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