In Niger, a nation grappling with structural underfunding in its healthcare sector, the Health Common Fund was launched in 2006. Initiated by the Ministry of Public Health with initial support from AFD and the World Bank, the fund now includes six major donors and has successfully mobilized €91 million between 2015 and 2019.

This collaborative financing mechanism aims to enhance the health outcomes for Niger’s population, particularly women and children, by reinforcing the implementation of the National Health Development Plan (PDS). By consolidating resources from various partners, the fund seeks to bolster the government’s capacity to deliver healthcare services nationwide.

Participatory evaluation approach

The evaluation of the fund’s operations and impact employed a participatory methodology, engaging central and decentralized ministry officials alongside all partner organizations. Insights from this assessment directly informed the design of AFD’s fourth phase of support for the fund.

The evaluation revealed that the fund’s relevance has grown over time. It has adapted its management approaches to accommodate partners’ preferences for targeting specific PDS activities while adhering to aid alignment principles. Additionally, the fund has strengthened strategic dialogue between the ministry and its partners, though coordination among partners still requires improvement.

Tripled budgets and efficient management

Another notable achievement is the fund’s efficiency, with its financial management quality earning high praise. This is evidenced by the tripling of budgets in 2018-2019 compared to previous periods. The fund has implemented clear, universally accepted procedures and significantly enhanced the Ministry of Health’s management capabilities. It stands as a reliable and predictable partner for regional health departments, enabling them to fund their annual activity plans.

The evaluation identified critical gaps in tracking funding, achievements, and outcomes, which hinder the measurement of targeted actions’ effectiveness. More broadly, it underscores recurring concerns about the top-down nature of PDS planning and the weak quality of its monitoring and evaluation framework.

Emphasizing results and visibility

Dr. Abaché Ranaou, Secretary-General of the Ministry of Public Health and Strategic Coordinator of the Health Common Fund, shares his perspective:

“To ensure coordinated implementation of successive National Health Development Plans aimed at enhancing the social well-being of the Nigerien population, the Ministry of Public Health, in collaboration with technical and financial partners in the sector, established a donor common fund in 2005, operational since 2006. This initiative aims to align partner actions with national priorities, harmonize their interventions, and ensure the predictability and stability of international aid.”

The fund’s evaluation, led by AFD, has yielded overwhelmingly positive results. These findings bolster partners’ confidence in the Ministry of Public Health and encourage further adherence to the fund—a source of national pride benefiting the people.”

While the evaluation highlights tangible results, it also identifies areas for improvement. The Health Common Fund requires further adjustments, particularly in communication, programmatic aspects, monitoring, and evaluation. To persuade technical and financial partners and other stakeholders, it is crucial to emphasize the visibility of actions and highlight the results achieved relative to the resources mobilized.”

→ Explore further insights in AFD’s online evaluation report for Africa