Aid Effectiveness in Ethiopia Abduljelil Reshad Director, Resource Mobilization Directorate, FMOH, Ethiopia

Background Code of conduct /2005/ and HHM /2007/ was developed and endorsed, Country IHP roadmap for Ethiopia was launched (February, 2008) Country IHP Compact developed & signed (Aug 2008) IHP has built on the existing sector coordination and dialogue mechanisms, MDG Performance Fund JFA developed and signed (April 2009)

Background cont…. 9 Major DPs Joined MDG-PF, HSDP IV has been developed Using JANS attributes through participation of all partners FMA conducted: JFA was reviewed as per FMA recommendation Inline with HSDP IV Partnership framework and GHI strategy developed and endorsed, GHI plan developed, provisionally endorsed and agreed to submit to US congress,

Aid Effectiveness: Ethiopian Definition Aid supports HSDP priorities and strategies, Preferably finance underfinanced areas, including health systems strengthening- HEP, HC construction, Service delivery at primary level, Improved Harmonization and alignment of planning, budgeting and reporting,

Progress so far (1) Majority of development aid is now supporting the priorities and strategies of Government, Different DPs support different strategies within government defined priorities:

Progress so far (2): There is clear evidence that development aid shifted to underfinanced areas: PBS contributed in financing of employment of human resource (38000 HEWs and nurses and other health professionals), About 50 % of 2,500 HCs constructed are financed by development aid, The gains in malaria, TB and HIV aids are possible through GFTAM and PEPFAR Funding, There is a recent increase in funding for maternal health: commodities, drugs, supplies, ME, Ambulance, etc…

Progress so far:(3) There is also increasing use of government planning, budgeting and reporting system: Increasing number of bilateral DPs are part of the MDG PF; the size of the pooled fund tripled in three years to more than $100 million per year, GF support for HSS is increased, Predictability of funding Improved, Almost All DPs are participating in the RM exercises, Big international agencies and DPs are financing through the budget support (PBS), About 80% of DP activities are on plan, 58% of DP activities on budget, With the exception of few, most are using government reporting systems,

Challenges Some Bilateral Agency rules and regulation remains a challenge towards moving forward to one budget, International development aid environment becoming more focused on attribution which will compromise the effort to reduce government transaction cost, Government’s systems needs to be strengthened further to get the best out of available resources, Requirement repetitive assessment by some DPs,

What should the government do to improve aid effectiveness further? Further Strengthening its systems: Planning, Budgeting, Procurement, In Ethiopian case, implement IFMS, The new grant management system, Strengthening its dialogue and mutual accountability mechanisms with partners, Continue to take proactive role to ensure partners only support country’s priorities,

What should DPs do? 1.Explore their systems of planning, budgeting and reporting and as much they can be flexible to adapt to recipient country systems, 2.Move away from attribution, virticalization towards strengthening country health systems despite growing domestic pressures, 3. build in country capacity to understand and meet specifics, 4.As much as possible use government preferred service delivery, planning, budging and reporting systems.

Conclusion (1) Country IHP developed and endorsed by Major DPs, National Health sector strategic Plan developed with the involvement of All DPs and stakeholders, FM and procurement system improved from time to time to ensure value for money, DPs supports the national strategic plan, mainly underfunded and government priorities,

Predictability of DPs funding Improved, Flow of fund increased, Still there is a need to adhere country planning, budgeting and reporting system, Needs further effort to in place mutual accountability, Conclusion (2)

Thank you so much for Your Attention.