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Official Development Assistance to the Moldovan Health Sector – 2011 Fourth Edition. 30 March 2012. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA. Aim.
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Official Development Assistance to the Moldovan Health Sector – 2011 Fourth Edition 30 March 2012 MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Aim To provide a full picture of the external official development assistance to the health sector thus highlight gaps of donor’s assistance across the priorities laid down in the national strategic policy documents and to provide forecasts on future foreign assistance on short and medium term perspectives MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Objectives • To picture donors activities in the larger framework of the health system functions and donors alignment towards the Moldovan health system strategies • To improve quality of information available for sector coordination and strategic decision-making for strategic planning of financial resources in health sector • To illustrate donors’ short and medium term commitments to the Moldovan health sector • To review the coordination mechanisms in place MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Differences with previous editions • Measurement of aid alignment with health system priorities and functions • Measurement of aid alignment to the Paris Declaration on Aid Effectiveness • Web-based interface for data collection • Validation process MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Methodology • The study design compelled two phases: questionnaire development and identification of the eligibility criteria. • The data collection was conducted through an online interface and strengthened through validation interviews. • Data analysis was conducted by the research team in close collaboration with the software developer MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Eligibility criteria The assistance provided by the agencies covered by this enquiry had to fulfill both sets of criteria given by: 1. OECD DAC definition of ODA Grants or loans to countries and territories on the DAC List of ODA Recipients (developing countries) and to multilateral agencies which are: (a) undertaken by the official sector; (b) with promotion of economic development and welfare as the main objective; (c) at concessional financial terms (if a loan, having a grant element of at least 25 per cent). In addition to financial flows, technical co-operation is included in aid. Grants, loans and credits for military purposes are excluded. Transfer payments to private individuals (e.g. pensions, reparations or insurance payouts) are in general not counted. 2. The State Chancellery of Moldova Annex I of Government Decision no. 246 of 8th April 2010: “List of the technical assistance projects that qualify for international treaties, for tax exemptions, custom taxes and 0% VAT for goods and services provided by them” MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Official Development Assistance in Health Sector implemented in 2011 External Development Partners Multilateral Bilateral European Union Delegation in the Republica Moldova Austrian Agency for Development (ADA) United Nations Children’s Fund (UNICEF) German Agency for International Cooperation (GIZ) United Nations Population Fund (UNFPA) GAVI Alliance Government of the People’s Republic of China The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFTAM) United Nations Office on Drugs and Crimes (UNODC) Government of Romania Japan International Cooperation Agency (JICA) The World Bank Group (WB) International Atomic Energy Agency (IAEA) Swiss Agency for Development and Cooperation (SDC) JointUnited Nations Programme on HIV/AIDS (UNAIDS) World Heath Organization (WHO) Turkish Agency for Development and International Cooperation (TIKA) United Nations Development Program (UNDP) United States Government (USG)
ODA projects or programs per donor # of programs or projects
Geographic coverage National, targeted regional and pilots MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Aid modalities MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2011
Grants and loan MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2011
Type of funding MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2011
Investments MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of funds disbursed for Investments in 2011
Technical Assistance MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of funds disbursed for Technical Assistance in 2011
Health System Core Functions MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2011
Health Service Provision, by components MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of funds disbursed for Health Service Provision in 2011
Program priority areas MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2011
Donor perceptions about MTEF MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA Number of donors
Aid Predictability Intention to continue support to health sector, short-term, 2012-2013 MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA Number of donors
Findings • In 2011 external donors have disbursed an equivalent of US$ 51.7 mln to health sector in Moldova, which represents a total 14% compared to the public expenditure on health in equivalent of US$ 363 mln. • Among core health system functions, most donor assistance supports activities related to Health Systems Delivery and Resource Generation, while Stewardship and Governance and Health Financing receives less financial allocations. • Funds are disbursed unevenly in the different health service delivery component: Public Health Sector and Emergency Care is receiving far less attention than Primary Health Care and Hospital Care. • Funds are disbursed unevenly in the different program priority areas: communicable disease are receiving the largest share of the disbursements, while burden of disease lies in non-communicable diseases. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Findings • Geographic coverage is not uniform, Chisinau and Balti receiving most attention in targeted regional coverage. Some districts receive focused support from more donors. • In health sector, donors aligned well to support priorities in national health policies and national programs, however programs related to HIV and TB and Hospital Health Care Development received attention from more donors compared to other health priorities. • Due to limitations of MTEF relevance to donor strategic programming, alignment to MTEF categories is far more complicated. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Findings Checked against the “Results of the 2011 Survey on Monitoring the Paris Declaration -Moldova” and Paris Declaration general target indicators • Only 14% of the 2011 health sector commitments were recorded in the sector budget (versus 85% Paris Declaration target value). • Donors are concentrating on technical assistance more than they do in other sectors (average 20%). • Funds disbursed in 2011 topped the scheduled ones by 18% points. • The number of donors who could not provide the exact amount of pledged funds for 2012-13 was high (10/15). On the timeframe 2014-2020 none of the donors interviewed was able to give the amount pledged. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA
Thank you for your attention MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA