Comparative analysis of two different approaches to putting IHP+ into practice: Mali and Benin

Introduction: The International Health Partnership and related initiatives (IHP+) seeks to achieve better results by mobilising development partners around a single country-led national health strategy, guided by the principles of the Paris Declaration on Aid Effectiveness. At country level, the IHP+ materializes through the preparation, signature, implementation, and monitoring and evaluation of a "Country Compact" – a negotiated and signed agreement in which partners commit to implement and uphold the priorities outlined in the national health strategy. Some of the main determining features of the IHP+ are the leadership of the recipient government over the preparation and implementation process of the Compact, broad domestic ownership of the national health plan, and mutual accountability for results. Methods: In this communication, we perform a comparative analysis of two very different approaches that have been followed in Mali and Benin. It is based on authors' experience in the IHP+ process in Mali, extensive document review and interviews with most significant stakeholders involved in the process both in Mali and Benin. Results: Mali has prepared its country Compact on the grounds of its 10-year experience in leading a sector-wide approach (SWAp) in the health sector. It has therefore benefited from improved donor coordination, MoH leadership in piloting the national programme, trust capital between partners and broad ownership of the health plan. It has succeeded in making the IHP+ process even more inclusive. On the contrary, Benin had no health SWAp to start with. The preparation process of the Compact was much less inclusive and country-led, resulting in narrow ownership and vague commitments. Nevertheless, it is hoped that the IHP+ can help launch a new partnership dynamic within the health sector. Conclusion: Beyond common principles, the IHP+ is put into practice in different ways from country to country according to their context.GRAP-PA Sant

L'efficacité de l'aide en santé en Afrique de l'Ouest: maintenant plus que jamais

La préoccupation d'améliorer l'efficacité de l'aide au développement dans le secteur de la santé est plus que jamais d’actualité. L'approche sectorielle permet d'obtenir des améliorations importantes à ce niveau et connaît un renouveau à travers le Partenariat International pour la Santé et initiatives liées (IHP+). Dans ce commentaire, nous montrons comment l'IHP+ a été mis en œuvre dans trois pays ouest-africains francophones: le Bénin, le Burkina Faso et le Mali. La dynamique existant dans le secteur de la santé dans chacun des pays a influencé la façon dont l'IHP+ s’y est traduit. Au-delà de ces dynamiques différentes, l'IHP+ a permis de renforcer la place des plans et dispositifs nationaux de coordination comme plateforme de suivi-évaluation et de redevabilité du secteur santé. Toutefois, certaines pratiques contraires aux principes de l'efficacité de l'aide perdurent encore, en particulier le manque d'alignement sur les systèmes de gestion nationaux et le manque de prévisibilité de l'aide.GRAP-PA Sant

Comparative analysis of two different approaches to putting IHP+ into practice: Mali and Benin

Introduction: The International Health Partnership and related initiatives (IHP+) seeks to achieve better results by mobilising development partners around a single country-led national health strategy, guided by the principles of the Paris Declaration on Aid Effectiveness. At country level, the IHP+ materializes through the preparation, signature, implementation, and monitoring and evaluation of a "Country Compact" – a negotiated and signed agreement in which partners commit to implement and uphold the priorities outlined in the national health strategy. Some of the main determining features of the IHP+ are the leadership of the recipient government over the preparation and implementation process of the Compact, broad domestic ownership of the national health plan, and mutual accountability for results. Methods: In this communication, we perform a comparative analysis of two very different approaches that have been followed in Mali and Benin. It is based on authors' experience in the IHP+ process in Mali, extensive document review and interviews with most significant stakeholders involved in the process both in Mali and Benin. Results: Mali has prepared its country Compact on the grounds of its 10-year experience in leading a sector-wide approach (SWAp) in the health sector. It has therefore benefited from improved donor coordination, MoH leadership in piloting the national programme, trust capital between partners and broad ownership of the health plan. It has succeeded in making the IHP+ process even more inclusive. On the contrary, Benin had no health SWAp to start with. The preparation process of the Compact was much less inclusive and country-led, resulting in narrow ownership and vague commitments. Nevertheless, it is hoped that the IHP+ can help launch a new partnership dynamic within the health sector. Conclusion: Beyond common principles, the IHP+ is put into practice in different ways from country to country according to their context.info:eu-repo/semantics/nonPublishe

Bottom-Up Approaches to Policy-making and Aid Effectiveness in the Health Sector: The case of Mali

Introducing bottom-up approaches into policy-making processes can be a good pathway towards improving aid and development effectiveness. At this regard, the case of Mali is emblematic because health plans are elaborated through decentralised mechanisms: committees at local level elaborate annually their own operational plans; these are then presented at regional level and traduced into regional plans, which are finally aggregated at the central level into the national plan, according to the national policy guidelines. In 2011, the elaboration of the new health programme for the period 2012-2022 enabled to strengthen planning capacities and coherence through the introduction of new bottom-up mechanisms improving stakeholders’ participation and better taking stock of local experiences. Indeed, for policies to be really effective, two key components of the policy-making process are particularly important. Firstly, past experience should be better taken into account and evidence should be used to inform new strategies. This requires the integration of learning dynamics all along the policy process, where stakeholders’ experience and local evidence become essential inputs for planning new strategies and plans. For this evidence to be successfully translated into policies, the influence of individual, organisational and system capacities and resources should be also considered. Secondly, a mindset shift is needed from a linear to a systemic understanding of development. This requests stakeholders to accept that development and health results are multifactorial and that they should be rather expected over the long term. Based on lessons learned from the Malian experience and on literature review, our presentation introduces a framework for action that highlights key determinants and constraints related to the use of bottom-up mechanisms in policy-making in the health sector in a context of aid dependence.info:eu-repo/semantics/nonPublishe

Semantic web rule languages

[en] This case study analyses how far donors implement aid effectiveness principles at health district level in Mali, and why. It shows that not all aid effectiveness principles are implemented at a similar degree. Most projects have limited impact on health services, but many programmes supported by donors offer positive opportunities for health system strengthening. The representations of different categories of stakeholders diverge – notably, regarding the role of different actors in service provision. A number of consistent strategic logics influence actors’ behaviour. We show that while many donors have committed at global level to respect aid effectiveness principles, implementation lags behind.info:eu-repo/semantics/publishe

Le développement des compétences, un facteur d'amélioration de la performance organisationnelle de l'entreprise au Mali

Cette étude cherche à comprendre le rôle du développement des compétences dans l’amélioration de la performance organisationnelle des entreprises maliennes, dans le but de savoir si les compétences développées en gestion des ressources humaines apportent des avantages organisationnels à l’entreprise. L’étude tente aussi d’établir la nature du lien entre le développement des compétences et la performance organisationnelle. Nous avons mené une étude qualitative basée sur des entretiens semi-directifs au Mali. A l’aide de la technique dite boule de neige, nous avons obtenu un échantillon de 21 personnes. Nos résultats ont révélé que le développement des compétences joue un rôle important dans le processus de l’amélioration de la performance organisationnelle. Nos résultats indiquent que le développement des compétences permet d’atteindre une amélioration de la productivité du personnel, un faible taux de Turn-over, de rotation, une satisfaction et une motivation accrue du personnel. Cette étude a des implications managériales, car elle a permis de mettre en relief le lien positif entre le développement des compétences et la performance organisationnelle, ainsi en les persuadant à investir davantage dans leur développement personnel

Aid for health in times of political unrest in Mali: Does donors' way of intervening allow protecting people's health?

Mali has long been a leader in francophone Africa in developing systems aimed at improving aid effectiveness, especially in the health sector. But following the invasion of the Northern regions of the country by terrorist groups and a coup in March 2012, donors suspended official development assistance, except for 20 support to NGOs and humanitarian assistance. They resumed aid after transfer of power to a civil government, but this was not done in a harmonized framework. This article describes and analyses how donors in the health sector reacted to the political unrest in Mali. It shows that despite its long sector-wide approach experience and international agreements to respect aid effectiveness principles, donors have not been able to intervene in view of safeguarding the investments of co-operation in the past decade, and of protecting the health systemss functioning. They reacted to the political unrest on a bilateral basis, stopped working with their ministerial partners, interrupted support to the health system which was still expected to serve populations needs and took months before organizing alternative and only partial solutions to resume aid to the health sector. The Malian example leads to a worrying conclusion: while protecting the health system's achievements and functioning for the population should be a priority, and while harmonizing donors' interventions seems the most appropriate way for that purpose, donors' management practices do not allow for reacting adequately in times of unrest. The article concludes by a number of recommendations.GRAP-PA Sant

Sub-national tailoring of seasonal malaria chemoprevention in Mali based on malaria surveillance and rainfall data

International audienceBackground: In malaria endemic countries, seasonal malaria chemoprevention (SMC) interventions are performed during the high malaria transmission in accordance with epidemiological surveillance data. In this study we propose a predictive approach for tailoring the timing and number of cycles of SMC in all health districts of Mali based on sub-national epidemiological surveillance and rainfall data. Our primary objective was to select the best of two approaches for predicting the onset of the high transmission season at the operational scale. Our secondary objective was to evaluate the number of malaria cases, hospitalisations and deaths in children under 5 years of age that would be prevented annually and the additional cost that would be incurred using the best approach.Methods: For each of the 75 health districts of Mali over the study period (2014-2019), we determined (1) the onset of the rainy season period based on weekly rainfall data; (ii) the onset and duration of the high transmission season using change point analysis of weekly incidence data; and (iii) the lag between the onset of the rainy season and the onset of the high transmission. Two approaches for predicting the onset of the high transmission season in 2019 were evaluated.Results: In the study period (2014-2019), the onset of the rainy season ranged from week (W) 17 (W17; April) to W34 (August). The onset of the high transmission season ranged from W25 (June) to W40 (September). The lag between these two events ranged from 5 to 12 weeks. The duration of the high transmission season ranged from 3 to 6 months. The best of the two approaches predicted the onset of the high transmission season in 2019 to be in June in two districts, in July in 46 districts, in August in 21 districts and in September in six districts. Using our proposed approach would prevent 43,819 cases, 1943 hospitalisations and 70 deaths in children under 5 years of age annually for a minimal additional cost. Our analysis shows that the number of cycles of SMC should be changed in 36 health districts.Conclusion: Adapting the timing of SMC interventions using our proposed approach could improve the prevention of malaria cases and decrease hospitalisations and deaths. Future studies should be conducted to validate this approach