Lessons from Health Sector Performance Reporting & Monitoring

1. Lessons from Health Sector Performance Reporting & Monitoring Geneva, 5th October 2012 Strengthening Accountability to Achieve the Health MDGs

2. Results Framework Performance Monitoring & Evaluation of the IHP+

3. 2. Transparent Information from Performance Reporting & Monitoring Why monitor? 3. Mutual Accountability Processes with Forum for Discussion AVAILABILITY COLLABORATION COORDINATION HEALTH RESULTS THROUGH STRENGTHENED HEALTH SYSTEMS COLLECTION UTILIZATION 1. Mechanism for Participation, based on IHP+ Global and Country Compacts DEMAND COOPERATION

4. Reflecting on 5 Years of Monitoring August 2008 May 2010 April 2011 October 2012

5. NOT YET PARTICIPATING IN IHP+RESULTS FOR ANNUAL PERFORMANCE REPORTING OR SELF REPORTING & ACCOUNTABILITY 1 2 PARTICIPATING IN IHP+RESULTS GOVERNMENTS OF: GOVERNMENTS OF: Cambodia, Cameroon, Cape Verde, Chad, Côte d’Ivoire, Gambia, Guinea, Kenya, Madagascar, Pakistan, Vietnam, Zambia. DEVELOPMENT PARTNERS: Canada, Finland, France, Italy, Portugal, International Labour Organisation (ILO), Bill & Melinda Gates Foundation . DEVELOPMENT PARTNERS: 4 3 ENSURING HEALTH SECTOR AID EFFECTIVENESS COMMITMENTS ARE SYSTEMATICALLY AND ROUTINELY MONITORED TAKING STEPS TO USE IHP+RESULTS REPORTING TO STRENGTHEN MUTUAL ACCOUNTABILITY 1. Mechanism for Participation, based on IHP+ Global and Country Compacts This represents the end goal of a virtuous cycle.

6. 2. Transparent Information from Performance Reporting & Monitoring

7. How information has been collected & managed MAR - JUL 2010 Developed and/or agreed by IHP+ signatories. Reviewed in July 2011. MAY - JUL 2012 Draft scorecards discussed with participating signatories. FEB - APR 2012 Questionnaire based on Standard Performance Measures. Data collected and used as basis for ratings. IHP+ GLOBAL COMPACT STANDARD PERFORMANCE MEASURES QUESTIONNAIRE RATING SCORECARD

8. How this Information has been used (or not!) 3. Mutual Accountability Processes with Forum for Discussion

9. What change has IHP+Results contributed to • Some evidence of increasing cooperation to deliver more effective aid (but not yet at level of collaboration) • Information is now available • Voluntary Participation is increasing • Greater Transparency with Performance Reports, Scorecards and Web Data • Discussions are being had about aid in the health sector (some country-led), with power shift in conversations • Other: Conceptual positioning of IHP+ as an aid effectiveness intervention; Sectoral perspective on aid effectiveness (TTHATS); Alignment for COIA etc

10. What have been the challenges? • Lack of appropriate use of the IHP+Results mechanism and information products, to improve coordination or to inform collaborations between partners • Not collecting and reporting the right Information at the right time • Participation for the wrong reasons (cooperative compliance rather than learning) and incentives are not compelling • Transparency without data integrity because information is not systematically validated, or being questioned • Discussions not taking place at the right levels, with the right people (mutual accountability and review mechanisms are not in place or being routinely used) • Lack of capacity within partner institutions?

11. What we have learned PROCESS (PARTICIPATION): Voluntary participation seems to work Some sense of compliance (cooperation) driving participation, rather than learning Transaction costs are heavy and will continue to be if reporting has value Triangulation is important for credibility, but how important – can we ever reach truth? Locating the process at country level remains the aspiration NB: Monitoring must adapt and evolve • USE (FORUM FOR DISCUSSION) • Limited discussion of reports and scorecards • Prospects for use in 2012/13 are better – key to future demand for monitoring • Civil society role in promoting use is important – IHP+ needs to better resource CSOs to engage • Important to articulate the value of monitoring aid effectiveness to health results • Use and accessibility are connected – scorecards have been valuable in this regard MEASURES (TRANSPARENCY) • Paris Indicators a good strategic choice • Some indicators need attention: not appropriate, not useful (procurement, PBAs, capacity building) • Some definitions need attention (‘active’) • Lack of qualitative information weakens potential for learning & improvement • Framework needs to be able to detect & report unanticipated changes • Targets need to be better defined (lowest common denominator vs aspiration?) • IAG

12. How to improve? 2. Transparent Information from Performance Reporting & Monitoring 3. Mutual Accountability Processes with Forum for Discussion AVAILABILITY COLLABORATION COORDINATION HEALTH RESULTS THROUGH STRENGTHENED HEALTH SYSTEMS COLLECTION UTILIZATION 1. Mechanism for Participation, based on IHP+ Global and Country Compacts DEMAND COOPERATION

13. Questions on Future Monitoring • What needs to be done to stimulate demand for future monitoring? • How should specific technical issues relating to information relevance, validity & availability be addressed (and by whom?) • How can better use be made of the information – especially through collaborative discussions & by country level decision-makers?