PARTNERSHIP FOR HEALTH DEVELOPMENT
Dr. Mirta Roses PeriagoDr. Mirta Roses PeriagoDirectorDirectorAMROAMRO
4th Global Meeting of Heads of WHO 4th Global Meeting of Heads of WHO Country Offices with DG and RDsCountry Offices with DG and RDs
Geneva, November 2007
What does it mean
Partnership for Health Development?
Typology to classify Partnership
• Research and Development
• Technical assistance/service support
• Advocacy
• Financing
MOH MOEC
MOF
PMO
PRIVATE SECTORCIVIL SOCIETYGOVERNMENT
NACP
CTU
CCAIDS
INT NGO
PEPFAR
Norad
CIDA
RNE
GTZ
SidaWB
UNICEF
UNAIDS WHO
CF
GFATM
USAID
NCTP
NCTP
HSSP
HSSP
GFCCPGFCCPDAC
CCM
T-MAP
3/5
SWAPSWAP
UNTG
PRSP PRSP
Source: Mbewe, WHO
Major negative consequences of GHP interactions with countries
Countries struggle to absorb GHP resources because GHPs do not provide adequate technical and other support to implement programs
Countries are burdened with parallel and duplicative processes and systems from multiple GHPs, since GHPs often bypass and undermine those that countries already have in place A. Shifts in policy and
technology not well supported
B. Relevant assistance for implementation not forthcoming
C. Country coordination forums proliferating and not set up to be effective
A. “One size fits all” processes do not recognize country diversity”
B. GHP-led efforts on cross-cutting system-level issues cause duplication
21
3
Consequences of GHP
interactions
Complication: GHPs have not communicated effectively with countries and partners
Hosting missions and report writing are major burdens at the district level
*Assumes around 50 working days per quarter and 100 per half year although reported to work in excess of thatSource:In-country interviews; DMO visitor log; team analysis
PEPFAR
GFATM
NTLP
Gates Foundation
Norwegian TB
EPI
UNICEF
WHO
NACP
NMCP
London School
Total
4
2
2
1
1
1
1
1
1
1
1
16
3.00
3.00
3.00
3.00
3.00
2.00
2.00
2.00
2.00
2.00
0.25
~25.25
JICA
Finnish
Axios
UNICEF
World Vision
MoH – TB
MoH – Malaria
MoH – AIDS
MoH – EPI
MoH – Maternal HealthWeekly notifiable disease reports
Total
Harmonizing report writing
can help reduce the
burden
TANZANIA DISTRICT EXAMPLESReport writing can consume even more time
Number of full days per quarter spent on writing reports (Morogoro)
Missions can consume 10-20% of a DMO’s timeNumber of one-day missions to Temeke during last 6 months
GHP communication is weak on multiple levels, especially with countries
Communication channels
“It is almost impossible to get responses by e-mail or phone from our GHP contact . . ..”
“. . . even if were to reach him, we don’t feel like we could push back.”
Variation in quality/quantity of communication with GHP• Communication channels
inadequate• Unclear feedback• Perceived lack of secretariat’s
country knowledge
Weaknesses
Country
GHP Secretariat
“We don’t have formal agreements with partners.”
“Field offices receive no guidance on how they should cooperate with or support GHP programs.”
Lack of clarity on roles/responsibilities to support GHP activities
Multilateral/Implementing
Partners
GHP flexibility not clear to country
(do not feel empowered to ask)
Challenges• Countries struggling to absorb partnerships
resources• The need for enhanced coordination of partners • Country coordination mechanisms and forums
proliferating• Performance-based funding approaches• Partnerships bypassing and undermining
country plans and processes• Distorting effects of uncoordinated funding flows
Challenges
• Proliferation of partnerships leading to lack of clarity of roles and responsibilities with other implementing partners.
• Inadequate information flow
• Restricted concept of partnerships.
Governance Challenge
• Accountability frameworks for Partnerships and countries
• Internal governance
• Representation on multiple boards
• Interface of PHDs with multilateral organizations
Thank youDr. Mirta
Roses Periago AMRO’s Director