Presentació sobre l'AOD de Gertrudes Machatine, assessora del projecte de reforçament dels serveis clínics de VIH/ SIDA a Moçambic (CHASS/SMT) de la Consultora Abt Associates i fins fa uns mesos Directora del Departament de Cooperació i Planificació del Ministeri de Salut de Moçambic (MISAU). Jornada "Què està canviant en cooperació sanitària en salut?"

1. Mozambique
Accountability Monitoring Tools
Managing for results

2. Background
• On Health SWAP since 2000
• IHP+ Country compact signed in 2008
• Pooled Funds arrangement (30 -50 % of funding
in the health sector) with still vertical funds
• Memorandum of Understanding (MoU) signed
with 13 donors
• 5 Year Government Plan
• Poverty Reduction Strategy
• Health Sector Strategic Plan 2007-12
• Several disease or program specific plans
finalized
IHP+ Country Health Teams meeting, 9-10 December, Brussels

3. Most of Health Sector Resource envelope is covered by Projects
IHP+ Country Health Teams meeting, 9-10
December, Brussels

4. Feasible? Get what you wanted?
Managing by results:
– Results are interlinked;
– Subject to political choices;
– Susceptible to manipulation;
– Dependent on functional systems & capacity.
• Yes, but you need close monitoring to avoid
getting of track or even lost.

5. examples
We get what we aim at on the basis of targeted programs:
• Child health:
– specific malaria or vaccination programs
– TB program
Difficult to achieve the last 10% improvement without its
integration into the overall health system
It is difficult to get what we aim at:
• Sexual Reproductive Health: requires access for overall
improvement and quality across the whole national health
service delivery system.
i. Malnutrition: requires intersectoral cross-sectional
approach.

6. Barriers
• Health partners:
– Have short term concerns, want results yesterday
– Change their priorities with every new domestic
election
– Are not predictable
– Want to plant flags
• Less empowerment of the local capacity
Require zero corruption, instead of zero tolerance

7. How to overcome?
Long term vision MTEF: 3 years
EXPECTED
RESOURCES PLAN RESULTS
MoF
Donors
Other
JANS
1. Qualitative Control
Fundamental question: 2. Validation
What is the likely set of results to be achieved given the negotiated resource
envelope and proposed plan?
Achieved country ownership, leadership, alignment, harmonization, funding for
results and mutual accountability:
Thus, the plan validated by the JANS can be a negotiable settlement which does not
require fears for fungibility nor about additionality

8. Is it worth? For whom?
• Yes, if we avoid hidden agendas.
• For people who have elected our
governments, in the north and the south,
(from Rovuma to Maputo)