Development Partners DPs

1
Development Partners (DPs)

• How can Public Health information influence DPs
  decision making ?
• Health warning
• By Ms Marilyn Mcdonagh
• DFID Kenya

2
Historical Perspective - Donors

• Varied considerably political.
• Fragmented
• Projects covering individual donor concerns
  rather than government priorities.
• Individual procedures financing , procurement ,
  monitoring.

3
Problems

• Established parallel systems, duplication,
  undermined Gov system.
• Distorted Government commitments,
• High Transaction costs for Gov, Mission fatigue
• Substituted for Gov commitment eg fund EPI, FP
  Gov can uses resources on other things.
• Avoided the need for Gov to make choices about
  how to use available resources.
• Unsustainable - EPI classic example.

4
Changes Development Partners

• Support to Gov own strategies, higher level PRSP,
  ERS,
• Focus on reaching poor people -
• Achievement of MDGs ,
• Complementing strategies - Programme support
  rather than projects, avoid duplication and
  parallel systems SWAPs, basket funding, DBS,
• More focus on PEM / MTEF
• Donor Harmonisation

5
Challenges

• Budgets not allocated in support of Polices, eg
  Kenya
• Strategies exist but very few supported by costed
  Business Plans,
• Why do we need a BP - road map of how objectives
  will be achieved, existing commitments, gaps and
  priorities.

6
Challenges

• Discipline hard choices need to be made not
  accustomed to this way of working.
• Links to PER, PEM, MTEF. Budgets allocated as
  last year not by what PER showed. Need for PEM.
• Encourage CS to hold Gov accountable for
  delivering services demand.

7
What does this mean in the health Sector?

• Gov in the driving seat.
• Strengthen Gov systems,
• Less support to individual projects , more
  support to the health programme based on
  prioritised costed plan.
• BUT complementing strategies projects needed to
  learn lessons, hard to reach marginal groups,
  inefficient public services.

8
Health sector

• More contracting of Gov with NGOs rather than
  DP.
• Partnerships to deliver the programme, not just
  the public sector.
• Less earmarked money ( EPI vehicles M and E ),
  more joined up working , efficiency.
• Break down of empires and focus on the health
  sector.

9
Decisions.

• Government Policy and Priority,
• Strengthen existing system, not establish
  parallel systems
• Activities - evidence based eg A/N perfunctory
  ,need informed choices.
• Decrease in MM was it really achieved through
  hospital deliveries carried out by Drs - no so
  why that policy ?

10
Decisions.

• Will it impact on MDGs and how much ?
• Impact on the poor, new technologies who benefits
  ? How will you ensure equity ?
• Cost effectiveness - opportunity cost informed
  choices
• Training epidemic !!

11
Decisions.

• Scale up - can the successful,activities be
  rolled out nationally ?
• Sustainability ?

12
Conclusion Key

• DPs seeking more to support gov policies and
  strengthen gov systems through a partnership with
  all stakeholders.
• CSO to hold Govs accountable for providing
  services.

13

• Look at how resources are allocated across the
  whole HS , which means hard choices often have to
  be made.
• Evidence based policy making,
• Poverty and MDG focused.