Governance and Coordination: SWAp SECTOR WIDE APPROACH COORDINATION

WHAT IS SWAp Rwada Contexte WHAT IS SWAp Rwada Contexte  Approach adopted in partnership between GoR & DPs to support health sector development and reform programs, to improve efficiency and effectiveness of sector support and predictability of resource allocation.  Approach adopted in partnership between GoR & DPs to support health sector development and reform programs, to improve efficiency and effectiveness of sector support and predictability of resource allocation.

SWAp: Commitment of GOR Leadership Leadership All resources for HSSP reflected in MTEF All resources for HSSP reflected in MTEF Consistency between Health District Plans & HSSP Consistency between Health District Plans & HSSP Annual JHSR Annual JHSR Consult all Partners on major amendments of policy and HSSP and if significant changes in budget allocation are necessary in the course of the year Consult all Partners on major amendments of policy and HSSP and if significant changes in budget allocation are necessary in the course of the year

SWAp: Commitment of Dev Partners Align & harmonize own planning, performance monitoring and reviewing activities Align & harmonize own planning, performance monitoring and reviewing activities Plan, negotiate and implement with GoR and other Partners Plan, negotiate and implement with GoR and other Partners Support and avoid distortion Support and avoid distortion Harmonize policy dialogue, consultation and information Harmonize policy dialogue, consultation and information Support an aligned approach to capacity building Support an aligned approach to capacity building

SWAp: Collective responsibilities Fund activities related to HSSP Fund activities related to HSSP Disburse funds timely and increase annual funding Disburse funds timely and increase annual funding Ensure consistency with EDPRS, Vision 2020 Ensure consistency with EDPRS, Vision 2020 Manage development assistance using existing structures in order to reduce transaction costs and improve sustainability Manage development assistance using existing structures in order to reduce transaction costs and improve sustainability Recognise the Health Sector Working Group (HSWG) as highest advisory coordination body Recognise the Health Sector Working Group (HSWG) as highest advisory coordination body

SWAp: Modes of Cooperation SWAp: Modes of Cooperation Planning (HSSP,EDPRS,MTEF,JHSR) Planning (HSSP,EDPRS,MTEF,JHSR) Monitoirng and Evaluation Framework Monitoirng and Evaluation Framework Financial Procedures: consistent with aid Policy, « on plan »= HSSP, « on budget » = MTEF Financial Procedures: consistent with aid Policy, « on plan »= HSSP, « on budget » = MTEF Technical and financial reporting: MoH summary Technical and financial reporting: MoH summary Capacity Development: needs based Capacity Development: needs based Cooperation with the private sector Cooperation with the private sector Disagreement and Amendment of MoU Disagreement and Amendment of MoU

SWAP Progress SWAP Progress MoU signed in Oct 07 Dev Partners MoU signed in Oct 07 Dev Partners The SWAP Task Force was put in place with clear TOR in the middle of 2008 The SWAP Task Force was put in place with clear TOR in the middle of 2008 Prioritization for the Sector Budget Support and the Capacity Development Pooled Fund Prioritization for the Sector Budget Support and the Capacity Development Pooled Fund Regular meetings on behalf of DP & MoH Regular meetings on behalf of DP & MoH

Health SBS : Particularities Disconnected from activities, linked to results Disconnected from activities, linked to results Focus on EDPRS and HSSP priorities Focus on EDPRS and HSSP priorities Particular focus on poverty alleviation through care at primary and secondary level Particular focus on poverty alleviation through care at primary and secondary level Intensified sector dialogue complementary to general budget support (GBS) Intensified sector dialogue complementary to general budget support (GBS) Utilisation of selected EDPRS and all GBS indicators for: Utilisation of selected EDPRS and all GBS indicators for: –M&E –Associated triggers for disbursement

SBS: Trigger system Technical Technical –Health insurance coverage –Service utilisation rate outside MVK –% of HCs and DHs providing comprehensive care package, fulfilling staffing norms –Contraceptive & condom utilisation prevalence –% of professionally assisted deliveries –DTCP III vaccination coverage Financial Financial –Increase of domestic budget to sector and to primary/secondary care level –Proven additionality of HSBS funds

SBS Prioritization SBS Prioritization Family Planning : procurement & distribution of contraceptives & other products Family Planning : procurement & distribution of contraceptives & other products Maternal Health: Emergency obstetrical and neonatal care (training & equipment) Maternal Health: Emergency obstetrical and neonatal care (training & equipment) Financial Access: Subsidies for mutuelles (solidarity fund), subsidies for free mutuelles premiums for the poor Financial Access: Subsidies for mutuelles (solidarity fund), subsidies for free mutuelles premiums for the poor HRH : remuneration & incentives (PBF) in rural areas HRH : remuneration & incentives (PBF) in rural areas Equipment of health facilities Equipment of health facilities

CDPF : Functioning and Activities Ojbective: Financing & Coordination Tool on Cap Dev 3 Modes: In Kind (partners announce Cap Dev Act to CDPF) In Kind (partners announce Cap Dev Act to CDPF) Ad Hoc activities (Comité decides: MoH & Donor) Ad Hoc activities (Comité decides: MoH & Donor) Mid & Long Term financing CD Act (via the CD Plan) Mid & Long Term financing CD Act (via the CD Plan)

Bottlenecks SWAp: SWAp: Despite good team spirit and good will, not yet systematic application of SWAp procedures : –Different level of knowldege –Constraints of diverse administrative requirements SBS: SBS: –Follow up of some prerequisites –Priority definition, Rigorous monitoring of jointly fixed triggers CDPF: CDPF: –Communication to be improved (MoH intern, MoH-DPS) –Delay in funds disbursements

MURAKOZE MURAKOZE