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Re-articulating and strengthening the review-programming-monitoring cycle - P4H Network

Re-articulating and strengthening the review-programming-monitoring cycle

Since the 2010s, Niger’s healthcare system has suffered from leadership and coordination problems. Since 2021, reforms supported by WHOthe P4H focal person and all partners, have revitalized programming practices, strengthened leadership and improved data analysis and coordination.

Since the 90s, Niger’s healthcare system has developed and continuously strengthened a culture of activity review based on annual and multi-year programming. But this organization and know-how have been gradually eroded since the mid-2010s. This phenomenon has been widely documented, from the Ministry of Health’s organizational audits to the latest Health and Social Development Plans (PDSS). This is reflected, for example, in the abandonment of the local implementation of these PDSS through regional and district health development plans and micro plans for health structures, the end of six-monthly reviews of the implementation of annual action plans, the organization of annual reviews conducted during the 1In addition, coordination meetings between the Ministry of Health (MSP) and its technical and financial partners (TFPs) were spaced out and then gradually abandoned.

A renewal of strategic frameworks and a return to best practices

The state of the healthcare system, a long-standing fact, has been placed at the heart of strategic documents and a series of reforms initiated since 2021. They have enabled a gradual strengthening of leadership and a new dynamic in programming.

With the support of the World Health Organization, the MSP has carried out a study on the reform of coordination and consultation frameworks. reform of the Fonds commun santéled by the P4H country focal point; the sector’s players have again developed a new Health and social development plan. These various initiatives have made it possible to define strategic orientations, renew the working framework and identify key reforms and best practices to be initiated or reinitiated.

Within this framework, technical work is underway on the content and organization of the annual policy and budget guidelines issued by the MSP General Secretariat, the timetable, organization and tools of the national technical health committees, and the institutionalization or re-institutionalization of biannual reviews. The tools developed have enabled more detailed analysis of programmatic data, articulation of available financial information, and more precise and critical presentations of performance during reviews.

The dissemination of these tools and the development or redevelopment of a planning culture was carried out by teams of experienced MSP and TFP managers, who were involved in the various stages and levels of the review exercise, from district to central level.

Key institutional and technical innovations

The revival of best practices has been accompanied by key technical and institutional innovations. They are decisive in ensuring the ongoing management and regular monitoring of the SSDP’s implementation, but also in ensuring that this dynamic is maintained over the long term. For example, the regular MSP and PTF promotes leadership, accountability and alignment. It provides an update on the key reforms of the PDSS and the status of health indicators. It is fed by data mobilized within the framework of dashboards combining public health data, and process and administrative data at all levels.

These reforms are bearing fruit and encouraging alignment, as shown by the fact that some TFPs are prepared to abandon their own parallel review and programming arrangements to join this reformed framework.