Lessons from Lessons from Health Sector Health Sector Performance Performance Reporting & Reporting & MonitoringMonitoring
Strengthening Accountability to Achieve the Health MDGs
Geneva, 5th October 2012
Results Framework Performance Monitoring & Evaluation of
the IHP+
AVAILABILITYAVAILABILITY
COLLECTIONCOLLECTION UTILIZATIONUTILIZATION
DEMANDDEMAND
HEALTH RESULTSTHROUGH
STRENGTHENED HEALTH SYSTEMS
HEALTH RESULTSTHROUGH
STRENGTHENED HEALTH SYSTEMS
Why monitor?2. 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
Reflecting on 5 Years of Monitoring
August 2008 May 2010 April 2011 October 2012
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
This represents the end goal of a virtuous cycle.
1. Mechanism for Participation, based on IHP+ Global and Country Compacts
2. Transparent Information from
Performance Reporting & Monitoring
How information has been collected & managed
MAR - JUL 2010Developed and/or agreed by IHP+ signatories.
Reviewed in July 2011. FEB - APR 2012
Questionnaire based on Standard Performance Measures. Data collected and used as basis for ratings.
MAY - JUL 2012Draft scorecards discussed with participating
signatories.
IHP+GLOBAL
COMPACT
STANDARDPERFORMANCE
MEASURES QUESTIONNAIRE RATING
SCORECARD
How this Information has
been used (or not!) Development
agenciesHQ-level reviews; Country sector reviews
National governments
Govt Reviews; Country sector reviews; Compact Reviews
Civil SocietyParliamentarians (Nigeria); IHP+ Civil
Society Consultative Group; Busan side-event.
The IHP+ network Key contributor to TT HATS (Busan)
Accountability meetings
Southern Civil Society Forum (Ghana, Feb 2011), Action for Global Health (Paris, May 2011; Madrid, June 2011)
ResearchersCenter for Global Development paper on QuoDAH (May, 2011); Globalization & Health paper (July 2012)
General Public Lancet article and letter.
3. Mutual Accountability Processes with
Forum for Discussion
What change has IHP+Results contributed to
Some evidence of increasing cooperation to deliver more effective aid (but not yet at level of collaboration)
Information is now available
Voluntary Participation is increasing
Greater Transparency with Performance Reports, Scorecards and Web Data
Discussions are being had about aid in the health sector (some country-led), with power shift in conversations
Other: Conceptual positioning of IHP+ as an aid effectiveness intervention; Sectoral perspective on aid effectiveness (TTHATS); Alignment for COIA etc
What have been the challenges?
➔ Lack of appropriate use of the IHP+Results mechanism and information products, to improve coordination or to inform collaborations between partners
➔ Not collecting and reporting the right Information at the right time
➔ Participation for the wrong reasons (cooperative compliance rather than learning) and incentives are not compelling
➔ Transparency without data integrity because information is not systematically validated, or being questioned
➔ Discussions not taking place at the right levels, with the right people (mutual accountability and review mechanisms are not in place or being routinely used)
➔ Lack of capacity within partner institutions?
What we have learnedMEASURES
(TRANSPARENCY)1. Paris Indicators a good
strategic choice2. Some indicators need
attention: not appropriate, not useful (procurement, PBAs, capacity building)
3. Some definitions need attention (‘active’)
4. Lack of qualitative information weakens potential for learning & improvement
5. Framework needs to be able to detect & report unanticipated changes
6. Targets need to be better defined (lowest common denominator vs aspiration?)
7. IAG
PROCESS (PARTICIPATION):
1.Voluntary participation seems to work
2.Some sense of compliance (cooperation) driving participation, rather than learning
3.Transaction costs are heavy and will continue to be if reporting has value
4.Triangulation is important for credibility, but how important – can we ever reach truth?
5.Locating the process at country level remains the aspiration
6.NB: Monitoring must adapt and evolve
USE (FORUM FOR DISCUSSION)
1.Limited discussion of reports and scorecards
2.Prospects for use in 2012/13 are better – key to future demand for monitoring
3.Civil society role in promoting use is important – IHP+ needs to better resource CSOs to engage
4.Important to articulate the value of monitoring aid effectiveness to health results
5.Use and accessibility are connected – scorecards have been valuable in this regard
AVAILABILITYAVAILABILITY
COLLECTIONCOLLECTION UTILIZATIONUTILIZATION
DEMANDDEMAND
HEALTH RESULTSTHROUGH
STRENGTHENED HEALTH SYSTEMS
HEALTH RESULTSTHROUGH
STRENGTHENED HEALTH SYSTEMS
How to improve?2. 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
Questions on Future Monitoring
1) What needs to be done to stimulate demand for future monitoring?
2) How should specific technical issues relating to information relevance, validity & availability be addressed (and by whom?)
3) How can better use be made of the information – especially through collaborative discussions & by country level decision-makers?
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