Burkina Faso Case

Burkina Faso CaseBurkina Faso Case

Is Burkina Faso ready for a SWAP?

Burkina Faso: basic indicators

52 yearsLife expectancy at birth

19 %Adult literacy rate

16 %Urban population

556 per 100,000 live birthsMaternal mortality ratio

94 per 1000 live birthsInfant mortality rate

6.6 per woman 15-49Total fertility rate

2.4 % per annumPopulation growth rate

11.3 millionPopulation

DataIndicator

B F: economic indicators

88 %Drugs as percent of health spending

$63 per yearAverage household spending on health

4 %Health expenditure as % of GDP

$10Per capita health expenditure

$240Income per capita

DataIndicator

Health system performance issues

Over-centralized resources leading to: Technical inefficiency—low value for

money Poor allocative efficiency—spending

money on the wrong things High costs to patients (who spend a lot

for drugs) Poor quality of care—poor performance

by health workers at poor facilities

Reform initiatives

New role for ministry of health in setting norms, planning, special programs

District health team approach, with community management committee implication

New approaches to resource management, including block grants to districts

General contracting of civil servants with performance evaluation

SWAp readiness Criteria

Donor coordination

Government openness to SWAp

Management capacity--MOH

Government allocations to health sector

Prospects for harmonization of donor procedures

Interest in basket funding

Macroeconomic conditions

AssessmentEnabling factor

Discussion questions

Based on your reading of the case (or knowledge of BF), comment the criteria of readiness in the previous slide? How to do you assess these criteria?

Would a SWAp enable BF to improve the management capacity of its MOH, or would weak existing capacity defeat a SWAp?

Would a SWAp contribute to efforts to improve the performance of BF’s health system?

Are donors ready for a SWAp? Would you recommend that BF move to a

sector-wide program?

Take 45 min for discussion

Discussion questions

Based on your reading of the case (or knowledge of BF), comment the criteria of readiness in the previous slide? How to do you assess these criteria?

Would a SWAp enable BF to improve the management capacity of its MOH, or would weak existing capacity defeat a SWAp?

Would a SWAp contribute to efforts to improve the performance of BF’s health system?

Are donors ready for a SWAp? Would you recommend that BF move to a

sector-wide program?

Burkina Faso CaseBurkina Faso Case

Could Burkina Faso engage a SWAp

process ?

Central ideas

Government, Donors and other groups of civil society are involved in a new type of partnership

Management and coordination of aid is shared equally by stakeholders on both sides

Government in the Driver-seat

Advantages

More efficient use of funds for development purposes

More control by the Government over the development agenda

Better donor coordination & reduce administrative burden for the Govnt

Flexibility to design strategies corresponding to local conditions

Consistency between policy and dvpt goals by all stakeholders

Long term approach to development

Disadvantages Greater influence of the donors

in deciding Government policy & high level decision

Difficult in attributing results to particular donor

Less opportunity for innovative approaches from multiplicity of development agencies

Less control of how funds are used

Here is what Burkina has

DONOR Community?

UNDP

UNFPA

Int’l NGO

WHO

E U

BILATERALS

UNICEF

A D BW Bank Af D B

Here is what Burkina wants

HEALTH SWAp

A D BW Bank Af D B

UNDP

UNFPA

Int’l NGOs

WHO

E U

BILATERALS

UNICEF

Commitment of Burkina government Burkina ownership in SWAp process Capacity of the MoH Clear and consistent strategies Transparent budgeting and

accounting system

Policies and strategies remain consistent

Here is what Burkina needs to do

Preconditions

How strong is the commitment ?

An agency must be designated or created to guide SWAp process in the country

The agency is endowed with authority to implement the course of action for the SWAp,

An adequate budget must be appropriated to enable the agency to carry out its mandate.

How to strengthen Ownership?

National consultations Clear overall vision: role of the

state in the sector endorsed by the Head of State

Sector strategy endorsed by MoH and Legislature

Core of influential officials sharing relevant donor perspectives

Ministry of Finance support: spending programmes realistically matched to the Budget available

How strong is ownership ?

Strong Government Leadership

Government change Agents

seeking Alliance

Donor Leadership

Finally……

Mechanism that gives back control

of health development programs to

Burkina government

Focusing on the long-term policy &

strategy decisions in the Health

Sector

An approach rather than a blueprint

Ownership and Timing apropriate

Building discipline and trust from

both sides: Government and donors

Burkina building carefully a Health

SWAp ?