Sustaining and Accelerating Change: 4th IHP+ Country Teams Meeting in Nairobi

1. 4TH IHP+ COUNTRY TEAMS MEETING: Sustaining and Accelerating Change, Getting Results12-14 December 2012 Nairobi, Kenya

2. JFMA Process • For Sierra Leone to own the process a National Counterpart Team(NCT) was formed and its membership was drawn from key stakeholders in Public Financial Management • Operationalising the NCT was difficult considering its diversity in the number of government institutions involved. • NCT is useful in moving forward with the road map and contributing to the FMA report.

3. Working with development partners • DPs had dealt directly with implementers for their respective programmes in isolation from the central ministries • DPs were not in touch wit the AGD in the opening of bank accounts for the implementation of their interventions • DP interventions to a large extent had not been on-budget and on-treasury which has lead GOSL to miss out valuable information particularly inflows and expenditures of health • DPs have asked for separate reports and audits and this has been time consuming and counter-productive for the staff • DPs have had reasons for their past behaviors but this has hampered accountability and transparency.

4. Benefits • Stronger risk assessment and management for all operations financed by DPs in the health sector; • Less frequent FM assessments, a single FM framework and processes (partly aligned with the country’s fiduciary framework); • United accounting and reporting support systems including common rules & requirements • Single set of periodic reports and reduced burden on production of reports with better transparency • Single and streamlined audits with better scope and visibility by auditors and management

5. Challenges • DPs and government to incorporate the tasks into their functions/government institutions and work programs (same calendar and timetables), • DPs to develop, operationalize, maintain close coordination/collaboration among themselves to reduce divergent approaches • Establishing and funding the Integrated Program Administration Unit (IPAU) and absorbing stand alone PIUs

6. Recommendations to donors • Draft and sign MOU which documents common FM arrangements • Coorporate with government for compliance with rules– eg. opening and operating bank accounts, align decision and approval processes with those of the country and good practices • Ensure adequate and timely information is provided (eg. cost of in-kind goods delivered, informing the Auditor General for audits, numbers for Budgeting) • Support the MOHS for capacity building and establishment of the IPAU and absorbing other PIUs

7. Recommendations to other Ministries of Health • Resolve any governance issues that may exist • Coordinate and ensure that funds accessibility is facilitated reducing bottlenecks at the MoH • Engage MoF to facilitate funds accessibility and capacity building • Better planning and budgeting process by working with DPs to align DP-gov. budget cycle, including preparation of realistic plans and cash-flow projections

8. Next steps • Translate recommendations into a National Action Plan and prepare MoU for a Joint Financial Management Arrangement (JFMA) • Draft Action Plan and JFMA MoU will be submitted to the Health Sector Steering Group and discussed at Stakeholders conference • The MoU will be signed by the GOSL and development partners