Sierra Leone's progress to make health aid effective
Country compact lays a good foundation
In Sierra Leone, different ministries, development agencies and civil society organizations are finding new ways of working together to finance and plan a national health strategy. In 2009, the government developed a national health sector plan. This was drawn from government’s policy document Agenda for Change (or Poverty Reduction Strategic Plan II).
In August 2010, Sierra Leone decided to work according to aid effectiveness principles in order to make their national health plan as effective as possible. With support from the highest levels of government, a range of partners agreed the basis and content of a country compact. This provided a solid foundation for a joint working arrangement to get partners to support the plan.
Partners who agreed to work together in this way included the Ministry of Health, the Ministry of Finance, the Ministry of Local Government, development agencies, national civil society and faith-based organizations. Once the compact was agreed in April 2011 and without waiting for the formalities of signatures, they immediately began to implement the new ways of joint working. This included work on a Financial Management Assessment or FMA moving towards a Joint Funding Agreement.
Financial Management Assessment (FMA)
Interest in the FMA was triggered by a mission in 2012 of the World Bank, GAVI, the Global Fund and WHO. This group of agencies have agreed to jointly work to support government to improve financial systems in line with the Paris Declaration and the IHP+ Principles.
In January 2012, these development agencies carried out a scoping mission to better get to know the policy environment in Sierra Leone. They wanted to understand how the government financial mechanisms work on the ground and how best to conduct the FMA. The Ministry of Finance was particularly proactive and keen to engage because the government policy document ‘Agenda for Change’ contains an objective to improve financial systems. The Ministry of Health took a crucial leadership role to coordinate the different partners involved. Together, partners devised an Aide Memoire which laid out what should be done during the Financial Management Assessment and they later created a RoadMap. Based on government documentation, experts from the development agencies also carried out a desk review assessment. The objective is to create a government workplan with support from all the partners leading immediately to a Joint Funding Agreement. Anyone who signs this agreement commits to jointly work with the government to improve their financial management system.
The Financial Management Assessment is an important part of the process, but it is just the start. “The assessment is not the end result, it is a means to an end. As an operational person, this is really important” said Dr Teniin Gakuruh, WHO country office, Sierra Leone.
Joint funding agreement and civil society involvement
The Joint Funding Agreement is an additional instrument to the country compact and there are a host of players involved. Because this is a financial agreement between a government and a range of agencies that provide funds, civil society and faith-based organisations in Sierra Leone are not signatories. However national Non-Governmental Organizations (NGOs), Faith-Based Organizations (FBOs) and Community-Based Organizations (CBOs) are signatories to the Country Compact. This lays a very good platform for the CSOs to begin dialogue with the government and they play a significant role during discussions about health strategy and health policy. FBOs have requested to receive government funding, and so have an interest in the financial arrangements made as a result of the funding agreements.
Sierra Leone has made significant progress to make health aid more effective. This can be credited to a strong county compact, high level commitment from various Ministries and development agencies and the engagement of civil society and faith-based organisations. Through the agreed ways of joint working laid out in the country compact, partners are able to use tools such as the Financial Management Assessment more effectively.
Categories: Sierra Leone
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