Aid Effectiveness in
Ethiopia
Abduljelil Reshad
Director, Resource Mobilization Directorate,
FMOH, Ethiopia
Background
• Code of conduct /2005/ and HHM /2007/ was
developed and endorsed,
• Country IHP roadmap for Ethiopia was launched
(February, 2008)
• Country IHP Compact developed & signed (Aug
2008)
• IHP has built on the existing sector coordination
and dialogue mechanisms ,
• MDG Performance Fund JFA developed and signed
(April 2009)
Background cont….
• 9 Major DPs Joined MDG-PF,
• HSDP IV has been developed Using JANS
attributes through participation of all partners
• FMA conducted: JFA was reviewed as per
FMA recommendation
• Inline with HSDP IV Partnership framework
and GHI strategy developed and endorsed,
• GHI plan developed , provisionally endorsed
and agreed to submit to US congress ,
Aid Effectiveness: Ethiopian
Definition
• Aid supports HSDP priorities and
strategies,
• Preferably finance underfinanced areas,
including health systems strengtheningHEP, HC construction, Service delivery at
primary level,
• Improved Harmonization and alignment
of planning, budgeting and reporting,
Progress so far (1)
• Majority of development aid is now
supporting the priorities and strategies of
Government,
• Different DPs support different strategies
within government defined priorities:
Progress so far (2):
There is clear evidence that development aid shifted to
underfinanced areas:
• PBS contributed in financing of employment of
human resource (38000 HEWs and nurses and
other health professionals),
• About 50 % of 2,500 HCs constructed are
financed by development aid,
• The gains in malaria, TB and HIV aids are
possible through GFTAM and PEPFAR Funding,
• There is a recent increase in funding for maternal
health: commodities, drugs, supplies, ME,
Ambulance, etc…
Progress so far:(3)
• There is also increasing use of government planning , budgeting
and reporting system:
• Increasing number of bilateral DPs are part of the MDG PF; the
size of the pooled fund tripled in three years to more than $100
million per year,
• GF support for HSS is increased,
• Predictability of funding Improved , Almost All DPs are
participating in the RM exercises,
• Big international agencies and DPs are financing through the
budget support (PBS),
• About 80% of DP activities are on plan ,
• 58% of DP activities on budget,
• With the exception of few, most are using government
reporting systems,
Challenges
• Some Bilateral Agency rules and regulation
remains a challenge towards moving forward to
one budget,
• International development aid environment
becoming more focused on attribution which will
compromise the effort to reduce government
transaction cost,
• Government’s systems needs to be strengthened
further to get the best out of available resources,
• Requirement repetitive assessment by some DPs,
What should the government do to
improve aid effectiveness further?
• Further Strengthening its systems:
• Planning, Budgeting, Procurement,
• In Ethiopian case, implement IFMS, The new
grant management system,
• Strengthening its dialogue and mutual
accountability mechanisms with partners,
• Continue to take proactive role to ensure
partners only support country’s priorities,
What should DPs do?
1. Explore their systems of planning, budgeting and
reporting and as much they can be flexible to adapt
to recipient country systems,
2. Move away from attribution, virticalization towards
strengthening country health systems despite
growing domestic pressures,
3. build in country capacity to understand and meet
specifics ,
4. As much as possible use government preferred
service delivery, planning, budging and reporting
systems.
Conclusion (1)
• Country IHP developed and endorsed by Major
DPs,
• National Health sector strategic Plan developed
with the involvement of All DPs and stakeholders,
• FM and procurement system improved from time
to time to ensure value for money,
• DPs supports the national strategic plan, mainly
underfunded and government priorities,
Conclusion (2)
• Predictability of DPs funding Improved , Flow of
fund increased ,
• Still there is a need to adhere country planning,
budgeting and reporting system ,
• Needs further effort to in place mutual
accountability ,
.
Thank you so much for
Your Attention