IHP+ Country Teams Meeting, 12 – 14 th December 2012 Nairobi, Kenya

1. Review of different stakeholders needs in relation to Joint Assessment of National Strategies and Plans (JANS)Preliminary Findings IHP+ Country Teams Meeting, 12 – 14th December 2012 Nairobi, Kenya

2. Introduction • The objectives are: • to identify the needs of the different stakeholder groups with regards to assessment of a new strategy; • Analyse the extent to which these needs are met by current JANS practice, and the opportunities and constraints to achieving greater harmonisation of development partner procedures for assessing national strategies and alignment of these to country processes and needs; • To set out preliminary suggestions on how to proceed based on this analysis • Process • Interviews with countries, development partners and CSOs • Document review of lessons from existing JANS • Preliminary findings only available as interviews incomplete • Lessons from document review • Lessons from interviews and questionnaires with development partners

3. Lessons from document review:Evidence that the JANS influenced funding decisions • Very limited evidence to date that health sector JANS has actually contributed to funding decisions: • bilaterals usually already involved in a SWAp in IHP+ countries • GAVI: JANS necessary but insufficient for funding decisions and requires IRC to confirm that weaknesses have been addressed • GFATM: disease specific JANS were used for national strategy first wave funding decisions. Intention was to continue for second wave and HSFP but subsequent funding opportunities were postponed • Some evidence that JANS impacted on the mode of funding that DPs use: • a JANS approved plan can serve as one of several criteria that some DPs will use in determining HOW they will channel resources to country • but DPs will still require additional decision making processes • Strong evidence that assessment of fiduciary arrangements is needed alongside JANS - intention of JANS is to provide an overview on this • some DPs will always need more rigorous financial management appraisal than others but this process could be better harmonised

4. Preliminary lessons from DP questionnaires:How development partners use JANS in funding decisions

5. Preliminary lessons from DP interviews:How DPs assess national health strategies • Criteria for Assessing a Strategy • Most DPs use generic guidance for assessing national health strategies • DPs do not have health strategy specific criteria • General DP view that scope of JANS is useful but not sufficient for funding decisions – provides additional evidence and assurance of quality of strategy • Format of assessment • Most DPs have a format for programme documentation that agency staff complete • No specific format for national strategy assessment (largely because no formal guidance for national strategy assessment) • Who appraises? • For most DPs, staff conduct appraisal (or consultants) • Some have formal peer review requirement – e.g. World Bank • Global Fund requires independence in appraisal

6. Preliminary findings from DP interviews:JANS and other key elements of a funding decision Scope of JANS • Development partners broadly positive on scope • Financial management assessment is required but outside scope and intention of JANS Level of detail • Implementation arrangements and institutional capacity • These are covered in JANS but some agencies require more detail because national health strategy and JANS are high level and do not include operational plans • Results focus is increasing significantly among most DPs • All development partners under huge pressure to demonstrate results • Some national health strategies and JANS assessment need more detail • JANS tool covers results in a number of places – potential for clearer focus? Process • Political considerations are as important as technical • particularly for bilateral donors who are increasingly sensitive to political risk • Timing of DP funding decisions a out of sync with sector strategy/JANS

7. Preliminary lessons from DP interviews:DPs use JANS in different ways • Bilateral donors and multilateral development banks • Usually have a resident advisor if they are in the sector and therefore participate already in harmonised sector processes, JARs, MTRs, etc • JANS used by development partners to provide reassurance of quality strategy, to persuade headquarters of quality strategy, and if no country presence to provide evidence and assurance of quality strategy • marginal impact on transaction costs • Global funds/initiatives • Usually not resident and driven by global assessment processes • Highly focused on particular results but increasingly aware that sector approach is needed to deliver specific outcomes • Potential for reduced transaction costs but need to balance local flexibility and harmonisation with an expectation of global quality standards • UN agencies • Highly focused on results • Still have their own budgeting timelines – eg WHO biannual budget • May be more focused on other aid effectiveness priorities – UNDAF etc

8. How could DPs maximise use of JANS? • Options with direct impact on content and use of existing JANS: • Clearer articulation of results required in national strategies and in JANS – for all DPs • Consistent quality and rigour of health strategies and JANS • Shifting the timing of DP funding decisions to link with country strategy development process • Options within a wider context that indirectly impacts on use of JANS: • Increasing harmonisation of and shared responsibility for financial management assessment, linked to JANS process • Clearer links between health strategies and implementation plans and assessment of capacity to deliver • Specific focus on articulation of results of interest to global funds (HIV, malaria, immunisation, MDG4/5) • JANS are new – more and improved use could lead to greater confidence in JANS and greater role informing decision making