Governance and Governance and Coordination: SWApCoordination: SWAp

SECTOR WIDE APPROACH COORDINATION

WHAT IS SWApWHAT IS SWAp Rwada Contexte Rwada ContexteApproach adopted in partnership Approach adopted in partnership

between GoR & DPs to support health between GoR & DPs to support health sector development and reform programs, sector development and reform programs, to improve efficiency and effectiveness of to improve efficiency and effectiveness of sector support and predictability of sector support and predictability of resource allocation.resource allocation.

SWAp: Commitment of GORSWAp: Commitment of GOR

• LeadershipLeadership

• All resources for HSSP reflected in MTEFAll resources for HSSP reflected in MTEF

• Consistency between Health District Plans & Consistency between Health District Plans & HSSPHSSP

• Annual JHSRAnnual JHSR

• Consult all Partners on major amendments Consult all Partners on major amendments of policy and HSSP and if significant of policy and HSSP and if significant changes in budget allocation are necessary changes in budget allocation are necessary in the course of the yearin the course of the year

SWAp: Commitment of Dev SWAp: Commitment of Dev PartnersPartners• Align & harmonize own planning, performance Align & harmonize own planning, performance

monitoring and reviewing activities monitoring and reviewing activities

• Plan, negotiate and implement with GoR and other Plan, negotiate and implement with GoR and other

PartnersPartners

• Support and avoid distortionSupport and avoid distortion

• Harmonize policy dialogue , consultation and Harmonize policy dialogue , consultation and

informationinformation

• Support an aligned approach to capacity buildingSupport an aligned approach to capacity building

SWAp: Collective SWAp: Collective responsibilitiesresponsibilities• Fund activities related to HSSPFund activities related to HSSP

• Disburse funds timely and increase annual fundingDisburse funds timely and increase annual funding• Ensure consistency with EDPRS, Vision 2020Ensure consistency with EDPRS, Vision 2020

• Manage development assistance using existing Manage development assistance using existing structures in order to reduce transaction costs and structures in order to reduce transaction costs and improve sustainabilityimprove sustainability

• Recognise the Health Sector Working Group Recognise the Health Sector Working Group (HSWG) as highest advisory coordination body(HSWG) as highest advisory coordination body

SWAp: Modes of SWAp: Modes of CooperationCooperation• Planning (HSSP,EDPRS,MTEF,JHSR)Planning (HSSP,EDPRS,MTEF,JHSR)

• Monitoirng and Evaluation FrameworkMonitoirng and Evaluation Framework

• Financial Procedures: consistent with aid Policy, Financial Procedures: consistent with aid Policy, « on plan »= HSSP, « on budget » = MTEF« on plan »= HSSP, « on budget » = MTEF

• Technical and financial reporting: MoH Technical and financial reporting: MoH summarysummary

• Capacity Development: needs basedCapacity Development: needs based

• Cooperation with the private sectorCooperation with the private sector

• Disagreement and Amendment of MoUDisagreement and Amendment of MoU

SWAP ProgressSWAP Progress• MoU signed in Oct 07 Dev PartnersMoU signed in Oct 07 Dev Partners

• The SWAP Task Force was put in place The SWAP Task Force was put in place with clear TOR in the middle of 2008with clear TOR in the middle of 2008

• Prioritization for the Sector Budget Prioritization for the Sector Budget Support and the Capacity Development Support and the Capacity Development Pooled FundPooled Fund

• Regular meetings on behalf of DP & MoHRegular meetings on behalf of DP & MoH

Health SBS : ParticularitiesHealth SBS : Particularities

• Disconnected from activities, linked to Disconnected from activities, linked to resultsresults

• Focus on EDPRS and HSSP prioritiesFocus on EDPRS and HSSP priorities• Particular focus on poverty alleviation Particular focus on poverty alleviation

through care at primary and secondary through care at primary and secondary levellevel

• Intensified sector dialogue complementary Intensified sector dialogue complementary to general budget support (GBS)to general budget support (GBS)

• Utilisation of selected EDPRS and all GBS Utilisation of selected EDPRS and all GBS indicators for:indicators for:– M&EM&E– Associated triggers for disbursementAssociated triggers for disbursement

SBS: Trigger systemSBS: Trigger system• TechnicalTechnical

– Health insurance coverageHealth insurance coverage– Service utilisation rate outside MVKService utilisation rate outside MVK– % of HCs and DHs providing % of HCs and DHs providing

comprehensive care package, fulfilling comprehensive care package, fulfilling staffing normsstaffing norms

– Contraceptive & condom utilisation Contraceptive & condom utilisation prevalenceprevalence

– % of professionally assisted deliveries% of professionally assisted deliveries– DTCP III vaccination coverageDTCP III vaccination coverage

• FinancialFinancial– Increase of domestic budget to sector Increase of domestic budget to sector

andand to primary/secondary care level to primary/secondary care level– Proven additionality of HSBS fundsProven additionality of HSBS funds

SBS PrioritizationSBS Prioritization• Family Planning : Family Planning : procurement & distribution of procurement & distribution of

contraceptives & other products contraceptives & other products

• Maternal HealthMaternal Health: Emergency obstetrical and : Emergency obstetrical and neonatal care (training & equipment) neonatal care (training & equipment)

• Financial AccessFinancial Access: Subsidies for mutuelles : Subsidies for mutuelles (solidarity fund), subsidies for free mutuelles (solidarity fund), subsidies for free mutuelles premiums for the poor premiums for the poor

• HRHHRH : remuneration & incentives (PBF) in rural areas : remuneration & incentives (PBF) in rural areas

• Equipment Equipment of health facilities of health facilities

CDPF : Functioning and ActivitiesCDPF : Functioning and ActivitiesOjbective: Financing & Coordination Tool on Cap DevOjbective: Financing & Coordination Tool on Cap Dev

3 Modes: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)

BottlenecksBottlenecks• SWAp: SWAp:

Despite good team spirit and good will, not yet systematic Despite good team spirit and good will, not yet systematic application of SWAp procedures :application of SWAp procedures :

– Different level of knowldege Different level of knowldege – Constraints of diverse administrative requirementsConstraints of diverse administrative requirements

• SBS: SBS: – Follow up of some prerequisites Follow up of some prerequisites – Priority definition, Rigorous monitoring of jointly fixed Priority definition, Rigorous monitoring of jointly fixed

triggerstriggers

• CDPF: CDPF: – Communication to be improved (MoH intern, MoH-DPS)Communication to be improved (MoH intern, MoH-DPS)– Delay in funds disbursementsDelay in funds disbursements

MURAKOZEMURAKOZE