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Mozambique – Funding the Health Sector. Celeste Kinsey Health SWAp Mozambique. Financing for Health in Mozambique. Managed by Government National budget $150M Sector budget support $75M Vertical funds $75–90M Projects $20M. Estimates. Managed by Partners Projects $330M USA $250M
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Mozambique – Funding the Health Sector Celeste Kinsey Health SWAp Mozambique
Financing for Health in Mozambique Managed by Government • National budget $150M • Sector budget support $75M • Vertical funds $75–90M • Projects $20M Estimates Managed by Partners • Projects $330M • USA $250M • Other $80M • Private $10M
National Budget • Decreasing expenditure on health • Between 2008 and 2010 allocations dropped from approx 11% to 8% • Well below Abuja target of 15% • Competing priorities • Huge volume of external funds
Prosaúde Since 2004, with change in 2008 2 types of support Internal Funds External Funds Fully aligned with national systems One plan, One budget, One performance framework for the sector No in-year triggers for disbursement Sector Budget Support
Projects, Vertical and Private Funds • Current estimate is 185 projects = 65% of funding for sector • Many partners and implementing agencies • Difficult to achieve coherence and ensure coordination • Information is often difficult to obtain • Poor predictability • Complex management separate from normal business • Takes special efforts to coordinate with government and also between partners
Characteristics of health sector financing in Mozambique • Heavy dependence on external funds • Highly fragmented • Complex management requirements • Majority of financing is outside of national budget or plans
Health Sector Wide Approach SWAp Saúde • 2003 - present • Code of Conduct • Memorandum of Understanding • Health Partners Group • Working groups – coordination and technical
SWAp Saude • Coordination • All partners at the table, no matter how they fund • Representation by a Troika • Communication • Joint dialogue: CCS, CCC, HPG, Working Groups • Monitoring • Follows implementation of the PESS and PES, annually, is based upon SWAp dialogue, annual review, plans and reports
Lessons Learned • Need a Health Financing Strategy • Donor coordination, dedicated time, willingness to work together and good communication are essential • We work better when we work together