In Mozambique the IHP+ is not a priority: the SWAp structure and mechanisms matter more to the government and the partners. That is what I was told during my interviews with IHP+ signatories in Mozambique over the last few weeks. However, the IHP+ is considered to have reinforced the commitments already made through the SWAp and the Memorandum of Understanding.

What key issues were raised during my interviews?

The IHP+ provoked different reactions from the different interviewees:

• Government interviewees emphasized better priority setting, identification of funding gaps and the presentation of a three year prospective costed plan as the activities they had designed to fulfill their IHP+ commitments.

• More aligned partners acknowledged such progress as a result of matured and functional SWAp mechanisms but pointed to the difficulties in absorption of funds, mostly delays due to frailties in the procurement system.

• Human resources has recently become an important topic on the SWAp agenda. The Human Resources National Development Plan for the sector has been well accepted and funding is being made available to implement its operational plans. But it takes time to put into effect.

Government representatives acknowledged constraints on the absorption of funds and the negative consequences for districts most in need. Under the new financial management law unused funds cannot be transferred to the next budget so planning requires careful specification of activities for that financial year. Some believe that a project approach would allow more flexibility (particularly if implemented over more than one financial year), keeping the sequence of activities and funding release closer to what is needed for smooth implementation.

What is the future for health sector funding in Mozambique?

Prospects for future funding are mixed. Some interviewees referred to uncertainty over funds for coming years, others stated they were no longer funding health sector activities, and others had created a deadline to end funding. However, other donors were increasing funding or committing funds for multilateral funding of cooperation programs signed with the government.

Apparently in 2009 there has been a decrease in funds available for the health sector through mechanisms promoted by the IHP+. It is difficult to say how it may have affected health sector funding overall. There are major funders in the health sector that are not signatories of the IHP+. It is important to look in the future at what will be the consequences of some IHP+ signatories stopping direct funding to the health sector.

Where next for cooperation in the Health Sector in Mozambique?

The IHP+ data collection questionnaire asks questions related to HIV/AIDS funding. In Mozambique, HIV/AIDS funds are managed by CNCS (Mozambique’s National AIDS Council) - yet the IHP+ compact does not include CNCS. IHP/SWAp partners mentioned slow uptake of funds available for HIV/AIDS and hoped PEN III (Mozambique’s National AIDS Plan) would improve the situation, but I did not go to CNCS and so I cannot comment on this either way. If you have any further information please leave a comment below, we would love to hear your thoughts.  You can find details of Mozambique's HIV/AIDS planning see here)

On a more positive note, the cooperation program led by the World Bank may indicate new ways of passing aid to the health sector. This project aims to strengthen establishment and capacity in the three northern provinces in the country and is co-financed by several donor agencies. The five-year program is ‘on plan’ and ‘on budget’ (according to the Treasury), with disbursement adjustable in case capacity to absorb funds increases. World Bank procurement requirements are more stringent than national standards, bringing the program procurement requirements up to international standards. The government coordinates partner interactions but this role, if minimized, would allow the government to concentrate on implementation, the weakest link so far in the planning cycle.

Do you have any experience in this area? Do you have any comments or feedback? Then please sign up to leave a comment – I look forward to hearing your views.

Cesar Sousa is the IHP+Results Country Researcher in Mozambique