3 June 2015

A Joint Financial Management Assessment of the health sector has taken place.

Working together on finance in Burundi

In Burundi in 2014, IHP+ carried out an 'intensified action‘ mission and recommended, with the approval of the Ministries of Finance and Health, that a joint financial management assessment (JFMA) of the heath sector take place.

The assessment took place in October 2014 and sought to do two things. Firstly, it aimed to understand how existing donor-funded operations work in the health sector and develop a harmonized or Joint Fiduciary Arrangements (JFA) for donor-financed projects. Secondly, it evaluated avenues for using the country’s Public Financial Management system in executing these projects.

IHP+ coordinated the assessment, and involved the following development partners: African Development Bank (AfDB), European Union (EU), The Global Fund (GF) and the World Bank (WB). Other partners, such as GAVI and USAID, did not directly participate in the assessment but were affiliated. The National Counterpart Task Force (for the proposed Basket Fund), consisting of officials from the Ministries of Health and Finance, served as the main focal point for the assessment.

Findings and ways forward

The assessment found that projects in the Burundi health sector are mostly designed and financed through implementation units specific to each donor, each using their own procedures. The exception to this is a Performance-Based Financing initiative where a group of donors contribute to the health sector through a financial arrangement embedded in the Ministry of Health and using the national financial management system. Overall, these approaches have resulted in fragmented financing channels and funding not necessarily aligned to national health priorities, although the health sector planning process appears to be reliable and one of the strongest in the country.  

Recommendations for improvement are to have a gradual approach towards alignment with the following steps: 

  1. Harmonization of donors procedures and financial arrangements as a first step
  2. Development and capacity building pending completion of on-going Public Financial Management reforms
  3. Strengthening the control environment within the Health Ministry
  4. Development of FM procedures consistent with national rules and regulation and that meet donors harmonized requirements.

A follow-up mission scheduled in May has since been suspended due to the current political crisis. However, when it does take place, the goal of the mission will be to disseminate the report and to agree on an action plan that will support the strengthening of fiduciary oversight in the ministry and arrangements for FM harmonization and alignment.

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