Vertical Health Funds and Aid Effectiveness

by

Dr Eddie AddaiDirector Policy Planning Monitoring and Evaluation

Ministry of Health, Ghana

Introduction

• SPA study funded by USAID

• Country perspective on VHF/GHI

• Elicit recipient Government and NGOs– experiences and concerns with VHF/GHI– How they are integrating them into country

health systems

• Paris declaration on Aid Effectiveness served as useful reference point

Vertical Health Funds

• Provide critical additional funding for scaling up interventions

• Usually predictable, reliable and timely

• Introducing new management practices– Results based financing

• Expanding partnerships in countries – NGO participation and capacity building

• Increasing attention for priority diseases

Vertical Health Funds• Suffer from tunnel vision

– Creating disease silos• Usually have parallel systems and processes

– Come with their policies and procedures limit ownership– CCMs duplicate and not always linked to wider sector coordination

mechanisms– Off budget and off plan – On the blind side of Ministries of Finance

• High transactions cost in proposal preparation, reporting and meeting fatigue

• Sustainability – What happens to patients on treatment when funds run out, donor

fatigue or poor performance?• Crowd out other programs, skew planning, complicate coordination

and lead to supply driven agenda – Market shifts, rent seeking and budget dependency

Vertical Health Funds

• More actively incorporate Paris Principles• Monitor system distortions of VHFs• Increase fund flexibility to address system

bottlenecks• Move incrementally towards the use of country

plans • Put VHFs on budget and on plan

– Not equal to budget support but facilitates achievement of all the 5 Paris Principles

• Strengthen country coordination and interface with Ministry of Finance

“Too many policies that do not always match up and not enough action”

“Donors should come together and have one strategy”

“Some development partners are paying lip service to coordination while at the same time withholding

information especially financial details that is considered essential to government planning”