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African Development Bank Group –Human Development Department September 2014

Value for Money, Sustainability and Accountability in the Social Sectors Volume 1 N° 3

Newsletter of the VfM Unit

Editor : Nejmudin Bilal

Value for Money, Sustainability

and Accountability in the So-

cial Sectors

Contact us :

VfM Unit

Tel. +216 7110 1143

Email : vfm@afdb.org

OSHD

AfDB

CONTENTS

The Lagos Forum 1 VfM and Parliamentarians 1 Concepts & Issues 2 Problems and Challenges 2 Solutions & Strategies 2

Venue and logistics 3 Staffing and material 3

ECOWAS 4 Actionable recommendations

4 MPs’ views 5

Getting better evidence 5 Improving relations with

the executive 5 “Facing our constituents” 6 Donor relations 6 Regional and inter-

parliament role 6 Facilitators 8

Lagos Event in the News 8 The way forward 8

The Lagos Forum

VfM and Parliamentarians

The Lagos Forum, the

First Capacity-building

event for Parliamentari-

ans organized by VfM,

was held in Lagos, Nige-

ria, on 19 and 20 June

2014.

This Special Edition of

the VfM programme’s

newsletter is devoted to

it.

It gathered some 25

MPs (Members of Na-

tional Parliaments and

the ECOWAS Parlia-

ment) from the fifteen

member states of the

Economic Community

of West African States

(ECOWAS)

Two days were organ-

ized into seven sessions

covering the three top-

ics of the event destined

to help parliamentarians

press for better value for

money in social sectors.

Parliaments are among

the most important en-

gines for socio-economic

development and

growth.

As they establish the

laws by which a society is

governed, any initiative

to ensure better Value for

Money in social sectors

naturally accords para-

mount importance to

them.

This means addressing

the two effective key

challenges for MPs: the

knowledge gap and the

experience gap, particu-

larly for newly elected

MPs.

MPs often lack the

academic qualification,

education or professional

experience providing the

knowledge, skills and prac-

tical applications necessary

for them to press for value

for money in social services

in their legislative or over-

sight role.

See “MP’s views” (pages 5 & 6) for Af-rican MPs voices…

Therefore, capacity de-

velopment to foster these is

vital.

The founding text of the

VfM Programme, the Tunis

Declaration of 2012 signed

by Parliamentarians as well

as Ministers, says “We, the

Ministers of Finance and

Health and Parliamentari-

ans (…) call upon (…) par-

liamentarians and civil so-

ciety to support the imple-

mentation of these rec-

ommendations”

Its supporting statutes

say : “Projects financed by

the VFM programme may

encompass (…) support

(for) dialogue between

relevant ministries and

stakeholders (parliaments,

CSOs, private sector). This

may include, meetings

technical assistance,

studies and preparation of

advocacy documents. (…)

Building capacity including

training, (etc.).”

1 Rifat Atun, Professor of Global

Health, Harvard University, Bos-

ton, USA

Concepts & Issues

2 Salif Samake Senior Consultant,

AfDB

Problems and Challenges

31Bruno Meessens, Professor at

the Institute of Tropical Medicine

in Antwerp, Belgium

Solutions & Strategies

Allocation of resources

and planning must be

based on factual evi-

dence of needs, Professor

Meessens reiterated.

The proper transfer of

resources and their track-

ing must be ensured.

What to do? Monitor &

sanction deviance, adopt

mechanisms to avoid

capture; remove barriers

which exclude users.

No less than 7 tools that

help do this were intro-

duced and explained. All

rely on data and its analy-

sis.

Which are the areas

where improvements can

be made? The Input mar-

ket (purchase of drugs,

equipment etc.), and the

workforce – human re-

source management.

Equity – enabling access

to social services for the

poorest most deprived is

the next challenge.

Finance is a challenge

for most African nations

PBF for performance-

based finance is one solu-

tion. Putting a price (and

reward) on each service

delivered successfully.

A culture of account-

ability, literate legal em-

powerment, disclosure

and publication of results

are all key to improving

governance.

“What is VfM ?” Profes-

sor Rifat Atun set the stage

in the first tutorial session

by explaining : “making

best use of the resources

available”, “measuring

what you get and what

you have spent”.

He explained how to

conceptualize the process

leading from resources to

impact, through inputs,

outputs and outcomes.

Atun laid out ways to

ensure that spending was

allocated to the most

cost-effective means and

as little waste occurred as

possible.

He demonstrated the

urgency of dealing with

this: demographic and

income growth coinciding

with crisis and the decline

in aid, mean getting more

value for money cannot

wait.

It is imperative to plan

on the basis of hard fac-

tual evidence, budgeting

and prioritizing the most

effective simple measures

(see Box 5 High Impact

Health

Interventions”).

Reviewing the tools and

methods to improve VfM

and their financing, Prof

Atun ended by reminding

MPs how they could use

their roles to apply these.

As legislators, they can

use their rule-making role;

their oversight role en-

ables them to ensure rules

are applied; and as repre-

sentatives, that their con-

stituencies’ and citizens’

needs.

Salif Samake asked “Are

the most efficient, benefi-

cial measures the ones

that get priority funding ?

No.”

Social services can be

plagued with inefficiencies

and wastage.

Do we know where the

money goes and how

much?

The 2010 World Health

Report estimates that

globally,“20-40% of all

health spending is wasted

through inefficiency”.

People end up paying

too much out of their own

pocket, and public fund-

ing for social services of-

ten ends up benefiting

those that are not the

most needful.

Far too many African

nations still spend too little

on public health (below

the recommended target

of $44 per capita).

The figures from

UNESCO on the number

of primary school pupils

per maths or reading

textbooks across African

nations illustrate the ineffi-

ciency in education, lead-

ing to a mass of poorly

educated youth.

Figures for the lack of

drinking water or toilets in

primary schools also ex-

plain the poor indicators of

African basic education.

Again regarding health,

Samake showed people

are paying far too high a

price for medicines.

There remain too many

causes of hardship, most of

which can be related to

poor governance, he

concluded.

VFM UPDATE P 3

Venue and logistics

Staffing and material All the proceedings are recorded,

as for previous VfM events, (state-

ments and presentations) and used

as training material on the EADI’s

on-line training website (see oppo-

site).

1 Latefa Camara, AfDB consultant,

recording sessions for training

In addition to the presentations

and specific material prepared for

the event, VfM is working on text-

books manuals.

A compendium of data on

health, education and human de-

velopment in ECOWAS countries

was provided to participants, as

well as case studies from global

sources. Afri-Dev’s scorecards were

also made available and distrib-

uted

2 Material prepared for the participants

The Event has ben fully recorded

and analysed in a detailed report

by local organizer and parliamen-

tary network Afri-Dev.

It will be available from the VfM

secretariat after review and con-

tains all the findings, details of dis-

cussions and Parliamentarians rec-

ommendations.

3 TM Nejmudin Bilal and Rotimi Sankore

of Afri-Dev fine-tune the details

Participants’ re-

sponse to evalua-

tion “The mix of

presentational

methods (group

works, panel dis-

cussion, etc.) was

broadly appropri-

ate” ranging from

Strongly disagree

to Strongly agree,

through 1 to 5.

Figure 4 All the sessions of this and other VfM events are

available on-line to registered users on the EADI website

www. http://einstitute.afdb.org/

Lagos, the economic

capital of Nigeria, the

ECOWAS’ host nation, was

the bustling scene of the

MPs gathering.

The Eko-Hotel’s magnifi-

cent main convention cen-

tre amply catered for ple-

nary presentations by VfM’s

experts and the collective

opening and closing ses-

sions.

The local event organizers

and partners, Afri-Dev, the

Africa Africa Health, Human

& Social Development In-

formation Service), are spe-

cialized in parliamentary

networking and capacity building in the social

sectors and Lagos-based.

The course was conducted in English and

French with simultaneous interpretation and

projections on separate screens.

ECOWAS

Actionable recommendations

The event lead to the

following actionable

recommendations :

“1. That AfDB and

partners facilitate a

series of 2-day capacity

building meetings to be

conducted in each

country for all members

of parliamentary com-

mittees of Social Sectors,

and Budget and Fi-

nance. This should in-

clude sessions on mul-

tisectoral investment

and policy making, and

how to utilize and inter-

pret evidence and

data.

2. That these

meetings be institution-

alized and repeated

occur regularly for every

new intake of parlia-

mentarians in each

country to ensure conti-

nuity and sustainability.

3. That resources

be mobilized to ensure

that Social Sector

Committees in each

country national parlia-

ment are supported with

by at least one perma-

nent expert on multisec-

toral investment and

policy in the social sec-

tors.

4. The duties of

these experts will be

amongst others to liaise

with and between So-

cial Sector, Finance and

Budget parliamentary

committees; and also

between the parliamen-

tary committees, and

Ministries responsible for

Social Sector, Finance

and Budget; and devel-

opment agencies and

partners– i.e. to support

evidence based-based

planning, high impact

and cost effective inter-

ventions.

5. That towards

these, Social Sector

committees should im-

mediately work with

Finance /Budget and

Planning committees

and Ministry colleagues

to improve investment in

National Bureaus / Of-

fices of Statistics.

6. To support over-

sight and accountability

functions including re-

sults based-based plan-

ning and Value for

Money – the capacity of

Social Sector commit-

tees should be built to

include tracking of and

monitoring of resources

by thematic areas and

at constituency level

7. That a plenary

presentation on the

outcomes of the Value

for Money capacity

building work be pre-

sented to the next pos-

sible sitting of the full

ECOWAS Parliament.

8. That the out-

comes and recommen-

dations be presented to

the next possible meet-

ing of Speakers of par-

liament from ECOWAS

member states.

9. That the AfDB

and partners work with

the ECOWAS Parliament

to engage the ECOWAS

Ministerial Conference

of Finance, Economic

Development and So-

cial Sectors on Value for

Money Investment.

10. That an urgent

platform be urgently

facilitated to ensure

continued interaction

between ECOWAS So-

cial Sector parliamen-

tarians and key stake-

holders to facilitate sus-

tainable capacity build-

ing.”

AfDB works with Re-

gional communities of

nations – EAC in East

Africa, SADC in southern

Africa, ECOWAS in West

Africa…

The relationship with

ECOWAS lead to the co-

organizing partnership

with the ECOWAS par-

lament for the Lagos

event.

ECOWAS (CEDEAO in

French) regroups fifteen

West African nations.

The ECOWAS parlia-

ment is the legislative

organ of the Economic

community, based in

Abuja, Parliament con-

sists of 115 seats. Each of

the 15 Member State

has five seats at least.

The remaining seats are

shared in proportion to

the population.

Its secretary General

Dr. Cheikh Abdel Kader

Dansoko, represented

by Jacob Amuta

Onogwu (left), pro-

nounced the opening

speech.

Parliamentarians

agreed with the organ-

izers that ECOWAS

should play an impor-

tant rule in following up.

Meetings on the results

of the capacity building

Forum should be held

ECOWAS agreed to

partner with AfDB for

further such capacity

building meetings in the

future.

5 ECOWAS parliament emblem 6 Opening speech by

Jacob Amuta Onogwu

7 The fifteen ECOWAS member states

VFM UPDATE P 5

MPs’ views

Getting better evidence

8 Hon. Fatou Mbye, Gambia

9 Hon. Fomba Fatimata Niam-bali

(Mali)

Improving relations with the executive

Many of the tools and

instruments available to

improve effectiveness,

accountability, sustain-

ability rely on the pro-

duction, collection,

analysis and disclosure

of factual evidence

(data).

MPs complained of

the inadequacy of na-

tional statistical bureaus,

the lack of skilled staff in

the parliaments to ob-

tain and analyse such

data when it exists, and

the obstacles to the

transmittal of informa-

tion from the executive

to the legislative and to

the people.

Skills and equip-ment

The lack of equipment

– particularly Information

technology and the skills

to use it – were also

mentioned as a hin-

drance.

“Parliamentarians

would benefit from bet-

ter IT equipment and

training in using it. The

lack of both delays the

availability of timely

evidential data” said

Hon. Hassan Abdul

Sesay of Sierra Leone’s

Youth. Information. Tour-

ism Commission.

Legislators suggested

that staff be allocated

to the task of gathering

evidence across sectors,

to benefit both them

and the executive, in

national and the re-

gional parliaments.

Asked about her view

of the likely impact of

changes in information

technology and its

adoption by African

citizens on their role as

parliamentarians, an MP

said « “we must see the

momentous changes

underway on our conti-

nent as opportunities

rather than threats”

The pressure to get

more, better evidence

comes from the top as

well as the bottom of

communities.

Both arms of govern-

ment need better skills,

training, equipment.

Relations between the

two need improving –

trust, mandatory col-

laboration, honesty and

diligence must charac-

terize the relationship

between elected politi-

cians and executives of

the national administra-

tion.

The relationships be-

tween legislative and

executive need a cul-

ture change, from un-

friendliness or uncoop-

erativeness to mutually

respectful diligence

favouring service to the

people

“MPs may be misin-

formed by officials, civil

servants” lamented one

participant.

Taxation and fis-cal affairs

Budgeting, planning

and the transfer and

tracking of resources

have to do with revenue

collection as well, they

said.

MPs role in the fiscal

process, the local level

also have a bearing on

ensuring social pro-

grammes are funded

and effective.

Input market and costs

MPs pointed out the

extra costs due to the

necessity to borrow and

the lack of domestic

manufacturing capac-

ity.

“Lack of domestic re-

sources leads to costs in

the form of interest on

loans and unpredictabil-

ity of donor-supplied

aid”

“Lack of domestic

manufacturing capacity

leads to costly imports”

said one MP.

“We, the Ministers of Fi-

nance and Health and

Parliamentarians”

…“call upon: parliamen-

tarians and civil society to

support the implementa-

tion of these recommen-

dations”

Box 4 Tunis Declaration 2012

“Facing our constituents”

Donor relations

Regional and inter-parliament role

MPs had several sug-

gestions regarding do-

nors.

Harmonization be-

tween them should not

just be paid lip-service

but effectively applied.

National plans reflect-

ing national priorities

should lead the way

and attract the aid

needed, rather than the

other way around.

Donors too, should be

assessed according to

the results and success of

their aid operations, in

order that effective op-

erations be rewarded

and ineffectual ones

sanctioned or stopped.

Said Honourable Fatou

Mbye (Health Comission,

Gambia) “We (MPs) lack

adequate time and re-

sources to scrutinize de-

velopment projects…are

under pressure to ap-

prove, sometimes in a

month, even a week”

Reliance on aid, lately

on the decline and suf-

fering from unpredict-

ability, was criticized

and the development of

domestic revenue col-

lection and increased

better social spending

advocated.

There is no lack of

formal rules about aid,

what is lacking is the

political and material

resources to implement

them.

Politicians are there to

serve their constituents.

Their role derives from

this representation, yet it

is also a hindrance to

effective social services.

MPs admitted that

party affiliation could

prevent a legislator from

criticizing a social pro-

ject his or her party sup-

ported.

Another issue was the

simple way many peo-

ple viewed the success

of social policy – social

projects just had to be

visible, attributable, to

be successful.

“In our countries, if you

do not have things to

point to – that’s the

hospital, that’s the

school -, you are a bad

politician” lamented

Hon (Mr) Hassan Abdul

Sesay (Commission on

Youth. Information, tour-

ism, Sierra Leone).

People themselves

have to be informed on

the effectiveness of

different health, educa-

tion and social meas-

ures, to demand them,

and on what can and

cannot be demanded

from elected represen-

tatives.

As Afri-Dev Parliamen-

tary network coordina-

tor Rotimi Sankore said

“polio vaccination may

not be very visible, but

the cripples in the street

if it is not done, are”

There was consensus

on the usefulness of the

event itself in bringing

together MPs to realize

they faced similar prob-

lems, could learn from

each others’ experi-

ence and mutual sup-

port.

The Gambian repre-

sentative in particular

showcased a pilot sys-

tem of scorecards in the

North of the country

whereby users and citi-

zens could rate social

services and their judg-

ment was taken into

account by the execu-

tive and legally binding.

There was a staunch

defence of their role by

the Gambian MP ; “we

as parliamentarians

have enacted legisla-

tion that has helped

ensure food security,

national accountability,

government plan-

ning…all of which im-

prove people’s lives”

Parliamentarians

called on the regional

body the ECOWAS par-

liament, to institute

regular sessions on the

VfM topics (see Action-

able recommenda-

tions), and on the AfDB

to pursue support for

national and regional

parliamentary actions

for VfM.

10 Parliamentarians at work Hon.

Hassan Abdul Sesay Hon. Ibrahim

Sulaiman Sesay

11Participants - debate

- Birth Spacing

- Antenatal care

- Prevention of HIV transmis-

sion from mother to child

- Skilled attendant at birth

- Postnatal care for mothers

and newborns

- Exclusive breastfeeding for

six months

- Three doses of the com-

bined diphtheria, pertussis

and tetanus vaccine

- An<bio<c treatment for

pneumonia

- Insecticide-treated bed net

use against malaria

Box 5 High Impact Health

Interventions

VFM UPDATE P 7

Newsletter of the VfM

Unit

Editor : Nejmudin Bilal

Value for Money, Sus-

tainability and Account-

ability in the Social Sec-

tors

Contact us :

VfM Unit

Tel. +216 7110 1143

Email : vfm@afdb.org

OSHD

AfDB

The Event banner

Parliamentarian participants Name Committee/organization Country Website

Hon (Ms) Zalissa Ouillio Koumare Finance & Budget Burkina Faso Website

Hon(Mr) Halidou Sanfo Social & Cultural Burkina Faso Website

Hon(Mr) David Lima Gomes Health Cape Verde Weebsite

Hon(Mr) Fernando Lopes Robalo Education Cape Verde Website

Mr Atse Roland Olivier Akissi Adminstrateur Charge des

Affaires Internationales

Cote d’Ivoire

Hon (Mr) Souleymane Toure Social & Cultural Cote d’Ivoire Website

Hon (Mr) Lassina Kone Economic & Financial Cote d'Ivoire Website

Hon(Mr) Sulayman Joof Education Gambia Website

Hon(Mr) Amadou Khan Finance & Budget Gambia Website

Hon(Ms) Fatou Mbye Health Gambia Website

Hon(Mr) James Klutse Avedzi Finance Ghana Website

Hon(Mr) Mathias Asoma Puozaa Education Ghana Website

Hon (Mr) Dramane Goita (t) Finance Mali Website

Hon (Ms) Aissata Haidara Education Mali Website

Hon(Ms) Fomba Fatimata Niam-

bali

Health & Social affairs

(ECOWAS Parliament)

Mali Website

Hon (Mr) Kalilou Ouattara Health Mali Website

Hon(Mr) Yaya Sangare Education, Science, Tech-

nology (ECOWAS Parlia-

ment)

Mali

Website

Mr Jacob Amuta Onogwu Principal Administrative

Officer (ECOWAS Parlia-

ment)

Nigeria

Website

Mr Bertin K Some Parliamentary Assistant

Social Sectors (ECOWAS

Parliament)

Nigeria

Website

Hon (Mr) Hassan Abdul Sesay Youth. Information. Tourism Sierra Leone Website

Hon (Mr) Ibrahim Sulaiman Sesay Clerk of Parliament Sierra Leone Website

Hon(Ms) Mabinty Kadijah Sillah Health. Human Rights Sierra Leone Website

Hon (Ms) Afi Ntifa Amenyo Epse

Bebou

Health Togo Website

Hon (Mr) Kayaba Malle Education Togo Website

Hon (Mr) Yawovi Osseyi Finance Togo Website

IN MEMORIAM

The passing on 5 July

2014 of an honour-

able participant,

Dramane Goita (born

17 January 1973 in

Yorosso, Mali), was

learnt with distress by

us all

The organizers hereby

express their sincere

condolences to the

family and friends.

Link to official an-

nouncement by

Mali’s National As-

sembly

Facilitators

Lagos Event in the News

The way forward [From Event Evaluation) “In the future, for which

of the following topics would you like to have more

in-depth and extended days during the event?” S/N Response options Response %

a. High impact interventions

and evidence based

planning

14 21%

b. Efficiency, transfer and

tracking of resources

14 21%

c. Financing 7 10%

d. Inequality and equity fo-

cused interventions

14 21%

e. Input Market 6 9%

f. Accountability and com-

munity voice to improve

value for money

12 18%

Onche Odeh of the Daily

Independent (Nigeria)

wrote in an article head-

lined AfDB to help Nigeria,

others in resource man-

agement (June 22) : “The

African Development

Bank Group (AfDB) has

started the process of

building the capacity of

parliamentarians in Nige-

ria and other West African

countries on how to make

judicious use of monies

being allocated to gov-

ernments in their respec-

tive countries.”

An Editorial in Nigeria’s

the Guardian entitled

Bank, parliamentarians,

ECOWAS seek value for

social services on 23 June

wrote “Speaking on

behalf of ECOWAS

Secretary General,

Cheikh Abdel Kader

Dansoko, ECOWAS

Parliament representative,

Jacob Amuta Onogwu,

said that the objective of

the forum is to "remove

the bottle-necks

constraining the effective

use of resources".

Announcing the event in

advance, Gambia’s The

Point, wrote “It should

provide an opportunity for

the members of the

PAC/PEC of the National

Assembly in The Gambia

to attend, and gain some

fresh insights in this area,

as well as to share

experiences and

knowledge on best

practice with the other

participants.” [“Gambia:

Focusing On Value for

Money” via AllAfrica, 22

May]

“We have learned a lot,

but knowledge is noth-

ing unless you use it, let’s

start acting, we want

you to spread the word

to your colleague MPs,

become ambassadors

for Better value for

Money.” concluded

Chief Health Analyst

and VfM member Fab-

rice Sergent (left).

Ousmane Doré, AfDB’s

Nigeria office director,

who introduced the

event, here in discussion

with event organizer

Nejmudin Bilal.

This, the fifth capacity-

building event organized

by VfM since its inception

a little more than a year

ago, is the first such gath-

ering of parliamentarians.

Further forthcoming

events are planned for

the East African Commu-

nity (EAC) parliamentari-

ans, and the Southern

African Development

Community (SADC).

Handbooks and manu-

als are in preparation or

underway – on the phar-

maceutical industry, the

fiscal space concept, the

role of private investment

etc.

As the various stake-

holders are sensitized and

informed on the ways to

improve Value for Money

in Social Sectors, aid or-

ganizations learn from

them the particular chal-

lenges they face and

respond accordingly.

EBOLA

As the ex-post

report on the event

notes : “The Ebola

outbreak in West

Africa that initially

began in the first

quarter of 2014 on a

relatively small

scale, and then re-

ignited in July is

sadly, evidence of

the importance of

building the policy-

making capacity of

parliamentarians

and Ministries.”

“Indeed better and

more efficient

investment could

have prevented, or

mitigated the

ongoing epidemic.”

The AfDB has mobi-

lized at unprece-

dented rate and

scale to respond to

the tragedy. See

Link