Bob Fryatt Presentation, Ihp+ & Cso Consultation

1. The InternationalHealth Partnership +IHP+ CSO ConsultationMay 23, 2008 Bob Fryatt, Head,Partnerships and Coordination Health Systems and Services World Health Organization

2. Why now? 3. Progress towards MDGs:Inadequate Trend in Under-Five Deaths, 1960-2015 (Millions deaths per year) 4. Health system constraints:unaddressed

Human resourcesProduction, retention and migration

Infrastructure L ogistics, procurement, physical infrastructure

Catastrophic health expenditures Reduction of out-of-pocket expenditure social protection

Ineffective delivery Integration, primary care, community engagement, non-state providers, management

5. Investment in health:insufficient 6. International funding:unpredictable Source:WHO, NHA Data, 2006 Donor Commitments for Health as % of Total Health Expenditure 7. Support to countries:inefficient 8. What has been the response? 9. Paris Declaration on aid effectiveness 10. Systemsandprogrammes: getting results Maternal & Child Health National strategy Vital registration IMCI Emergency obstetrics Continuum of care Fighting AIDS National strategy Surveillance Safe sex Treatment Continuum of care common agenda? more efficient? better outcomes? Service delivery Medical products, technologies Information systems Human resources Health financing Leadership / governance Strengthened health systems 11. What does the IHP+ offer? 12. 1. Enabling Countries. Existingcountrymechanisms DevelopmentPartners Bilaterals/ multilaterals Civil Society Donors Int Agencies Improved Outcomes for MDGs 1b, 4, 5, & 6 Scaling Up Effective Coverage One costed,results-orientednational healthplan and budget Inter-agency country health sector teams Long-term, predictablefinancing One common M&E and mutual accountabilityframework Country Compact Fix health Systems bottlenecks One common review process/ validation 13. Country compacts

ONE single

country health plan, results framework, policy matrix,

budget, fiduciary framework (some cases)

monitoring and reporting process,

country-based appraisal and validation process,

Benchmarks

for government performance,

for development partner performance

Agreement on aid modalities.

Process for resolution of non-performance and disputes.

14. A new way of doing business 15.

National Plans and Strategies

Results-Based Financing

Aid effectiveness and health

Service Delivery

Health Financing and social protection

Global Health Initiatives and Health Systems

2. Generating knowledge 16. 3. Enhanced coordination I nter-agencycountryhealthsector teams

Ministry of Health

Ministry of Finance

Civil Society

Bilaterals/Multilaterals

International health agencies

Inter-agency working groups Regularpartner forums(inc civil society) Inter- agencyCoreTeam

Washington DC

Geneva

Brazzaville (HHA)

Scaling-up Reference Group 1 ) Business: Gates, GAVI, GF,UNAIDS, UNFPA, UNICEF, WHO, WB 2) Steering:Same, plus development Partnersand civil society Inter-agency working groups Political Advocacy H8, SG 17. Technical Support & Harmonization for Health in Africa 18. 4. Accountability & performance..

Global accountability

Common M&E Framework

Agency constraints & commitments

Engaging civil society

19. Framework for monitoring performance and evaluationof the scale-up for better health Funding Domestic sources International sources Plan Coherent, prioritised and funded Harmonization Aligned international efforts with national plan Well coordinated and harmonized support National plan implementation Systems strengthening Priority interventions scale-up Capacity building Programmes Institutions People Accountability Performance monitoring Results focus and evaluation Use for better practicesHealth system strengthened Governance, HR, medical products, information Increased serviceutilization andintervention coverage Reduced inequity (e.g. gender, socio-economic position) Responsiveness No drop-off non-health sector interventions (e.g. water & sanitation) Improved survival Child mortality Maternal mortality Adult mortality due to infectious diseases Improved nutrition Children Pregnant women Reduced morbidity HIV, TB, malaria, repr. health Improved equity Social and financial risk protection Reduced impoverishment due to health expenditures Improved services Access, safety, quality, efficiency Inputs Outputs Outcomes Impact Process Aid process monitoring Resource tracking Strengthen country health information systems Evaluation: process, health systems strengthening, impact M & Eaction Health system monitoring Coverage monitoring Impact monitoring Implementation Monitoring 20. 4. Accountability & performance..

Global accountability