IHP+ encourages the documentation of lessons from effective development cooperation in health and the links to results. IHP+ has published a short paper examining examples from various countries and drawing out lessons for development partners: ‘Better results through effective development cooperation: the heart of the work we do’.

IHP+ also commissioned case studies in Benin, Mali and Nepal to address questions about effective development cooperation in health and whether it has contributed to better results. In addition, Ethiopia has reviewed its progress towards ‘One plan, one budget and one report’.

Lessons and emerging messages for policy makers

These lessons are drawn from the collective experience of IHP+ countries. 

Better coordination of resources can deliver greater value for money and better results.
In the Democratic Republic of Congo, a new Ministry of Health single donor coordination arrangement led to a significant reduction in management costs for donor funds from 28 percent to nine percent. The released funds have been used to increase bed net coverage. In Ethiopia, progressive alignment of donors has helped increase Primary Health Care coverage. 

More can be achieved together than separately.
Nepal introduced free maternal health care in a few districts in 2007. It showed impressive results and the Government was keen to scale up the approach. Now the policy has spread nationwide because government and donors acted collectively to ensure the necessary resources reached all districts. No one could have done it alone. 

The most pragmatic way to handle fragmentation is to get partners to align behind one sound country-led national health plan. 
Ethiopia scaled up its health extension worker policy nation-wide faster than many thought possible. In five years it has gone from small beginnings to being nation-wide. A key factor was that the federal Ministry of Health provided a clear vision and a credible plan which communicated to all donors where it needed support. 

Being more inclusive can be effective.
A plan developed in a back room will stay on the shelf. A plan that relies on one source of data, or looks only at the public sector, will have tunnel vision. There will be an incomplete picture of need and a partial response to that need. By engaging those who will put a national health plan into practice from the start, and representatives of people who will be affected by its implementation, the chances of effective implementation are vastly increased. The voices of vulnerable people are more likely to be heard, and resources may increase 

Within development partner organizations, staff members need the incentives and the authority to work in a collaborative and coordinated manner at country level.
Working in a coordinated way and supporting country-owned plans requires ‘give and take’ and development of trust. This can be disrupted by inappropriate decisions from headquarters level. 

Partners need to focus on contribution, not attribution.
All partners want to demonstrate results, and regular monitoring of performance is important. Such monitoring should use a shared plan and national systems where possible, with agreement on how to measure results and evaluate impact of a programme and the sector. Results (including improvements in  health outcomes) can be linked to each partner’s contributions to the shared programme, without needing to demonstrate that a specific result is due to their specific funding (known as attribution).