Overall performance of countries
The average score obtained by the 24 participating countries for the four accountability indicators was 74%. Eight countries had a score below the average. They tended to be newer members of the IHP+ with a median membership history of 2.5 years compared to the other 16 counties who had a median duration of membership of five years (Figure 6).
The overall performance of partner countries on the three financing indicators ranged from 0.3 to three out of three. Nine countries performed below the average of 2.3. While there was some correlation between performance and duration of membership in IHP+, it was weaker than for the accountability indicators. There was, however, a stronger correlation of performance with the level of external funding of the health sector (Figure 9). This may be due to preferences by development partners to support countries with stronger national financial management, or countries with higher level of external funding may have incentives to strengthen their systems to manage public finances.2
2 Sudan was excluded from this analysis because the level of external funding was not known, and El Salvador was excluded because the CPIA score was not available
There was significant variation among the 24 countries in performance on the seven indicators: the largest number of countries (19 or 79%) met the target for having a forward expenditure plan for the health sector; the smallest number of countries (seven or 29%) met the target for engaging civil society in health policy processes (figure 10).
Overall country performance scores were positively correlated with the number of years a country participated in the IHP+ (Figure 11). The correlation was stronger for accountability than for financial indicators. There was also a positive correlation between overall country performance scores and level of external funding, albeit less strong (Figure 12). This may indicate either a positive effect of IHP+ partnership on performance, especially on accountability, or that higher performing countries are more likely to join the partnership early and more likely to receive a larger amount of external funding. The correlation has to be interpreted with caution.