IHP+ Financial Management Technical Working Group One year after formation FMTWG (Nov 2015)

Background The financial management technical working was formed to help:  gather knowledge on good practices for joint approaches to FM harmonization and alignment;  synthesize and share this knowledge among development partners and partner countries; and  facilitate support to the implementation of these joint FM harmonization and alignment approaches.

First year work Activity Results Prepare and approve IHP+ guidance note on FM harmonization and alignment IHP+ guidance Note on what FM harmonization and alignment mean on IHP+ website Increase awareness of the need for FM harmonization and alignment through regular meetings and information sharing Group meets every two-months. Discussions are helping to: deepen the understanding of PFM issues in health; Identify potential countries for collaboration Identify and resolve bottlenecks to FM harmonization and alignment. Analytical study to build an evidence-based case for strengthening PFM in health, as well increase action on FM harmonization and alignment Supporting a study to develop a conceptual framework of PFM in health. The framework will help to clearly define the connections among PFM, health financing and health results Study will also collect and analyze data on the financial costs and benefits of unharmonized and unaligned DP implementation arrangements in the countries DPs provide health support. In-country FM harmonization initiatives Initiated or built on FM harmonization work in-country. Examples of in- country work is shown on the next slide.

In-Country FM harmonization work CountryWorkPartners InvolvedStatus Sierra LeoneBuilding on JFMA conducted in 2012 to strengthen fiduciary arrangements for implementing donors and government programs Global Fund, GAVI, World BankCreation of an Integrated Health Projects Administration Unit (IHPAU) in progress. Staff recruitment is almost completed. To be completed in 2016 BurundiJFMA conducted 2014 assessed the country system in managing donor funded projects to develop Joint fiduciary arrangement, in which identify areas for country system alignment AfDB, EC, Global Fund, GAVI, BTC, World Bank, SIDA Assessment report completed. Further work on hold due to political situation SenegalJFMA conducted in 2013 and joint use of country systems implemented for PBF project USAID, World Bank. - Global Fund is assessing the possibility of joining the use of country systems Global to conduct in-country mission in Q12016 to hold discussions with gov’t on the use of country systems Democratic Republic of CongoAssessment of strengths and weaknesses of FM systems in health completed BTC, EC, AfDB, World Bank, GAVI, Global FundA financial procedures manual that incorporates both donor and gov’t processes is being developed Other countries that have expressed interest in JFMAs LiberiaDiscussions to use country systems for implementing Pool Fund Irish Aid, DfID, Swiss Agency for Development and Cooperation (SDC), Agence Française de Développement (AFD), and UNICEF MoH interested in JFMA to help with transition to use of country systems. Discussion on next steps to be had in November Uganda JANS recommends joint FM assessment IHP+ partners asked to indicate interest in joining a JFMA Sudan Expressed interest in support from IHP+ on harmonization and alignment JICA, UNDP, EC, GAVI, Global Fund, World Bank, GAVI Request sent to core team. JFMA planning in process MalawiNominated for joint FM work by DPs GAVI, World Bank Consultatios Myanmar World Bank conducted an FM assessment in the health sector. Other DPs looking into adopting the recommendations and joining proposed FM arrangements World Bank, GAVI GAVI in discussions with the World Bank on using common country systems arrangements Pakistan Reliance on comprehensive and detailed assessment conducted by the World Bank. Leveraged WB expertise, avoiding duplication and saving on costs World Bank, GAVICollaboration is ongoing Nepal Joint assessment carried out, leading to joint FM arrangements GAVI, DfID, KfW, AusAID, World Bank, UNFPA, UNICEF and USAID Collaboration ongoing in a SWAp

Challenges encountered so far  Determining the entry point or timing for FM assessment is difficult  Participation of Bilateral development partners has been limited  Differences in the assessed level of fiduciary risk among DPs. This impacts the risk tolerance of DPs for FM harmonization and their interest in JFMAs altogether  Weak country-partner leadership. Most of the initiatives are driven by DPs  Slow progress in implementing JFMA recommendations at the country level due to: (i) DPs decision making processes; (ii) weak country partner leadership

Lessons learned  Leadership by country partner (CP) Ministry of Health in determining the need for alignment or harmonization is essential  Strong cooperation between CP’s ministries of heath and finance to support the development of sector financial management systems as part of the overall public financial management system is critical to success  Willingness of DPs to work together in-country is essential in moving beyond joint assessments  More evidence to support the cost of unharmonized and unaligned implementation arrangements will be useful to the IHP+ agenda on FM.

Focus of the next work program  Intensify in-country work on implementing JFMA recommendations on harmonized arrangements or use of country systems  Use evidence-based research/study to support case for harmonization and alignment  Solicit more participation in joint arrangements by bilateral partners and UN Agencies  Seek opportunities for collaboration in other regions other than Africa region  Work closely with country partners in imbedding FM harmonization and alignment principles in the implementation of the Global Financing Facility (GFF), and pursuit of Universal Health Coverage (UHC)

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