Countries that have documented lessons from their experience with joint assessments, or JANS, of their national health sector strategies or plans include: Nepal, Ethiopia, Uganda, Ghana, Kyrgyzstan, Sudan and Vietnam.
Other countries use the JANS tools more informally at different stages of plan development and implementation, and in some cases to review programme strategies. This has generated questions on how to ensure better synergy between sector and programme strategies processes.
- JANS is a sound tool. It helps bring different players together, strengthens strategies and increases trust.
- In all countries, JANS have had multiple objectives:
- To help improve the quality of the strategy or plan
- To increase confidence in the strategy or plan and so secure more aligned financial and technical support
- To reduce transaction costs associated with multiple separate assessments.
- Not all objectives have been equally met. JANS have in all cases helped strengthen the strategy or plan but the links to funding decisions are less clear and may take longer to be seen. More incentives are needed to change partners’ behaviour.
- We increasingly know what makes JANS effective.
The principles are critical. Several models for conducting a JANS have emerged and countries value this flexibility. An options paper on how to conduct a JANS is now available, and so is a review of stakeholder needs.
- Good documentation of the JANS process, findings and its impact is important.
A good record is particularly important to generate confidence in the strategy from those who were not part of the JANS itself.
- Greater synergy is needed between national sector and programme planning processes, as well as between health sector and programme joint assessments. In early 2012, a meeting on JANS was held in Hammamet, Tunisia and participants discussed this issue.
The JANS process significantly improved quality of the 5-year health plan. Outcomes: more trust and confidence from development partners; more streamlined support to the sector.