KENYA HEALTH SECTOR PARTNERSHIP Third IHP+ Country Health Sector Teams Meeting Brussels, December 2010 Kenya Health Sector Partnership PARTICIPATING PARTNERS Ministry of Medical Services (MOMS) Ministry of Public Health & Sanitation (MOPHS) Development Partners in Health (DPHK) Health NGO Network (HENNET) Public-Private Partners for Health Kenya (PPPH-K) Kenya Health Sector Partnership Health SWAp Code of Conduct signed August 2007 • Ministry of Finance • Ministry of Health (now MOMS, MOPHS) • 15 Development Partners • 3 private-sector partners Kenya Health Sector Partnership Guiding Documents for the Partnership • Kenya Vision 2020 & medium-term plans • Kenya Health Policy Framework (KHPF) • Kenya Health SWAp Code of Conduct (COC) • National Health Sector Strategic Plan (NHSSP) • Paris Declaration commitments • Millennium Development Goals commitments • IHP+ commitments Kenya Health Partnership Structures • • • • • • Health Sector Coordinating Committee (HSCC) HSCC Steering Committee SWAp Secretariat Development Partners in Health (DPHK) Health NGO Network (HENNET) Inter-Agency Coordinating Committees (ICCs) covering 17 key systems and technical areas • Provincial and District Stakeholders Forums Joint Financing Agreement Joint Financing Agreement (JFA) for the Health SWAp signed in September 2010: • Ministry of Finance • Ministries of Health (MOMS, MOPHS) • DANIDA, World Bank • Other partners expected to join over time • Creates joint funding baskets for service delivery at all levels, procurement, HRH, capacity and systems development Monitoring the Partnership • Code of Conduct (COC) performance reviewed for past 3 years as part of annual sector performance monitoring processes. • COC indicators largely match Paris Declaration and IHP+ partnership indicators. • COC tools still need improvement and are reviewed and updated annually based on reporting experiences. Status and Progress Country Ownership Split of MOH into MOMS and MOPHS in 2008 has fragmented leadership in the sector. Quality of coordinating structures is improving, but still needs attention. New challenges for the sector are emerging from new Constitution – decentralization, and constitutional “right to health” Status and Progress Alignment with Country Systems Remains a challenge: DPs perceive GOK systems to still be weak and high-risk for channeling funds and monitoring inputs. Systems-strengthening efforts are in progress, but are not well harmonized and coordinated. Some partners cannot move towards budget support, but all are willing to improve efforts to strengthen GOK systems. Status and Progress Harmonisation Still a challenge: many parallel structures and processes place undue burdens on MOHs and result in duplication of efforts and fragmented support to national programmes. But there is renewed commitment from all partners to improve on harmonization and coordination. New JFA provides opportunities for coordinated basket funding. Status and Progress Managing for Results Joint planning and review processes have improved considerably, but still need attention. HMIS systems are providing better quality data, and systems strengthening continues. Data to monitor equity issues is improving. Use of data for decision-making still needs improvement at all levels. Status and Progress Mutual Accountability Work on improving comprehensive sector budget and expenditure reporting and analysis continues. Sector reporting to the public on plans and achievements needs more attention. Kenya Partnership Dashboard (1) Principle xx Indicator Country ownership Country has a national development strategy for health, with clear priorities linked to the MTEF and reflected in annual plans and budgets. Alignment Procurement and FM systems that either (a) adhere to the broadly acceptable good practices, or (b) have a reform program in place to achieve these. % of aid flows to the Government sector that is reported on partners national budgets. % of donor support provided through coordinated programmes, consistent with national development strategies. Progress AOP 3 AOP 4 AOP 5 (COC Yr 1) (COC Yr 2) (COC Yr 3) Kenya Partnership Dashboard (2) Principle Alignment xx Indicator % of donor funds using country procurement and/or PFM systems which either (a) adhere to the broadly acceptable good practices, or (b) have a reform program in place to achieve these. Number of parallel Project Implementation Units. % of disbursements released according to agreed schedules in annual, or MTEF frameworks. % aid that is untied. Progress AOP 3 AOP 4 AOP 5 (COC Yr 1) (COC Yr 2) (COC Yr 3) Kenya Partnership Dashboard (3) Principle Harmonization xx Indicator % aid that is programme based. % of (a) field missions, and/or (b) country analytical work, including joint reviews, that are diagnostic. Managing for results Transparent and monitorable performance assessment framework to assess progress against (a) national strategies, and (b) sector progress. Mutual accountability Mutual assessment of progress in implementing agreed commitments on aid effectiveness. Progress AOP 3 AOP 4 AOP 5 (COC Yr 1) (COC Yr 2) (COC Yr 3) Kenya Partnership Dashboard (4) • Most indicators stagnated; these are mainly to do with issues of alignment • Three out of 12 indicators (10%) to do with country ownership, managing results and mutual accountability showed improvement from past years. Way forward Ownership • Develop new Health Sector Policy and NHSSP III • Undertake capacity building on leadership of MOH and County teams Alignment • Operationalize JFA and encourage additional DPHKs to join • Strengthen GOK financial management and procurement systems Harmonization • GOK and DPs to increase efforts to harmonize inputs on systems strengthening and key programme support. Managing for results • Institutionalize data quality monitoring systems and regular quarterly reporting • Build capacity and improve practices of using data for decision-making. Mutual accountability • Introduce annual ‘health status of the nation’ reports Conclusions • The Kenya Health Sector Partnership has progressed considerably over the past few years, though still has challenges to address. • Efforts should concentrate on improving alignment and harmonization for the sector to move forward on issues set out in Paris Declaration, IHP+ and MDG commitments.