25 July 2016

An update from the working group.

IHP+ and financial management

Harmonisation and alignment with national financial management (FM) systems is one of the seven behaviours that development partners could improve in order to accelerate progress on effective development cooperation in health. 

Currently, harmonisation among development partners with all or part of the national public financial management (PFM) system continues to be a challenge in many IHP+ countries. However, in recent years there appears to be increasing demand for this kind of effort thanks to the work of the IHP+ Financial Management Technical Group (FMTWG). 

In June 2014, the IHP+ Financial Management Working Group was formed to advance work at country level on financial management. Membership is open to all IHP+ Partners and current membership includes representatives from the World Bank (Chair) WHO, UNFPA, Global Fund, GAVI, EU, AfDB, KfW, USAID, Ethiopia, Sierra Leone, Senegal, and Nepal. 

The responsibilities of the working group are to 

  • Identify good practices and lessons learned from FM harmonization and alignment efforts in the health sector in partner countries
  • Identify bottlenecks to FM harmonization and alignment among DPs and also at the country level
  • Share good practices and identify principles and options for harmonization and alignment, including Joint Fiduciary Arrangements 
  • Review (and if needed revise) the IHP+ Guidance on Joint FM Assessment 
  • Discuss, on an on-going basis, emerging issues in FM harmonization and alignment 
  • Assist the IHP+ Core Team in facilitating, on request, support to countries including Joint FM Assessments and identification of suitable Joint Fiduciary Arrangements. 

What’s happening in countries?

FM work is consequently taking place in many countries. For example for development partner-financed projects in Senegal, work has been done to align financial management arrangements with country systems. Here, the Global Fund has joined the World Bank and USAID in using country systems for its Health Systems Strengthening grant. 

In Ethiopia, the government has drafted a new Joint Financial Arrangement with support from development partners and the arrangement is now signed and used by all the major development partners. 

In the Democratic Republic of Congo joint financial management procedures are being developed for government- and development partner-funded projects, and a joint FM manual has been prepared. Dissemination of the manual is due to take place later this year to engage stakeholders. 

Likewise, Sierra Leone has made strides in setting up and operationalising an Integrated Health Projects Administration Unit that is embedded in the Ministry of Health. With support from GAVI, Global Fund and the World Bank, the unit’s capacity is being strengthened to undertake the fiduciary responsibilities of all development partner-financed projects. 

Ongoing studies about understanding the costs and benefits of unharmonized and unaligned implementation arrangements in the health sector are taking place and results will be available soon (funded by IHP+ and World Bank). The World Bank, in collaboration with WHO are also developing a conceptual framework for PFM in health. 

Challenges and opportunities:
don’t wait until everything is fixed

Of course there are challenges. Development partner decision-making processes are slow, and there is low bilateral participation. It is also difficult to determine an entry point for collaboration due to the different development partner support cycles. Weak country leadership makes the joint effort supply driven, rather than demand driven. 

Looking ahead, the working group intends to intensify work on implementing Joint Financial Management Arrangements or use of country systems. It will use evidence-based research to support the case for harmonization and alignment. It will also solicit more participation in joint arrangements from bilateral partners and other Un agencies, and seek opportunities for collaboration in regions outside Africa. 

There is still enormous opportunity for joint action among DPs to strengthen national systems in the short- to medium-term to bring about the necessary changes to make alignment feasible in the long-term. 

There is no need to wait until all problems have been solved. The idea is to use a step-wise approach by using elements of country systems as soon as possible, as part of the process of improving systems and developing capacity. 


Please take part in our online consultation about the transformation of IHP+ into the International Health Partnership for UHC 2030. 


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