PARTNERSHIP FOR HEALTH DEVELOPMENT

1. PARTNERSHIP FOR HEALTH DEVELOPMENT 4th Global Meeting of Heads of WHO Country Offices with DG and RDs Geneva, November 2007 Dr. Mirta Roses Periago Director AMRO

2. What does it mean Partnership for Health Development?

3. Typology to classify Partnership • Research and Development • Technical assistance/service support • Advocacy • Financing

4. INT NGO WHO CIDA UNAIDS GTZ 3/5 RNE UNICEF Norad WB Sida USAID T-MAP MOF UNTG PMO CF DAC GFCCP PRSP PEPFAR HSSP GFATM MOEC MOH SWAP CCM NCTP CTU CCAIDS NACP GOVERNMENT CIVIL SOCIETY PRIVATE SECTOR Source: Mbewe, WHO

5. Major negative consequences of GHP interactions with countries 1 2 Countries are burdened with parallel and duplicative processes and systems from multiple GHPs, since GHPs often bypass and undermine those that countries already have in place Countries struggle to absorb GHP resources because GHPs do not provide adequate technical and other support to implement programs Consequences of GHP interactions • Shifts in policy and technology not well supported • Relevant assistance for implementation not forthcoming • Country coordination forums proliferating and not set up to be effective • “One size fits all” processes do not recognize country diversity” • GHP-led efforts on cross-cutting system-level issues cause duplication 3 Complication: GHPs have not communicated effectively with countries and partners

6. Hosting missions and report writing are major burdens at the district level Missions can consume 10-20% of a DMO’s time Number of one-day missions to Temeke during last 6 months TANZANIA DISTRICT EXAMPLES Report writing can consume even more time Number of full days per quarter spent on writing reports (Morogoro) 4 PEPFAR JICA Harmonizing report writing can help reduce the burden 2 GFATM Finnish 2 NTLP Axios 1 Gates Foundation UNICEF 1 Norwegian TB World Vision 1 EPI MoH – TB 1 UNICEF MoH – Malaria 1 WHO MoH – AIDS 1 NACP MoH – EPI 1 NMCP MoH – Maternal Health Weekly notifiable disease reports 1 London School Total 16 Total * Assumes around 50 working days per quarter and 100 per half year although reported to work in excess of that Source: In-country interviews; DMO visitor log; team analysis

7. Multilateral/Implementing Partners GHP communication is weak on multiple levels, especially with countries Communication channels Weaknesses Variation in quality/quantity of communication with GHP • Communication channels inadequate • Unclear feedback • Perceived lack of secretariat’s country knowledge “It is almost impossible to get responses by e-mail or phone from our GHP contact . . ..” “. . . even if were to reach him, we don’t feel like we could push back.” Country GHP Secretariat GHP flexibility not clear to country (do not feel empowered to ask) “We don’t have formal agreements with partners.” “Field offices receive no guidance on how they should cooperate with or support GHP programs.” Lack of clarity on roles/responsibilities to support GHP activities

8. Countries struggling to absorb partnerships resources The need for enhanced coordination of partners Country coordination mechanisms and forums proliferating Performance-based funding approaches Partnerships bypassing and undermining country plans and processes Distorting effects of uncoordinated funding flows Challenges

9. Proliferation of partnerships leading to lack of clarity of roles and responsibilities with other implementing partners. Inadequate information flow Restricted concept of partnerships. Challenges

10. Accountability frameworks for Partnerships and countries Internal governance Representation on multiple boards Interface of PHDs with multilateral organizations Governance Challenge

11. Thank you Dr. Mirta Roses Periago AMRO’s Director