Evaluating Niger’s Health Common Fund: Insights from AFD

Established in 2006, Niger’s Health Common Fund has mobilized 91 million euros to strengthen the country’s health policies. A recent evaluation by the French Development Agency (AFD) highlights the fund’s effectiveness and identifies key areas for improvement to enhance its impact on public health outcomes.

Niger’s healthcare challenges and the role of the Health Common Fund

In Niger, the healthcare sector has long grappled with structural underfunding, prompting the Ministry of Public Health to establish a multi-donor trust fund in 2006. Initially supported by the French Development Agency (AFD) and the World Bank, the fund now includes six major donors and has channelled 91 million euros between 2015 and 2019.

The fund’s primary goal is to improve the health of Niger’s population, with a particular focus on women and children, by aligning with the country’s Health Development Plan (PDS). By consolidating resources from international partners, it aims to bolster the government’s capacity to deliver healthcare services nationwide.

Key findings from the AFD evaluation

Strengths and achievements

The AFD’s participatory evaluation revealed several notable strengths of the Health Common Fund:

• Enhanced relevance over time: The fund has adapted its management approach to accommodate partner preferences while maintaining alignment with national health priorities.
• Improved coordination: It has fostered strategic dialogue between the Ministry of Health and its partners, though further collaboration among donors is needed.
• Efficient management: The fund is praised for its transparent and effective financial management, evidenced by a threefold increase in budgets during 2018-2019 compared to previous years.
• Reliable funding source: It serves as the sole predictable funding mechanism for regional health authorities, enabling them to finance annual activity plans.

Opportunities for improvement

Despite these successes, the evaluation identified critical gaps that require attention:

• Limited monitoring and evaluation: Weaknesses in tracking funding, project implementation, and outcomes hinder the ability to measure the effectiveness of targeted interventions.
• Planning challenges: The Health Development Plan’s top-down approach and inadequate monitoring-evaluation systems have been repeatedly flagged as areas needing reform.

Dr. Abaché Ranaou, Secretary General of the Ministry of Public Health and Strategic Coordinator of the Health Common Fund, emphasized the fund’s achievements and the need for continued collaboration:

« The Health Common Fund was created in 2005 to align partner actions with national priorities, harmonize interventions, and ensure the predictability of international aid. The AFD-led evaluation confirms its positive impact, reinforcing confidence in the Ministry of Health and encouraging further partner engagement. While the fund has delivered tangible results, we must prioritize improvements in communication, programmatic aspects, monitoring, and evaluation to enhance visibility and showcase the value of our collective efforts. »

Next steps for the Health Common Fund

The evaluation underscores the need for targeted adjustments to maximize the fund’s potential. Strengthening monitoring and evaluation, improving communication, and refining programmatic approaches will be essential to ensure the fund continues to drive meaningful health outcomes for Niger’s population.