Burkina Faso Case
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Transcript of Burkina Faso Case
Burkina Faso CaseBurkina Faso Case
Is Burkina Faso ready for a SWAP?
Burkina Faso: basic indicators
52 yearsLife expectancy at birth
19 %Adult literacy rate
16 %Urban population
556 per 100,000 live birthsMaternal mortality ratio
94 per 1000 live birthsInfant mortality rate
6.6 per woman 15-49Total fertility rate
2.4 % per annumPopulation growth rate
11.3 millionPopulation
DataIndicator
B F: economic indicators
88 %Drugs as percent of health spending
$63 per yearAverage household spending on health
4 %Health expenditure as % of GDP
$10Per capita health expenditure
$240Income per capita
DataIndicator
Health system performance issues
Over-centralized resources leading to: Technical inefficiency—low value for
money Poor allocative efficiency—spending
money on the wrong things High costs to patients (who spend a lot
for drugs) Poor quality of care—poor performance
by health workers at poor facilities
Reform initiatives
New role for ministry of health in setting norms, planning, special programs
District health team approach, with community management committee implication
New approaches to resource management, including block grants to districts
General contracting of civil servants with performance evaluation
SWAp readiness Criteria
Donor coordination
Government openness to SWAp
Management capacity--MOH
Government allocations to health sector
Prospects for harmonization of donor procedures
Interest in basket funding
Macroeconomic conditions
AssessmentEnabling factor
Discussion questions
Based on your reading of the case (or knowledge of BF), comment the criteria of readiness in the previous slide? How to do you assess these criteria?
Would a SWAp enable BF to improve the management capacity of its MOH, or would weak existing capacity defeat a SWAp?
Would a SWAp contribute to efforts to improve the performance of BF’s health system?
Are donors ready for a SWAp? Would you recommend that BF move to a
sector-wide program?
Take 45 min for discussion
Discussion questions
Based on your reading of the case (or knowledge of BF), comment the criteria of readiness in the previous slide? How to do you assess these criteria?
Would a SWAp enable BF to improve the management capacity of its MOH, or would weak existing capacity defeat a SWAp?
Would a SWAp contribute to efforts to improve the performance of BF’s health system?
Are donors ready for a SWAp? Would you recommend that BF move to a
sector-wide program?
Burkina Faso CaseBurkina Faso Case
Could Burkina Faso engage a SWAp
process ?
Central ideas
Government, Donors and other groups of civil society are involved in a new type of partnership
Management and coordination of aid is shared equally by stakeholders on both sides
Government in the Driver-seat
Advantages
More efficient use of funds for development purposes
More control by the Government over the development agenda
Better donor coordination & reduce administrative burden for the Govnt
Flexibility to design strategies corresponding to local conditions
Consistency between policy and dvpt goals by all stakeholders
Long term approach to development
Disadvantages Greater influence of the donors
in deciding Government policy & high level decision
Difficult in attributing results to particular donor
Less opportunity for innovative approaches from multiplicity of development agencies
Less control of how funds are used
Here is what Burkina has
DONOR Community?
UNDP
UNFPA
Int’l NGO
WHO
E U
BILATERALS
UNICEF
A D BW Bank Af D B
Here is what Burkina wants
HEALTH SWAp
A D BW Bank Af D B
UNDP
UNFPA
Int’l NGOs
WHO
E U
BILATERALS
UNICEF
Commitment of Burkina government Burkina ownership in SWAp process Capacity of the MoH Clear and consistent strategies Transparent budgeting and
accounting system
Policies and strategies remain consistent
Here is what Burkina needs to do
Preconditions
How strong is the commitment ?
An agency must be designated or created to guide SWAp process in the country
The agency is endowed with authority to implement the course of action for the SWAp,
An adequate budget must be appropriated to enable the agency to carry out its mandate.
How to strengthen Ownership?
National consultations Clear overall vision: role of the
state in the sector endorsed by the Head of State
Sector strategy endorsed by MoH and Legislature
Core of influential officials sharing relevant donor perspectives
Ministry of Finance support: spending programmes realistically matched to the Budget available
How strong is ownership ?
Strong Government Leadership
Government change Agents
seeking Alliance
Donor Leadership
Finally……
Mechanism that gives back control
of health development programs to
Burkina government
Focusing on the long-term policy &
strategy decisions in the Health
Sector
An approach rather than a blueprint
Ownership and Timing apropriate
Building discipline and trust from
both sides: Government and donors
Burkina building carefully a Health
SWAp ?