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Burkina Faso Case

Burkina Faso Case. Is Burkina Faso ready for a SWAP?. Indicator. Data. Population. 11.3 million. Population growth rate. 2.4 % per annum. Total fertility rate. 6.6 per woman 15-49. Infant mortality rate. 94 per 1000 live births. Maternal mortality ratio. 556 per 100,000 live births.

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Burkina Faso Case

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  1. Burkina Faso Case Is Burkina Faso ready for a SWAP?

  2. Indicator Data Population 11.3 million Population growth rate 2.4 % per annum Total fertility rate 6.6 per woman 15-49 Infant mortality rate 94 per 1000 live births Maternal mortality ratio 556 per 100,000 live births Urban population 16 % Adult literacy rate 19 % Life expectancy at birth 52 years Burkina Faso: basic indicators

  3. Indicator Data Income per capita $240 Per capita health expenditure $10 Health expenditure as % of GDP 4 % Average household spending on health $63 per year Drugs as percent of health spending 88 % B F: economic indicators

  4. Health system performance issues • Over-centralized resources leading to: • Technical inefficiency—low value for money • Poor allocative efficiency—spending money on the wrong things • High costs to patients (who spend a lot for drugs) • Poor quality of care—poor performance by health workers at poor facilities

  5. Reform initiatives • New role for ministry of health in setting norms, planning, special programs • District health team approach, with community management committee implication • New approaches to resource management, including block grants to districts • General contracting of civil servants with performance evaluation

  6. Enabling factor Assessment Macroeconomic conditions Government allocations to health sector Management capacity--MOH Government openness to SWAp Donor coordination Prospects for harmonization of donor procedures Interest in basket funding SWAp readiness Criteria

  7. Discussion questions • Based on your reading of the case (or knowledge of BF), comment the criteria of readiness in the previous slide? How to do you assess these criteria? • Would a SWAp enable BF to improve the management capacity of its MOH, or would weak existing capacity defeat a SWAp? • Would a SWAp contribute to efforts to improve the performance of BF’s health system? • Are donors ready for a SWAp? • Would you recommend that BF move to a sector-wide program?

  8. Take 45 min for discussion

  9. Discussion questions • Based on your reading of the case (or knowledge of BF), comment the criteria of readiness in the previous slide? How to do you assess these criteria? • Would a SWAp enable BF to improve the management capacity of its MOH, or would weak existing capacity defeat a SWAp? • Would a SWAp contribute to efforts to improve the performance of BF’s health system? • Are donors ready for a SWAp? • Would you recommend that BF move to a sector-wide program?

  10. Burkina Faso Case Could Burkina Faso engage a SWAp process ?

  11. Central ideas • Government, Donors and other groups of civil society are involved in a new type of partnership • Management and coordination of aid is shared equally by stakeholders on both sides  Government in the Driver-seat

  12. Advantages • More efficient use of funds for development purposes • More control by the Government over the development agenda • Better donor coordination & reduce administrative burden for the Govnt • Flexibility to design strategies corresponding to local conditions • Consistency between policy and dvpt goals by all stakeholders • Long term approach to development

  13. Disadvantages • Greater influence of the donors in deciding Government policy & high level decision • Difficult in attributing results to particular donor • Less opportunity for innovative approaches from multiplicity of development agencies • Less control of how funds are used

  14. Here is what Burkina has Int’l NGO E U UNDP DONOR Community? A D B W Bank Af D B WHO UNICEF UNFPA BILATERALS

  15. Here is what Burkina wants Int’l NGOs E U UNDP HEALTH SWAp A D B W Bank Af D B WHO UNICEF UNFPA BILATERALS

  16. Here is what Burkina needs to do Preconditions • Commitment of Burkina government • Burkina ownership in SWAp process • Capacity of the MoH • Clear and consistent strategies • Transparent budgeting and accounting system • Policies and strategies remain consistent

  17. How strong is the commitment ? • An agency must be designated or created to guide SWAp process in the country • The agency is endowed with authority to implement the course of action for the SWAp, • An adequate budget must be appropriated to enable the agency to carry out its mandate.

  18. How to strengthen Ownership? • National consultations • Clear overall vision: role of the state in the sector endorsed by the Head of State • Sector strategy endorsed by MoH and Legislature • Core of influential officials sharing relevant donor perspectives • Ministry of Finance support: spending programmes realistically matched to the Budget available

  19. How strong is ownership ? Strong Government Leadership Government change Agents seeking Alliance Donor Leadership

  20. Finally…… • Mechanism that gives back control of health development programs to Burkina government • Focusing on the long-term policy & strategy decisions in the Health Sector • An approach rather than a blueprint • Ownership and Timing apropriate • Building discipline and trust from both sides: Government and donors

  21. Burkina building carefully a Health SWAp ?

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