Annual Report on Official Development Assistance for Health Sector of Republic of Moldova - 2012 Fifth Edition

1. Annual Report on Official Development Assistance offered to the Health Sector of the Republic of Moldova – 2012Fifth Edition 19 July 2013 MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

2. ODA spent for “Health and Population” in the benchmark countries MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA US$/ capita equivalent, 2011

3. Report Objectives • to picture 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 provide evidences to strengthen donor coordination mechanism towards the on-going reforms in the Moldovan health sector • to illustrate donors’ short and medium term commitments to the Moldovan health sector • to inform on future sectoralstrategic plans and donors’ strategies to support the MOH of the RM MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

4. Differences with previous editions • Aid alignment with health system MTBF priorities and categories on the short term prospective • Comparison on the ODA received by the Moldovan health sector with the benchmark countries and with the previous edition MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

5. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

6. Key Results MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

7. Donors interviewed 2011 and 2012

8. Overall ODA disbursed per donor and by type of disbursement

9. Grants and loans MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA US$ equivalent, 2011 and 2012

10. Type of mechanism by which ODA is provided MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA US$ equivalent, 2011 and 2012

11. Geographic coverage National, targeted regional and pilots MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

12. Type of funding MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2011

13. Investments MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of funds disbursed for Investments in 2011,2012

14. Technical Assistance MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of funds disbursed for Technical Assistance in 2011, 2012

15. ODA distribution to Health System Core Functions MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2011, 2012

16. ODA provided for Health Service Provision by components MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of funds disbursed for Health Service Provision in 2011, 2012

17. ODA distribution against Public health priority areas MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA % of total funds disbursed in 2012

18. Alignment of ODA to national health policies

19. ODA implementation using National financial procedures MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA US$ equivalent, 2011 and 2012 19

20. Aid Predictability Intention to continue support to health sector short and mid-term, 2012-2017 MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA Number of donors

21. Aid Predictability Intention to continue support to health sector, short-term, 2012-2015 MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA Number of projects

22. Aid Predictability Scheduled and actual ODA disbursements MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA US$ equivalent, 2011 and 2012 22

23. Donor coordination and complementarity Joint missions MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA Number of missions, 2011 and 2012 23 23

24. Donor coordination and complementarity Analytical works MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA Number of works, 2011 and 2012 24 24

25. Findings • In 2012 external donors have disbursed an equivalent of US$ 47.4 million, which is a 12% adding to the overall public health expenditure occurred in 2012, estimated at US$ 390 million. If compared to the 2011 assessment, the ODA contribution to the total health sector public expenditure decreased with 2 percentage points (being 14% addition to the US$ 363 million in 2011) • The share of ODA in form of soft loans has significantly increased (it represent the 38% of the total funds detected, versus 11% in 2011) • Health sector continues to strike a good balance between investment (61.8%) and technical assistance (33.1%). Of note though is the fact that administrative costs are much lower than those reported in 2011 (5.1% in 2012 against 9% in 2011). MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

26. Findings • On the Health System Functions, “health service delivery” and “resource generation” continued to account for the larger share of the donor assistance scrutinized, as emerged in 2011. Within “health service delivery” more then a half of ODA is in line with the MoH greater priority of investing in the hospital sector reform. • ODA to hospital sector as a share of total expenditure has increased from the 40.5% to the 59.1% in the last year, while investments in primary health care dropped from 47.1% to 30%. • Funds are disbursed unevenly in the different public health priority areas: communicable diseases is reported as the prime priority and MCH, reproductive health and adolescent health as second priority, while non-communicable diseases and risk factors continued to receive little targeted funding in 2012 as in 2011. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA 26 26

27. Findings • In terms of Geographical Coverage, the distribution continues to be uneven. The main cities of Chisinau and Balti are covered by the highest number of donors. • In health sector, donors aligned well to support priorities in national health policies and national programs, however some national strategies and programmes receive less attention, such as the areas related to Pharmaceuticals and Diabetes. • Due to limitations of MTBF relevance to donor strategic programming, alignment to MTBF categories is far more complicated. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

28. Findings Checked against the “Results of the 2011 Survey on Monitoring the Paris Declaration -Moldova” and Paris Declaration general target indicators • 65% of the 2012 health sector commitments were recorded in the sector budget comparing to only 14% in 2011(versus 85% Paris Declaration target value). • Funds disbursed in 2012 exceeded the scheduled ones by 30% points. The same trend was recorded in 2011 with a difference of 18% points. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

29. Findings • The Joint Missions target was not reached but almost achieved, having recorded 34% of the total missions for 2012, comparing to at least 40% mentioned in the Paris Declaration. • The joint country Analytic Work indicator reached 82% to be “joint” for 2012, against the 66% target indicated by the Paris Declaration. • The level of commitment to increase aid predictability is further held back by the fact that again a high number of donors (11 of 22) could not provide the exact amount of pledged funds for 2013–2015. MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA

30. Thank you for your attention MINISTERUL SĂNĂTĂŢII AL REPUBLICII MOLDOVA