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What is IHP+

The International Health Partnership: aligning for better results Marjolaine Nicod, IHP+/WHO Maxwell Dapaah IHP+/WB.

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What is IHP+

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  1. The International Health Partnership: aligning for better resultsMarjolaine Nicod, IHP+/WHOMaxwell Dapaah IHP+/WB

  2. IHP+ is a partnership of countries, development agencies and civil society organizations that aim to accelerate better health services and health outcomes, particularly for the poor, by putting the principles on development effectiveness into practice. Partner commitments recorded in the IHP+ Global Compact Created in 2007 Goal: better results through more effective development cooperation What is IHP+

  3. A strong efficient health system is needed to deliver quality services for country health priorities

  4. IHP+: a response to rising number of partners, duplication, fragmentation International NGOs Bilaterals Medecins Sans Frontieres DCE Helen Keller PSI Belgium Spain Plan International Canada France Red Cross Luxembourg USAID China Netherlands UNAIDS Sweden UNFPA Japan UNICEF GAVI WFP Global Initiatives Global Fund Against AIDS, TB & Malaria WHO United Nations

  5. Unintended burden of multiple missions – reaches district level TANZANIA DISTRICT EXAMPLES Missions can consume 10-20% of a DMO’s time: Number of one-day missions to Temeke during last 6 months Report writing can consume even more time Number of full days per quarter spent on writing reports (Morogoro) PEPFAR 4 JICA Harmonizing report writing can help reduce the burden GFATM 2 Finnish NTLP 2 Axios Gates Foundation 1 UNICEF Norwegian TB 1 World Vision EPI 1 MoH – TB UNICEF 1 MoH – Malaria WHO 1 MoH – AIDS NACP 1 MoH – EPI NMCP 1 MoH – Maternal Health Weekly notifiable disease reports London School 1 Total Total 16 * Assumes around 50 working days per quarter and 100 per half year although reported to work in excess of that Source: McKinsey: In-country interviews; DMO visitor log; team analysis

  6. Supply logistics systems in Kenya

  7. Who is in IHP+? 2007 2016 Developing countries: 8 37 Bilateral donors: 8 17 Int'l agencies and foundations: 11 12 TOTAL 27 66

  8. The seven behaviours: not new but importantrequires action by all development partners The seven behaviours: not new but importantrequires action by all development partners

  9. How does IHP+ work? Mobilises support behind one national health strategy with clear priorities: • Inclusive national planning and joint assessment processes • Unified support for implementation, through country compacts • Harmonized financial management • One platform for monitoring and accountability for results • South-south exchange on effective development cooperation IHP+ works through its partners – governments, development partners, non state actors including CSOs. Builds on existing processes

  10. Country compacts Compacts: negotiated agreements between partners on how they will support the national health strategy/plan. Are many equivalent terms e.g. MOU Compacts can Bring more partners behind the national strategy – new development partners, civil society, NGOs Influence greater if commitments are made more explicit, are monitored Key elements Commitments by governments; development agencies; implementing partners Aid management modalities Monitoring arrangements and indicators for tracking progress Experience:2/3 of IHP+ partner countries have or are developing a compact Verdict of recent analysis:worth the effort, but on their own are not enough to get step change in partner behavior Go to http://www.internationalhealthpartnership.net/en/key-issues/compacts/

  11. Inclusive national planning and joint assessment processes • Joint assessment of National Strategy (JANS) developed to enhance quality of a national health strategy; to inform funding decisions and reduce transaction costs of multiple assessments • Shared, systematic assessment, using tool and guidelines developed by multi-partner IHP+ working group. • Principles: country-led; aligned with in-country processes; inclusive; strong independent element • Product: profile of strengths and weaknesses of a health strategy, not a pass/fail JANS experience to date • Used formally in 12 countries, informally by more. Lessons learned up on IHP+ website. • Helped strengthen national health strategies; less direct link to funding decisions http://www.internationalhealthpartnership.net/en/key-issues/national-health-planning-jans/

  12. Financial management harmonization and alignment A plethora of FM arrangements for donor funding brings complexity to a whole new level

  13. Harmonized financial management • Problem: • Under-use of country financial management systems • transaction costs due to duplicated financial management assessments, parallel financial management systems. • Action • Approach to joint financial management assessments developed. Standard elements of agreements on 'Joint Financing Arrangements' being defined • Countries encouraged to develop a costed national action plan to strengthen financial management, supported by all key government actors http://www.internationalhealthpartnership.net/en/tools/financial-management-assessment/

  14. General Principles • Align with country systems whenever they meet the minimum acceptable level. • Harmonize among development partners, when all or part of the national Public Financial Management (PFM) system is not sufficiently developed. • Agree and support implementation of a joint action plan that strengthens the national systems so as to bring about the necessary changes to make the alignment feasible. • Not wait until all problems have been solved, but use a step-wise approach by using elements of country systems as soon as possible as part of the process of improving systems and developing capacity.

  15. Examples of work done so far

  16. Today's environment • The Sustainable Development Goals (SDGs) a renewed global commitment to health, underpinned by Universal Health Coverage (UHC). • The inclusion of UHC in the SDGs presents an opportunity to promote a comprehensive and coherent approach to health, to focus on how the health system delivers integrated, people-centred health services. • Domestic resources account for the large majority of health spending even in fragile states and low income countries (LIC) and there is need to focus on levers to strengthen institutions and efficient use of these resources for increased health security and equity. • The Ebola and Zika tragedies have reminded everyone of the importance of public health systems and better ways of engaging with other sectors, to be relevant UHC cannot overlook growing concerns related to health security • Many African economies growing • Traditional development assistance for health has plateaued but still significant; non traditional donors increasingly important

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