Mozambique – Funding the Health Sector Celeste Kinsey Health SWAp Mozambique

Financing for Health in Mozambique Managed by Government National budget $150M Sector budget support $75M Vertical funds $75– 90M Projects $20M Estimates Managed by Partners Projects $330M USA $250M Other $80M Private $10M

Financing for Health On Budget

Financing for Health Total

National Budget Decreasing expenditure on health Between 2008 and 2010 allocations dropped from approx 11% to 8% Well below Abuja target of 15% Competing priorities Huge volume of external funds

Sector Budget Support Prosaúde Since 2004, with change in types of support Internal Funds External Funds Fully aligned with national systems One plan, One budget, One performance framework for the sector No in-year triggers for disbursement

Projects, Vertical and Private Funds Current estimate is 185 projects = 65% of funding for sector Many partners and implementing agencies Difficult to achieve coherence and ensure coordination Information is often difficult to obtain Poor predictability Complex management separate from normal business Takes special efforts to coordinate with government and also between partners

Characteristics of health sector financing in Mozambique Heavy dependence on external funds Highly fragmented Complex management requirements Majority of financing is outside of national budget or plans

Health Sector Wide Approach SWAp Saúde present Code of Conduct Memorandum of Understanding Health Partners Group Working groups – coordination and technical

SWAp Saude Coordination All partners at the table, no matter how they fund Representation by a Troika Communication Joint dialogue: CCS, CCC, HPG, Working Groups Monitoring Follows implementation of the PESS and PES, annually, is based upon SWAp dialogue, annual review, plans and reports

Lessons Learned Need a Health Financing Strategy Donor coordination, dedicated time, willingness to work together and good communication are essential We work better when we work together