For Haiti health projects, less reporting burden seen with results-based financing

The U.S. Agency for International Development and World Bank are working with the Haitian government to switch to results-based financing for health care projects in Haiti, a move officials at a summit on health in Haiti on Capitol Hill Thursday said should help to relieve the burden of data reporting on contractors. “We are working to establish more health data, particularly results-based finance. We will start doing impact evaluations to show the real impact we had on Haitian health,” said Florence Guillaume, Haiti’s public health and population minister. Currently, health financing is done on the basis of grants, not on the basis of program performance results, Guillaume said, but results-based financing will change this. Many grantees at the summit voiced their concern about what an increase in data reporting might mean for them considering many already find requirements burdensome on time and resources. “We have limited resources in budget and staff but need to collect data to honor terms of a grant. This is difficult, adds overhead and takes away from the operational work of the organization,” Katherine Matson, manager of major gifts at the nonprofit Hôpital Albert Schweitzer, told Devex after the summit. “[Monitoring and evaluation] is really important but much of the work is not funded so it can be a challenge,” she added. To a loud applause, Tran Doan, community outreach manager at HAS Haiti, said many contractors worry they might need to turn down grants that fund their work because they cannot afford to fulfill overbearing data reporting requirements. Results-based financing will hopefully make the data reporting process less onerous, said Susanna Baker, deputy health office chief at USAID Haiti, who noted that the agency likewise struggles with the amount of data it needs to report. Under the new approach, indicators will number just 17 instead of the current more than 140 that exists in other programs. Data isn’t just a requirement, Baker added, but is required to make good decisions. USAID and the World Bank are also helping the Haitian government streamline supply chains and health information systems to make them less fragmented. “USAID follows the ministry’s priorities, and it wants a national supply chain and national platform,” Baker said. USAID is combining several programs relating to supply chains into one system, and is in the process of building a central warehouse to house all donor commodities, Baker said. The Haitian health ministry recently endorsed dhis2, a USAID-proposed health information platform into which all donors can report to be used for decision-making. Community workers will also switch to handheld devices to report data that goes into the national platform, Baker said. The World Bank is working on bringing a results-based financing database into this platform, Baker said. Donors need to focus more on local capacity and holistic approaches to health finance since it was previously “largely provided on emergency basis in Haiti,” Sunil Rajkumar, senior economist for health at the World Bank, said at the summit. “The U.S. government is considering government-to-government financing and the World Bank approves,” he said, since it has seen to be effective elsewhere so long as there is effective third-party verification and reported results. Donors have been historically resistant to direct financing of governments and their institutions due to fear of corruption, and instead rely on a cadre of nongovernmental organizations and for-profit contractors that have their own efficiencies, Jake Johnson, international research associate at the Center for Economic and Policy Research, told Devex at the summit. “Results-based financing is fine, but it fails to address the underlying issue, which is a lack of resources,” he said, adding that the name sounds “ridiculous.” He quipped: “What was it before? Did we previously give money with no expectations of result?” Will results-based financing reduce waste in Haiti health spending? Share your views by leaving a comment below. Read more international development news online, and subscribe to The Development Newswire to receive the latest from the world’s leading donors and decision-makers — emailed to you FREE every business day.