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African Development Bank Group –Human Development Department September 2014
Value for Money, Sustainability and Accountability in the Social Sectors Volume 1 N° 3
Newsletter of the VfM Unit
Editor : Nejmudin Bilal
Value for Money, Sustainability
and Accountability in the So-
cial Sectors
Contact us :
VfM Unit
Tel. +216 7110 1143
Email : vfm@afdb.org
OSHD
AfDB
CONTENTS
The Lagos Forum 1
VfM and Parliamentarians 1
Concepts & Issues 2
Problems and Challenges 2
Solutions & Strategies 2
Venue and logistics 3
Staffing and material 3
ECOWAS 4
Actionable recommendations
4
MPs’ views 5
Getting better evidence 5
Improving relations with
the executive 5
“Facing our constituents” 6
Donor relations 6
Regional and inter-
parliament role 6
Facilitators 8
Lagos Event in the News 8
The way forward 8
The Lagos Forum
VfM and Parliamentarians
The Lagos Forum, the
First Capacity-building
event for Parliamentari-
ans organized by VfM,
was held in Lagos, Nige-
ria, on 19 and 20 June
2014.
This Special Edition of
the VfM programme’s
newsletter is devoted to
it.
It gathered some 25
MPs (Members of Na-
tional Parliaments and
the ECOWAS Parlia-
ment) from the fifteen
member states of the
Economic Community
of West African States
(ECOWAS)
Two days were organ-
ized into seven sessions
covering the three top-
ics of the event destined
to help parliamentarians
press for better value for
money in social sectors.
Parliaments are among
the most important en-
gines for socio-economic
development and
growth.
As they establish the
laws by which a society is
governed, any initiative
to ensure better Value for
Money in social sectors
naturally accords para-
mount importance to
them.
This means addressing
the two effective key
challenges for MPs: the
knowledge gap and the
experience gap, particu-
larly for newly elected
MPs.
MPs often lack the
academic qualification,
education or professional
experience providing the
knowledge, skills and prac-
tical applications necessary
for them to press for value
for money in social services
in their legislative or over-
sight role.
See “MP’s views”
(pages 5 & 6) for Af-
rican MPs voices…
Therefore, capacity de-
velopment to foster these is
vital.
The founding text of the
VfM Programme, the Tunis
Declaration of 2012 signed
by Parliamentarians as well
as Ministers, says “We, the
Ministers of Finance and
Health and Parliamentari-
ans (…) call upon (…) par-
liamentarians and civil so-
ciety to support the imple-
mentation of these rec-
ommendations”
Its supporting statutes
say : “Projects financed by
the VFM programme may
encompass (…) support
(for) dialogue between
relevant ministries and
stakeholders (parliaments,
CSOs, private sector). This
may include, meetings
technical assistance,
studies and preparation of
advocacy documents. (…)
Building capacity including
training, (etc.).”

2. 1 Rifat Atun, Professor of Global
Health, Harvard University, Bos-
ton, USA
Concepts & Issues
2 Salif Samake Senior Consultant,
AfDB
Problems and Challenges
31Bruno Meessens, Professor at
the Institute of Tropical Medicine
in Antwerp, Belgium
Solutions & Strategies
Allocation of resources
and planning must be
based on factual evi-
dence of needs, Professor
Meessens reiterated.
The proper transfer of
resources and their track-
ing must be ensured.
What to do? Monitor &
sanction deviance, adopt
mechanisms to avoid
capture; remove barriers
which exclude users.
No less than 7 tools that
help do this were intro-
duced and explained. All
rely on data and its analy-
sis.
Which are the areas
where improvements can
be made? The Input mar-
ket (purchase of drugs,
equipment etc.), and the
workforce – human re-
source management.
Equity – enabling access
to social services for the
poorest most deprived is
the next challenge.
Finance is a challenge
for most African nations
PBF for performance-
based finance is one solu-
tion. Putting a price (and
reward) on each service
delivered successfully.
A culture of account-
ability, literate legal em-
powerment, disclosure
and publication of results
are all key to improving
governance.
“What is VfM ?” Profes-
sor Rifat Atun set the stage
in the first tutorial session
by explaining : “making
best use of the resources
available”, “measuring
what you get and what
you have spent”.
He explained how to
conceptualize the process
leading from resources to
impact, through inputs,
outputs and outcomes.
Atun laid out ways to
ensure that spending was
allocated to the most
cost-effective means and
as little waste occurred as
possible.
He demonstrated the
urgency of dealing with
this: demographic and
income growth coinciding
with crisis and the decline
in aid, mean getting more
value for money cannot
wait.
It is imperative to plan
on the basis of hard fac-
tual evidence, budgeting
and prioritizing the most
effective simple measures
(see Box 5 High Impact
Health
Interventions”).
Reviewing the tools and
methods to improve VfM
and their financing, Prof
Atun ended by reminding
MPs how they could use
their roles to apply these.
As legislators, they can
use their rule-making role;
their oversight role en-
ables them to ensure rules
are applied; and as repre-
sentatives, that their con-
stituencies’ and citizens’
needs.
Salif Samake asked “Are
the most efficient, benefi-
cial measures the ones
that get priority funding ?
No.”
Social services can be
plagued with inefficiencies
and wastage.
Do we know where the
money goes and how
much?
The 2010 World Health
Report estimates that
globally,“20-40% of all
health spending is wasted
through inefficiency”.
People end up paying
too much out of their own
pocket, and public fund-
ing for social services of-
ten ends up benefiting
those that are not the
most needful.
Far too many African
nations still spend too little
on public health (below
the recommended target
of $44 per capita).
The figures from
UNESCO on the number
of primary school pupils
per maths or reading
textbooks across African
nations illustrate the ineffi-
ciency in education, lead-
ing to a mass of poorly
educated youth.
Figures for the lack of
drinking water or toilets in
primary schools also ex-
plain the poor indicators of
African basic education.
Again regarding health,
Samake showed people
are paying far too high a
price for medicines.
There remain too many
causes of hardship, most of
which can be related to
poor governance, he
concluded.

3. VFM UPDATE P 3
Venue and logistics
Staffing and material
All the proceedings are recorded,
as for previous VfM events, (state-
ments and presentations) and used
as training material on the EADI’s
on-line training website (see oppo-
site).
1 Latefa Camara, AfDB consultant,
recording sessions for training
In addition to the presentations
and specific material prepared for
the event, VfM is working on text-
books manuals.
A compendium of data on
health, education and human de-
velopment in ECOWAS countries
was provided to participants, as
well as case studies from global
sources. Afri-Dev’s scorecards were
also made available and distrib-
uted
2 Material prepared for the participants
The Event has ben fully recorded
and analysed in a detailed report
by local organizer and parliamen-
tary network Afri-Dev.
It will be available from the VfM
secretariat after review and con-
tains all the findings, details of dis-
cussions and Parliamentarians rec-
ommendations.
3 TM Nejmudin Bilal and Rotimi Sankore
of Afri-Dev fine-tune the details
Participants’ re-
sponse to evalua-
tion “The mix of
presentational
methods (group
works, panel dis-
cussion, etc.) was
broadly appropri-
ate” ranging from
Strongly disagree
to Strongly agree,
through 1 to 5.
Figure 4 All the sessions of this and other VfM events are
available on-line to registered users on the EADI website
www. http://einstitute.afdb.org/
Lagos, the economic
capital of Nigeria, the
ECOWAS’ host nation, was
the bustling scene of the
MPs gathering.
The Eko-Hotel’s magnifi-
cent main convention cen-
tre amply catered for ple-
nary presentations by VfM’s
experts and the collective
opening and closing ses-
sions.
The local event organizers
and partners, Afri-Dev, the
Africa Africa Health, Human
& Social Development In-
formation Service), are spe-
cialized in parliamentary
networking and capacity building in the social
sectors and Lagos-based.
The course was conducted in English and
French with simultaneous interpretation and
projections on separate screens.

4. ECOWAS
Actionable recommendations
The event lead to the
following actionable
recommendations :
“1. That AfDB and
partners facilitate a
series of 2-day capacity
building meetings to be
conducted in each
country for all members
of parliamentary com-
mittees of Social Sectors,
and Budget and Fi-
nance. This should in-
clude sessions on mul-
tisectoral investment
and policy making, and
how to utilize and inter-
pret evidence and
data.
2. That these
meetings be institution-
alized and repeated
occur regularly for every
new intake of parlia-
mentarians in each
country to ensure conti-
nuity and sustainability.
3. That resources
be mobilized to ensure
that Social Sector
Committees in each
country national parlia-
ment are supported with
by at least one perma-
nent expert on multisec-
toral investment and
policy in the social sec-
tors.
4. The duties of
these experts will be
amongst others to liaise
with and between So-
cial Sector, Finance and
Budget parliamentary
committees; and also
between the parliamen-
tary committees, and
Ministries responsible for
Social Sector, Finance
and Budget; and devel-
opment agencies and
partners– i.e. to support
evidence based-based
planning, high impact
and cost effective inter-
ventions.
5. That towards
these, Social Sector
committees should im-
mediately work with
Finance /Budget and
Planning committees
and Ministry colleagues
to improve investment in
National Bureaus / Of-
fices of Statistics.
6. To support over-
sight and accountability
functions including re-
sults based-based plan-
ning and Value for
Money – the capacity of
Social Sector commit-
tees should be built to
include tracking of and
monitoring of resources
by thematic areas and
at constituency level
7. That a plenary
presentation on the
outcomes of the Value
for Money capacity
building work be pre-
sented to the next pos-
sible sitting of the full
ECOWAS Parliament.
8. That the out-
comes and recommen-
dations be presented to
the next possible meet-
ing of Speakers of par-
liament from ECOWAS
member states.
9. That the AfDB
and partners work with
the ECOWAS Parliament
to engage the ECOWAS
Ministerial Conference
of Finance, Economic
Development and So-
cial Sectors on Value for
Money Investment.
10. That an urgent
platform be urgently
facilitated to ensure
continued interaction
between ECOWAS So-
cial Sector parliamen-
tarians and key stake-
holders to facilitate sus-
tainable capacity build-
ing.”
AfDB works with Re-
gional communities of
nations – EAC in East
Africa, SADC in southern
Africa, ECOWAS in West
Africa…
The relationship with
ECOWAS lead to the co-
organizing partnership
with the ECOWAS par-
lament for the Lagos
event.
ECOWAS (CEDEAO in
French) regroups fifteen
West African nations.
The ECOWAS parlia-
ment is the legislative
organ of the Economic
community, based in
Abuja, Parliament con-
sists of 115 seats. Each of
the 15 Member State
has five seats at least.
The remaining seats are
shared in proportion to
the population.
Its secretary General
Dr. Cheikh Abdel Kader
Dansoko, represented
by Jacob Amuta
Onogwu (left), pro-
nounced the opening
speech.
Parliamentarians
agreed with the organ-
izers that ECOWAS
should play an impor-
tant rule in following up.
Meetings on the results
of the capacity building
Forum should be held
ECOWAS agreed to
partner with AfDB for
further such capacity
building meetings in the
future.
5 ECOWAS parliament emblem
6 Opening speech by
Jacob Amuta Onogwu
7 The fifteen ECOWAS member states

5. VFM UPDATE P 5
MPs’ views
Getting better evidence
8 Hon. Fatou Mbye, Gambia
9 Hon. Fomba Fatimata Niam-bali
(Mali)
Improving relations with the executive
Many of the tools and
instruments available to
improve effectiveness,
accountability, sustain-
ability rely on the pro-
duction, collection,
analysis and disclosure
of factual evidence
(data).
MPs complained of
the inadequacy of na-
tional statistical bureaus,
the lack of skilled staff in
the parliaments to ob-
tain and analyse such
data when it exists, and
the obstacles to the
transmittal of informa-
tion from the executive
to the legislative and to
the people.
Skills and equip-
ment
The lack of equipment
– particularly Information
technology and the skills
to use it – were also
mentioned as a hin-
drance.
“Parliamentarians
would benefit from bet-
ter IT equipment and
training in using it. The
lack of both delays the
availability of timely
evidential data” said
Hon. Hassan Abdul
Sesay of Sierra Leone’s
Youth. Information. Tour-
ism Commission.
Legislators suggested
that staff be allocated
to the task of gathering
evidence across sectors,
to benefit both them
and the executive, in
national and the re-
gional parliaments.
Asked about her view
of the likely impact of
changes in information
technology and its
adoption by African
citizens on their role as
parliamentarians, an MP
said « “we must see the
momentous changes
underway on our conti-
nent as opportunities
rather than threats”
The pressure to get
more, better evidence
comes from the top as
well as the bottom of
communities.
Both arms of govern-
ment need better skills,
training, equipment.
Relations between the
two need improving –
trust, mandatory col-
laboration, honesty and
diligence must charac-
terize the relationship
between elected politi-
cians and executives of
the national administra-
tion.
The relationships be-
tween legislative and
executive need a cul-
ture change, from un-
friendliness or uncoop-
erativeness to mutually
respectful diligence
favouring service to the
people
“MPs may be misin-
formed by officials, civil
servants” lamented one
participant.
Taxation and fis-
cal affairs
Budgeting, planning
and the transfer and
tracking of resources
have to do with revenue
collection as well, they
said.
MPs role in the fiscal
process, the local level
also have a bearing on
ensuring social pro-
grammes are funded
and effective.
Input market and
costs
MPs pointed out the
extra costs due to the
necessity to borrow and
the lack of domestic
manufacturing capac-
ity.
“Lack of domestic re-
sources leads to costs in
the form of interest on
loans and unpredictabil-
ity of donor-supplied
aid”
“Lack of domestic
manufacturing capacity
leads to costly imports”
said one MP.
“We, the Ministers of Fi-
nance and Health and
Parliamentarians”
…“call upon: parliamen-
tarians and civil society to
support the implementa-
tion of these recommen-
dations”
Box 4 Tunis Declaration 2012

6. “Facing our constituents”
Donor relations
Regional and inter-parliament role
MPs had several sug-
gestions regarding do-
nors.
Harmonization be-
tween them should not
just be paid lip-service
but effectively applied.
National plans reflect-
ing national priorities
should lead the way
and attract the aid
needed, rather than the
other way around.
Donors too, should be
assessed according to
the results and success of
their aid operations, in
order that effective op-
erations be rewarded
and ineffectual ones
sanctioned or stopped.
Said Honourable Fatou
Mbye (Health Comission,
Gambia) “We (MPs) lack
adequate time and re-
sources to scrutinize de-
velopment projects…are
under pressure to ap-
prove, sometimes in a
month, even a week”
Reliance on aid, lately
on the decline and suf-
fering from unpredict-
ability, was criticized
and the development of
domestic revenue col-
lection and increased
better social spending
advocated.
There is no lack of
formal rules about aid,
what is lacking is the
political and material
resources to implement
them.
Politicians are there to
serve their constituents.
Their role derives from
this representation, yet it
is also a hindrance to
effective social services.
MPs admitted that
party affiliation could
prevent a legislator from
criticizing a social pro-
ject his or her party sup-
ported.
Another issue was the
simple way many peo-
ple viewed the success
of social policy – social
projects just had to be
visible, attributable, to
be successful.
“In our countries, if you
do not have things to
point to – that’s the
hospital, that’s the
school -, you are a bad
politician” lamented
Hon (Mr) Hassan Abdul
Sesay (Commission on
Youth. Information, tour-
ism, Sierra Leone).
People themselves
have to be informed on
the effectiveness of
different health, educa-
tion and social meas-
ures, to demand them,
and on what can and
cannot be demanded
from elected represen-
tatives.
As Afri-Dev Parliamen-
tary network coordina-
tor Rotimi Sankore said
“polio vaccination may
not be very visible, but
the cripples in the street
if it is not done, are”
There was consensus
on the usefulness of the
event itself in bringing
together MPs to realize
they faced similar prob-
lems, could learn from
each others’ experi-
ence and mutual sup-
port.
The Gambian repre-
sentative in particular
showcased a pilot sys-
tem of scorecards in the
North of the country
whereby users and citi-
zens could rate social
services and their judg-
ment was taken into
account by the execu-
tive and legally binding.
There was a staunch
defence of their role by
the Gambian MP ; “we
as parliamentarians
have enacted legisla-
tion that has helped
ensure food security,
national accountability,
government plan-
ning…all of which im-
prove people’s lives”
Parliamentarians
called on the regional
body the ECOWAS par-
liament, to institute
regular sessions on the
VfM topics (see Action-
able recommenda-
tions), and on the AfDB
to pursue support for
national and regional
parliamentary actions
for VfM.
10 Parliamentarians at work Hon.
Hassan Abdul Sesay Hon. Ibrahim
Sulaiman Sesay
11Participants - debate
- Birth Spacing
- Antenatal care
- Prevention of HIV transmis-
sion from mother to child
- Skilled attendant at birth
- Postnatal care for mothers
and newborns
- Exclusive breastfeeding for
six months
- Three doses of the com-
bined diphtheria, pertussis
and tetanus vaccine
- An<bio<c treatment for
pneumonia
- Insecticide-treated bed net
use against malaria
Box 5 High Impact Health
Interventions

7. VFM UPDATE P 7
Newsletter of the VfM
Unit
Editor : Nejmudin Bilal
Value for Money, Sus-
tainability and Account-
ability in the Social Sec-
tors
Contact us :
VfM Unit
Tel. +216 7110 1143
Email : vfm@afdb.org
OSHD
AfDB
The Event banner
Parliamentarian participants
Name Committee/organization Country Website
Hon (Ms) Zalissa Ouillio Koumare Finance & Budget Burkina Faso Website
Hon(Mr) Halidou Sanfo Social & Cultural Burkina Faso Website
Hon(Mr) David Lima Gomes Health Cape Verde Weebsite
Hon(Mr) Fernando Lopes Robalo Education Cape Verde Website
Mr Atse Roland Olivier Akissi Adminstrateur Charge des
Affaires Internationales
Cote d’Ivoire
Hon (Mr) Souleymane Toure Social & Cultural Cote d’Ivoire Website
Hon (Mr) Lassina Kone Economic & Financial Cote d'Ivoire Website
Hon(Mr) Sulayman Joof Education Gambia Website
Hon(Mr) Amadou Khan Finance & Budget Gambia Website
Hon(Ms) Fatou Mbye Health Gambia Website
Hon(Mr) James Klutse Avedzi Finance Ghana Website
Hon(Mr) Mathias Asoma Puozaa Education Ghana Website
Hon (Mr) Dramane Goita (t) Finance Mali Website
Hon (Ms) Aissata Haidara Education Mali Website
Hon(Ms) Fomba Fatimata Niam-
bali
Health & Social affairs
(ECOWAS Parliament)
Mali
Website
Hon (Mr) Kalilou Ouattara Health Mali Website
Hon(Mr) Yaya Sangare Education, Science, Tech-
nology (ECOWAS Parlia-
ment)
Mali
Website
Mr Jacob Amuta Onogwu Principal Administrative
Officer (ECOWAS Parlia-
ment)
Nigeria
Website
Mr Bertin K Some Parliamentary Assistant
Social Sectors (ECOWAS
Parliament)
Nigeria
Website
Hon (Mr) Hassan Abdul Sesay Youth. Information. Tourism Sierra Leone Website
Hon (Mr) Ibrahim Sulaiman Sesay Clerk of Parliament Sierra Leone Website
Hon(Ms) Mabinty Kadijah Sillah Health. Human Rights Sierra Leone Website
Hon (Ms) Afi Ntifa Amenyo Epse
Bebou
Health Togo
Website
Hon (Mr) Kayaba Malle Education Togo Website
Hon (Mr) Yawovi Osseyi Finance Togo Website
IN MEMORIAM
The passing on 5 July
2014 of an honour-
able participant,
Dramane Goita (born
17 January 1973 in
Yorosso, Mali), was
learnt with distress by
us all
The organizers hereby
express their sincere
condolences to the
family and friends.
Link to official an-
nouncement by
Mali’s National As-
sembly

8. Facilitators
Lagos Event in the News
The way forward
[From Event Evaluation) “In the future, for which
of the following topics would you like to have more
in-depth and extended days during the event?”
S/N Response options Response %
a. High impact interventions
and evidence based
planning
14 21%
b. Efficiency, transfer and
tracking of resources
14 21%
c. Financing 7 10%
d. Inequality and equity fo-
cused interventions
14 21%
e. Input Market 6 9%
f. Accountability and com-
munity voice to improve
value for money
12 18%
Onche Odeh of the Daily
Independent (Nigeria)
wrote in an article head-
lined AfDB to help Nigeria,
others in resource man-
agement (June 22) : “The
African Development
Bank Group (AfDB) has
started the process of
building the capacity of
parliamentarians in Nige-
ria and other West African
countries on how to make
judicious use of monies
being allocated to gov-
ernments in their respec-
tive countries.”
An Editorial in Nigeria’s
the Guardian entitled
Bank, parliamentarians,
ECOWAS seek value for
social services on 23 June
wrote “Speaking on
behalf of ECOWAS
Secretary General,
Cheikh Abdel Kader
Dansoko, ECOWAS
Parliament representative,
Jacob Amuta Onogwu,
said that the objective of
the forum is to "remove
the bottle-necks
constraining the effective
use of resources".
Announcing the event in
advance, Gambia’s The
Point, wrote “It should
provide an opportunity for
the members of the
PAC/PEC of the National
Assembly in The Gambia
to attend, and gain some
fresh insights in this area,
as well as to share
experiences and
knowledge on best
practice with the other
participants.” [“Gambia:
Focusing On Value for
Money” via AllAfrica, 22
May]
“We have learned a lot,
but knowledge is noth-
ing unless you use it, let’s
start acting, we want
you to spread the word
to your colleague MPs,
become ambassadors
for Better value for
Money.” concluded
Chief Health Analyst
and VfM member Fab-
rice Sergent (left).
Ousmane Doré, AfDB’s
Nigeria office director,
who introduced the
event, here in discussion
with event organizer
Nejmudin Bilal.
This, the fifth capacity-
building event organized
by VfM since its inception
a little more than a year
ago, is the first such gath-
ering of parliamentarians.
Further forthcoming
events are planned for
the East African Commu-
nity (EAC) parliamentari-
ans, and the Southern
African Development
Community (SADC).
Handbooks and manu-
als are in preparation or
underway – on the phar-
maceutical industry, the
fiscal space concept, the
role of private investment
etc.
As the various stake-
holders are sensitized and
informed on the ways to
improve Value for Money
in Social Sectors, aid or-
ganizations learn from
them the particular chal-
lenges they face and
respond accordingly.
EBOLA
As the ex-post
report on the event
notes : “The Ebola
outbreak in West
Africa that initially
began in the first
quarter of 2014 on a
relatively small
scale, and then re-
ignited in July is
sadly, evidence of
the importance of
building the policy-
making capacity of
parliamentarians
and Ministries.”
“Indeed better and
more efficient
investment could
have prevented, or
mitigated the
ongoing epidemic.”
The AfDB has mobi-
lized at unprece-
dented rate and
scale to respond to
the tragedy. See
Link