Action Group for Health, Human Rights and HIV/AIDS (AGHA) Uganda represented Ugandan Civil Society at the International Health Partnerships and Related Initiatives (IHP+) Second Annual Inter-Agency Country Health Sector Teams Meeting which took place in Bamako Mali between June 15-16 2009.
In September 2007, 26 signatories including the 8 major international organizations for health and 18 multilateral and bilateral donor governments, 7 countries, signed a global compact for achieving the health Millennium Development Goals (MDG). Central to the IHP + is the Global Compact which defines its purpose and serves as a mutually binding agreement between signatories at the global level. The signatories agreed to be held politically accountable for cooperating more effectively and with renewed urgency at both the global and country level so as to strengthen health systems and scale up health services and produce health results. The governments of the 8 initial IHP + partner countries agreed to cooperate by implementing their national health plans efficiently, strengthening health management information systems, tackling misuse of resources, and working with NGOs. The Paris Declaration on Aid Effectiveness of 2005 provides the basis for the IHP+ and describes how development partners should reform the ways in which they deliver and manage aid through among other things better alignment with national priorities, systems and procedures; integrating aid with recipient countries broader development agendas, promoting collaboration between donors; harmonizing programmes to reduce fragmentation and duplication of donor aid and lessen transaction costs and improve the predictability and increasing the time frame for funding commitments. The objectives of the Bamako meeting were to:
- Provide an overview of the progress made to date on the Global Compact as well as on national compacts;
- Share lessons learned from IHP+ activities since the Lusaka (2008) meeting;
- Share lessons from countries that are in the process of preparing a country compact and/or are in the process of implementing their compact;
- Review progress made on improving harmonization and alignment of donor aid
Since the 2008 meeting in Lusaka more partners have signed the global compact including Uganda, and Rwanda in February 2009. A high-level task force on Innovative health financing completed its work. This involved exploring innovative ways to fund health services, raising required funding and estimating required funding to meet MDGs. However, of concern was the finding that 45% of health funding at a global level is spent on TA.
Given the fact that Uganda signed up to IHP+, there is need to start discussions at the country level to see how the process can be moved forward. While Uganda signed the Global compact in February this year, no concrete steps have been taken to develop a country compact.
The Ministry of Health in Uganda currently has a sector wide approach (SWAp) to developing the National Health Policy and Health Sector Strategic Plans. This seeks to promote harmonization and alignment of funds in line with the Paris principles. Planning, implementation, assessment and review is jointly carried out by development partners, the Ministry of health, NGOs, and other line ministries like Finance, Planning and Economic Development. The joint review missions are evidence of joint planning and assessment. The Ministry of Health has in place Health Management Information Systems (HMIS)indicators which ideally should generate data that guides decision making for all stakeholders
However, not all stakeholders in the health sector are compliant with the existing framework. Some support to the health sector by some donors remains off budget, and thereby fragmenting donor support and misaligning sector priorities which have jointly been agreed upon. Uganda also has a framework for coordination of development assistance for health which has never been implemented or finalized. Some stakeholders have various indicators or and tools for measuring progress in the health sector, and therefore there is still no compliance to one M & E framework. In practice therefore the framework for application of IHP+ principles exists in Uganda through the SWAp. The greater challenge for Uganda is to put the existing policies, tools and strategies into practice as a country compact rather than developing a new country compact.
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