2023-01-18-世界卫生组织-Feedback_from_national_governments_and_relevant_authorities_-_Analysis_24页_857kb

SDG3 GAP Monitoring Framework Questionnaire Analysis Summary

Introduction

This report analyzes responses from national governments and relevant authorities to a short questionnaire on their health coordination environment, part of the SDG3 GAP monitoring framework.

Responses Received

• 75 focal points nominated, 52 questionnaires completed (69%).
• Highest response rates: Low-income countries (86%), Lower-middle-income settings (69%).
• Lowest response rates: AMR (40%), EUR (40%).

Quantitative Analysis

• Method: Responses rated on a scale from "Strongly Disagree" to "Strongly Agree", converted to scores (0-4) then percentages (0-100%).
• Statements: Six questions covering coordination and alignment principles.
  • General: Alignment with national plans, coordination between development partners.
  • Specific: Financial alignment with national budget, data use, technical assistance coordination, respect for national mechanisms.
• Findings:
  • Alignment (1A) and coordination (1B) were rated lowest (avg. 59%, 57%).
  • Use of national systems (1D) and joint TA plans (1E) rated highest (avg. 73% for 1D, 70% for 1E).
  • Lowest scores across regions were EMR (55%), highest were EUR and WPR (71%).
  • Average scores increase with higher income levels (59%, 66%, 68%).
  • General questions scored slightly higher (67%) than specific ones (62%).

Qualitative Analysis: Findings (Overview)

• Examples of Good Practice:
  • National strategic plans, pooling funds (e.g., Health Performance Fund), formal agreements (e.g., compacts), use of HMIS, established coordination mechanisms, joint planning/profiling.
  • Strong coordination seen during COVID-19 response in specific settings (e.g., Gabon, Namibia).
• Challenges:
  • Local Factors: Political context (instability), weak government capacity (especially within Ministry of Health), geography, sub-national coordination needs.
  • Agency Factors: Poor adherence/application of principles (flexibility, country ownership), agency-specific agendas/ mandates, challenging administrative structures/procedures/variations.
  • External Factors: Insufficient funding, lack of core coordination elements (health plan/ mechanism), duplicate coordination mechanisms (parallel systems), transparency issues (reporting).
• Suggested Corrective Measures:
  • Many measures were context-specific (see full details).
  • Common themes (Box 15 summary): Local ownership, ministry capacity building, agreements/compacts, functional & respected coordination mechanisms, joint planning, pooled funding (on budget), local monitoring use/joint reviews, response time to requests, learn from emergencies.

Use for Quality Improvement

• Responses help identify areas needing improvement and tailor actions by agencies.
• Pilot country analysis (Colombia, Lao PDR, Malawi, Nepal, Pakistan, Somalia, South Sudan, Tajikistan) highlighted region-specific needs and priorities.
• Low-income countries were highly responsive but face significant challenges.
• Common themes included tightening national-budget linkage to funding, improving flexibility and transparency, and strengthening coordination mechanisms.

Conclusions

• The analysis provides baseline data on national perspectives.
• These responses offer concrete insight into shared collaboration gaps.
• Finding disparities point to specific contexts where collaboration needs improvement.
• Stronger governmental capacity for coordination and funding mechanisms are crucial for effective health coordination in LMIC settings.
• Results will serve as a basis for future monitoring and improvement efforts by SDG3 GAP agencies.