UGANDA’S EXPERIENCE WITH
MONITORING AID EFFECTIVENESS
COMMITMENTS IN THE HEALTH
SECTOR
Dr. Sarah Byakika
Ministry of Health
5th October 2012
HOW IS IT BEING DONE, AND WHAT IS
BEING MONITORED?


Compact between GOU and Partners for
Implementation of the Health Sector Strategic and
Investment (HSSIP) 2010/11 – 2014/15
Guiding Principles:





Ownership and leadership by government
Alignment of all partner programmes, activities and
funding to one national plan (HSSIP) and harmonized
annual plan
Use of common management arrangements
Value for money, and
One monitoring framework to promote accountability
HOW IS IT BEING DONE, & WHAT IS
MONITORED?


Health Policy and Advisory Committee (HPAC)
serves as the main oversight and steering body
for monitoring implementation of the Compact.
Specifically responsible for;
Quarterly review of whether signatories are on track
with their commitments .
 Attendance of the quarterly sector performance
review meetings
 Participating in Annual reviews to monitor whether
“Government” has met its commitments with
respect to the implementation of HSSIP

HOW IS IT BEING DONE, & WHAT IS
MONITORED?
How it
should be
done?
What is
monitored?
What is being done?
Quarterly
review
during
HPAC
Whether
signatories are on
track with their
commitments
Not done. No monitoring
tool.
Quarterly
and Annual
sector
performance
reviews
Whether
government has
met its
commitments
Quarterly and annual
sector performance
reviews conducted based
on the key outputs in the
workplan and HSSIP core
indicators
WHAT IS BEING MONITORED?
INPUT & PROCESS
OUTPUT
Health financing
Service access and
Information,
readiness
Governance
GGA on health
TB case
1 as % of total
5 detection rate
gov’t budget
Per capita OPD
Workforce
6
utilization rate
Annual reduction
% of HFs w/o of
2 in absenteeism
7 any of 6 tracer
rate
medicines
% of posts filled
% functional
3
8
by trained HWs
HCs IV
Service quality and
Infrastructure
safety
% of villages/
% clients
4 wards with a
9
expressing
functional VHT
satisfaction
10
11
12
OUTCOME
IMPACT
Coverage of interventions
Health status
% pregnant women attending 4 ANC
sessions
% of deliveries in public and PNFP
% children under one year immunized
with 3rd dose pentavalent vaccine
Maternal Mortality
22 Ratio
Neonatal
mortality rate
Infant Mortality
24 Rate
23
% one year old children immunized
Under 5 mortality
25
rate
against measles
% pregnant women who have
Financial risk
14
completed IPT2
protection
% of children exposed to HIV
%
of
HHs
15 accessing HIV testing within 12 months 26 experiencing
catastrophic pay
% UFs with fever receiving malaria
16
treatment within 24 hrs
17 % eligible persons receiving ART
13
Risk factors and behaviours
18
% of households with a pit latrine
19
20
% U5’s new visits with stunting
% U5s with marasmus
21
Contraceptive Prevalence Rate
HOW ARE FINDINGS BEING USED, AND BY
WHOM?


Quarterly/biannual and annual reports compiled,
discussed and disseminated
Annual performance report findings are discussed at the
Joint Review Mission;





Involves all stakeholders in health
Focuses on performance against the core indicator targets,
Jointly identify challenges, priority interventions and targets
for the remaining period in the FY and subsequent year.
Expected to guide planning & resource allocation by
government and partners
Used for recognition and reward
HOW ARE FINDINGS BEING USED,
AND BY WHOM?

Used to meet other national and global reporting
requirements e.g. Government of Uganda Annual
Report, Project Reports, IHP+ report
WHAT HAS CHANGED, AS A RESULT?



Government taking lead in determining sector
priorities (HSSIP) and available resource
allocation
Using a common M&E framework (Country-led)
with harmonized M&E tools. Minimised
reporting requirements at implementation level
Joint Assessment Framework – jointly agreed
targets and monitoring avoiding conflicting
reports
MAIN LESSONS


Continuous dialogue necessary to bring all partners on
board (Long consultative process)
All key stakeholders need to be involved in
development of monitoring tools to cater for
data/reporting needs, ensure ownership, use and
transparency
MAJOR CHALLENGES


Not all donors are signatory to the Compact
Some partners hesitant to adopt the SWAPs –
off budget funding which is difficult to program and monitor and may
not be aligned to sector priorities
 Opting for project support and Parallel Implementing Units with focus
on achieving project indicators. (skews resources)


Difficult to track donor resources due to lack of transparency. (Some
do not share MOU, commitments or amounts disbursed with MoH
and this information is not easily accessible from MoFPED)

Sometimes disbursements are below commitments. Who is to be
held accountable?

Development Partner Commitments are not assessed or discussed
during the sector performance reviews.