalhealthpartnership.nethttp://www.internationalhealthpartnership.net