Guggi Laryea

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The International Health Partnership and related
initiatives (IHP)
Presentation for the Action for Global Health
Conference MadridMay 26, 2008
Guggi Laryea Civil Society Focal Point World Bank
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What is the IHP?

• A renewed effort to support countries in
  achieving their health MDGs (1b, 4, 5, 6)
• Through a single harmonized in-country
  implementation effort
• With scaled-up financial, technical and
  institutional support for health MDGs

How will it be implemented?

• Country-focused and country-led
• Builds on existing structures, mechanisms, and
  country health plans
• Provides long term, predictable financing for
  results-oriented national plans and strategies
• Ensures mutual accountability for delivering on
  compact commitments

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IHP Signatories

• As of 23 May 2008, the IHP global compact has
  been signed by
• Ten Ministers from developing country
  governments (Burundi, Cambodia, Ethiopia, Kenya,
  Madagascar, Mali, Mozambique, Nepal, Nigeria,
  Zambia),
• Nine international organizations (WHO, World
  Bank, Global Fund, GAVI Alliance, UNFPA, UNAIDS,
  UNICEF, UNDP, EC),
• Eleven bilateral donors (Australia, Finland,
  Sweden, UK, Norway, Germany, France, Italy,
  Portugal, Canada and Netherlands), and
• Other donors (Bill Melinda Gates Foundation
  African Development Bank).

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IHP Related Initiatives
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Objectives of the IHP

• Four main objectives consistent with the Paris
  Declaration on Aid Effectiveness
• Developing results-focused, country-led compacts
  that rally all development partners around one
  national health plan one ME framework and one
  review process, thus improving harmonization,
  alignment, focus on results and mutual
  accountability
• Generating and disseminating relevant knowledge,
  guidance and tools
• Enhancing coordination and efficiency at country,
  regional and global levels
• Ensuring mutual accountability and monitoring of
  performance

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Why now?
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Progress towards MDGs inadequate Trend in
Under-Five Deaths, 1960-2015 (Millions deaths per
year)
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Progress towards MDGs inadequate No region is on
track to reduce maternal mortality by
three-quarters by 2015.
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Health system constraints unaddressed

• Human resources Production, retention and
  migration
• Infrastructure
• Logistics, procurement, physical infrastructure
• Catastrophic health spending
• Reduction of out-of-pocket expenditure, social
  protection
• Ineffective delivery Integration and
  coordination, primary care, community engagement,
  non-state providers, management

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Investment in health insufficient
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International funding unpredictable
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Support to countries inefficient
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The challenge to put an end to deaths from
preventable and treatable illnesses needs ALL of
us to join forces.
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Value-Added of the IHP

• Country-focused and country-led activities
• ONE costed, results-oriented national health
  plan
• Build consensus and inclusion of all
  stakeholders through Country Compacts
• Long-term predictable financing for
  strengthening health systems which addresses
  volatility, fiduciary and procurement issues
• Improved harmonization and alignment of aid
  which reduces fragmentation and transaction costs
• Improved coordination between country
  governments and development partners
• Strengthened mutual accountability and
  transparency

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Strengthening Health Systems

• The fragmentation of donor assistance to health,
  including fragmented financing of health systems
  strengthening, generates serious constraints to
  the delivery and sustainability of results in
  health, including
• Funding distortions
• Increased transaction costs
• Unpredictable donor financing
• Lack of fungibility of donor financing
  (earmarked/vertical programs)
• Poor donor coordination/harmonization
• Lack of absorptive capacity (HRH, health
  systems)
• Insufficient cross-sectoral coordination/investmen
  t
• IHP aims to facilitate better coordination and
  increased financing for health based on
  country-led processes for improved results by
  rallying partners to support and take forward one
  costed, validated, results-oriented national
  health plan through the signing of country
  compacts, which will contribute to broader goals
  of overall health systems strengthening.

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Empowering Women

• The IHP seeks to improve results for achieving
  the health MDGs 1b, 4, 5, and 6, however
  progress against these MDGs will have positive
  spill-over effects and may lead to advances in
  other areas, such as improving gender equality
  and empowering women (MDG 3).
• Gender inequalities contribute to poor progress
  against MDG 5.
• Due to lack of access to information and family
  planning services, 108 million married women in
  developing countries have an unmet need for
  contraception.
• 66 of unintended pregnancies occur among women
  who are not using any method of contraception.
• Access and availability of high-quality
  contraceptive information and services would
  prevent many unintended pregnancies and reduce
  induced abortions.
• If contraception were provided to all women who
  lack access, maternal mortality would decline by
  2535.
• By delivering on health MDGs through the IHP,
  other positive results, such as womens
  empowerment and improved gender equality, should
  be achieved.

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Possible Elements of a Country Compact

• ONE single country health plan
• ONE single results framework
• ONE single policy matrix
• ONE single budget that will be the basis for
  funding
• ONE single mutual monitoring and reporting
  process
• ONE single country-based appraisal and validation
  process for the country health plan
• Benchmarks for government performance
• Benchmarks for development partner performance
• Agreement on aid modalities
• Process for resolution of non-performance and
  disputes

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ONE National Health Plan
Central to the compact is the national health
plan and how it will be used in the new aid
environment
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Common Monitoring Evaluation Framework
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IHP Management Structure
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The role of the IHP, country level
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Civil Societys involvement in the IHP

• Concept note on CS Engagement drafted and
  commented on currently being revised
• Consultation on mode of engagement has taken
  place
• 2 CS members on steering SuRG
• 1 southern CS solicited for business SuRG
• 1 CS member will join each thematic working group
• A consultative group will be formed

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Value Added of Civil Society in the IHP

• Engage and provide guidance on the implementation
  of the IHP work-plan
• assisting in the facilitation of the IHP
  process at the country level by encouraging local
  civil society organizations to participate in all
  stages of the development and implementation of
  country compacts
• Facilitate and improve dissemination of IHP
  outputs
• sharing good practices widely through existing
  networks,
• supporting implementation of locally appropriate
  implementation methods and strategies,
• establishing linkages with other existing similar
  or complimentary efforts.
• Monitor progress achieved as a result of the IHP
• advising on ways to strengthen effectiveness of
  the IHP process and
• effectively relaying potential and existing
  bottlenecks to implementation (global and country
  level) for problem solving (donor bottlenecks,
  implementation bottlenecks, etc)
• Ensure responsiveness of the IHP to
  government-led, inter-agency country teams,
  holding IHP development partners (donors,
  governments, etc.) accountable.

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Conclusions

• MDG goals 1b, 4, 5 and 6 will not be achieved
  without a revised and streamlined approach to
  implementation, which will require collaboration
  of all development partners.
• The IHP is an opportunity to harmonize and align
  development partners for improved health-related
  MDG outcomes, in line with the Paris Declaration
  on Aid Effectiveness.
• The focus of IHP is results at the
  country-level.
• Compacts are based on ONE National Health Plan
• Civil Society is key to ensuring successful
  implementation of the IHP

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Thank You!