72128 v1 rev In Sweet Harmony? A Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Phase 1 of a Joint Learning Initiative In Sweet Harmony? A Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Phase 1 of a Joint Learning Initiative Main Report May 3, 2012 by Denise Vaillancourt The World Bank Contents Preface............................................................................................................................................................................................ v Acknowledgements....................................................................................................................................................................vii Abbreviations and Acronyms.....................................................................................................................................................ix Executive Summary....................................................................................................................................................................xi CHAPTER 1  Objectives, Methodology and Regional Context......................................................................................... 1 1.1 Objectives............................................................................................................................................................................... 1 1.2 Conceptual Framework and Methodology........................................................................................................................ 2 1.3 Scope, Evidence Base, and Limitations............................................................................................................................... 4 1.3.1 Scope........................................................................................................................................................................ 4 1.3.2  Evidence Base and Limitations.............................................................................................................................. 4 1.4  Background and Regional Context..................................................................................................................................... 5 1.5  Report Organization............................................................................................................................................................. 6 CHAPTER 2  Are the Anticipated Benefits of the Approach Being Realized?............................................................... 7 2.1 Program Objectives and Design: An Important Caveat for Assessing Success...................................................................................................................... 7 2.2 Improved Sector Management and Coordination............................................................................................................ 8 2.3 Harmonization and Alignment of Development Assistance........................................................................................... 9 2.4  Enhanced Sector Stewardship...........................................................................................................................................10 CHAPTER 3  Are the Objectives of National Sector Programs Likely to be Achieved?............................................. 13 3.1 Samoa Second Education Sector Programme (ESP II)..................................................................................................13 3.2  Samoa Health Sector Program..........................................................................................................................................14 3.3 Solomon Islands Health Sector Support Program (HSSP)............................................................................................14 3.4 Vanuatu Education Road Map (VERM)..........................................................................................................................15 CHAPTER 4  How is the Approach Affecting Sector Program Results?....................................................................... 17 Quality and Relevance of the Strategic Sector Framework...........................................................................................17 4.1  Strength of Country Capacity and Incentives.................................................................................................................19 4.2  Quality and Functionality of the Partnership.................................................................................................................21 4.3  4.3.1  Who is in the partnership?................................................................................................................................... 21 4.3.2  To do what?........................................................................................................................................................... 23 iii 4.3.3  How do they interact?........................................................................................................................................... 24 4.3.4 Do Development Partners have the requisite capacity?...................................................................................... 24 Predictability, Flow and Use of Sector Resources...........................................................................................................24 4.4  CHAPTER 5  How is the Approach Affecting the Efficacy of the Development Partners?...................................... 27 CHAPTER 6  Findings, Counterfactual, Lessons, and Their Relevance to Global Experience................................. 29 6.1 Findings................................................................................................................................................................................29 6.2 Counterfactual.....................................................................................................................................................................30 6.3 Lessons for Improving Performance Under a SWAp.....................................................................................................30 6.3.1  Results Focus......................................................................................................................................................... 32 6.3.2  National Capacity Building.................................................................................................................................. 32 6.3.3 Development Partners’ Effectiveness and Capacity under a SWAp.................................................................... 33 6.4 Relevance of South Pacific Findings and Lessons to the Global Experience..............................................................34 6.5  Additional SWAp Guidance...............................................................................................................................................34 CHAPTER 7  Information Gaps and an Agenda for Fieldwork...................................................................................... 37 Annex 1.  Background and Regional Context........................................................................................................................41 Annex 2.  General Timeline of Initiatives to Improve Aid Effectiveness............................................................................47 Annex 3. Matrix of Pacific Island Countries and Donors Attending/Signing Declarations of International Conferences Calling for Aid Effectiveness...............................................................................53 Annex 4.  Country Governance Briefs....................................................................................................................................57 Annex 5.  Sectorwide Program Objectives and Design.........................................................................................................71 Annex 6.  Checklists, Guidelines, Good Practices under a SWAp.......................................................................................75 Bibliography................................................................................................................................................................................79 Figures Figure 1-1: SWAp Conceptual Framework: Linking Anticipated SWAp Benefits to Sector Results................................. 3 Tables Table 1-1: Health and Education SWAps in Samoa, Solomon Islands, Tonga and Vanuatu............................................... 5 Table 2-1: Relationship Between National Strategic Plans and Programs Supported by SWAps...................................... 8 Table 2-2: Development and Use of SWAp Tools for Improved Sector Management......................................................... 9 Table 2-3: Progress in Harmonizing and Aligning Development Assistance....................................................................... 9 Table 2-4: Achievement of Enhanced Sector Stewardship....................................................................................................10 Table 4-1: Signatories and Nonsignatories to Partnership Arrangements..........................................................................22 Table 4-2: SWAp Program Steering Committee Membership..............................................................................................22 Table 4-3: Coordinating Development Partner for Social Sector SWAps...........................................................................24 Table 6-1: Relevance, Efficacy, Efficiency and Sustainability of SWAps Reviewed to Date...............................................31 Table 6-2: Relevance of South Pacific Findings and Lessons to the Global Experience...................................................34 Table 7-1: Unfinished Agenda of the Desk Review and the Proposed Focus of Fieldwork..............................................38 iv // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Preface This desk study was conceived as the first phase of a DPs’ technical and financial contributions under a three-phase review of aid effectiveness efforts, largely SWAp, individually and collectively. This desk study channeled through Sectorwide Approaches (SWAps) in pulls together preliminary information and lessons the health and education sectors in selected islands in through a selective review of relevant aid effectiveness the Pacific Region. It is based heavily on in-depth desk and SWAp documentation and limited interviews and analyses of three ongoing SWAps: Samoa Education consultations, undertaken in 2010 and early 2011. Key Sector; Samoa Health Sector; and Solomon Islands studies issued late in 2011 are acknowledged in foot- Health Sector. Full reports on each of these SWAps are notes but not incorporated into this study’s analysis available as appendixes to this study in a CD attached to which was carried out in early 2011. This desk study also the back cover. This desk study also draws on prelimi- proposes a design for a possible second phase of the Re- nary information gathered on Vanuatu’s early efforts to view: fieldwork, to be undertaken jointly with Pacific Is- establish SWAps for health and education. While in- land governments, with a view to validating and depth assessments of education sector SWAps in Solo- fine-tuning preliminary findings and conclusions, filling mon Islands and Tonga were also originally envisaged information gaps, and deepening the analysis. A third as part of this study, these two assessments were ulti- phase of cross-country learning and exchange was also mately cancelled due to time and budget constraints. envisaged. Jointly designed and produced by four development partners (DPs) supporting SWAps in the Pacific Region,1 the Review is conceived as a learning initiative that 1 Asian Development Bank (ADB), Australian Agency for In- would distill lessons of experience to date and point to ternational Development (AusAID), New Zealand’s Ministry ways of enhancing the coordination and effectiveness of of Foreign Affairs and Trade (MFAT) and The World Bank. v Acknowledgements This study was undertaken jointly by the Asian Develop- The author acknowledges the technical support ment Bank (ADB), the Australian Agency for Interna- provided by Steven Pollard, ADB, on the analysis and in- tional Development (AusAID), the New Zealand tegration of governance issues, particularly: (1) provid- Ministry of Foreign Affairs and Trade (NZ-MFAT) and ing the author with relevant resource material; and the World Bank. The World Bank coordinated and led (2) commissioning a synthesis of governance issues for the review upon the request of the other three agencies. each of the four Pacific Islands, presented in Annex 4, The report was written by Denise Vaillancourt, un- authored by Paul Wooster, ADB Consultant. der the task leadership of Aparnaa Somanathan (World Interviews with the following World Bank staff Bank). Philip O’Keefe, Stephen Close, Susan Ivatts and brought important perspectives and content to the study, Michelle Lee were members of the core World Bank for which the author is grateful: Aparnaa Somanathan, team. The work was carried out under the supervision of Eduardo Velez Bustillo, Hope Phillips Volker, James Ste- Ferid Belhaj (Country Director, Papua New Guinea, phens, Juan Pablo Uribe, Piers Merrick, Jane Distelhorst Timor-Leste and Pacific Islands), Emmanuel Jimenez Sansbury, Philip O’Keefe, and Susan Ivatts. The author (Director, East Asia and Pacific Human Development also gratefully acknowledges the contributions of others Sector), Juan Pablo Uribe (Sector Manager, Health, Nu- interviewed: Chris Chamberlain, Independent Consul- trition and Population for East Asia and Pacific) and Ed- tant, Ian Morris, Independent Consultant, Muhammad uardo Velez Bustillo (Sector Manager, Education for East Pate, Executive Director of Nigeria’s National Primary Asia and Pacific). Arvil Van Adams (Consultant) con- Healthcare Development Agency, and Joel Negin, Senior tributed significantly to the design of the study’s concep- Lecturer and Research Fellow, International Public tual framework. Shampa Sinha (Consultant) provided Health, University of Sydney. support to the initial stages of the study. The World Bank’s internal review process benefitted ADB, AusAID and NZ-MFAT provided close from the technical contributions of peer reviewers: Tim- oversight of concept design and production of the re- othy Johnston, Toomas Palu, and Nicole Klingen. port under the leadership of (respectively): Steven Pol- The author is grateful to A. Juliana Williams, Opera- lard with Sakiko Tanaka and Paul Wooster at the ADB; tions Assistant, who graciously facilitated the conduct of Debbie Bowman with Beth Slatyer and Jerry Strudwick this study, Chandra Chakravarthi, Program Assistant, at AusAID; and Andrew Kibblewhite NZ-MFAT. whose assistance on formatting and desktop publishing Through four teleconferences this group provided in- was both timely and efficient, and Christopher Stewart, valuable guidance and feedback on the Concept Note who edited the report. Gratitude is also extended to the as well as early drafts of this study, and approved the fi- World Bank’s Health, Population and Nutrition Network nal draft in a fifth teleconference which took place in for supporting the costs of finalizing and publishing this February 2011. study. The Pacific Facility Trust Fund and IHP+ also provided funding for this study vii Abbreviations and Acronyms ACEO Assistant Chief Executive Officer JRM Joint Review Mission ADB Asian Development Bank M&E Monitoring and evaluation ADF Asian Development Fund MCH Maternal and child health AFD Agence Française de Développement MDG Millennium Development Goals (French Development Agency) MESC Ministry of Education, Sports and AusAID Australian Agency for International Culture Development MFAT New Zealand Ministry of Foreign Affairs CCA Controller and Chief Auditor and Trade CDP Coordinating Development Partner MFEM Ministry of Finance and Economic CEC Constitutional and Electoral Commission Management CEDAW Convention on the Elimination of All MHMS Ministry of Health and Medical Services Forms of Discrimination against Women MMR Maternal Mortality Rate CPR Contraceptive Prevalence Rate MoF Ministry of Finance DAC Development Assistance Committee MoH Ministry of Health DHS Demographic and Health Survey MoU Memorandum of Understanding DP Development Partner MTEF Medium-term Expenditure Framework EC European Commission MTR Mid-term review ESP Education Sector Programme NCD Noncommunicable disease EU European Union NGO Nongovernmental Organization GFATM Global Fund to Fight AIDS, Tuberculosis NHS National Health Service and Malaria NHSP National Health Strategic Plan GoF Government of France NSPF National Strategic Planning Framework GoJ Government of Japan NZAID New Zealand Agency for International GoS Government of Samoa Development HQ Headquarters OAG Office of the Auditor General HSSP Health Sector Support Program ODA Overseas Development Assistance IBRD International Bank for Reconstruction OECD Organisation for Economic Co-operation and Development and Development IDA International Development Association PAC Public Accounts Committee IEG Independent Evaluation Group PAYE Pay-As-You-Earn IMR Infant Mortality Rate PEFA Public Expenditure and Financial JICA Japan International Cooperation Agency Accountability JPA Joint Partnership Arrangement PFM Public Financial Management ix PHF Partner Harmonization Framework ToR Terms of Reference PIs Pacific Islands UNDP United Nations Development Programme PoW Program of Work UNESCAP United Nations Economic and Social RAMSI Regional Assistance Mission to the Commission for Asia and the Pacific Solomon Islands UNESCO United Nations Educational, Scientific SCU SWAp Coordination Unit and Cultural Organization SDS Strategy for the Development of Samoa UNFPA United Nations Population Fund SIG Solomon Islands Government UNICEF United Nations Children’s Fund SIP Sector Investment Program UNIFEM United Nations Development Fund for SOE State-owned Enterprise Women (now UN Women) SPA Special Purpose Account UNTA United Nations Technical Assistance SPC Secretariat of the Pacific Community VANGO Vanuatu Association of NGOs SUNGO Samoa Umbrella for Nongovernmental VERM Vanuatu Education Road Map Organizations WBAGI World Bank Aggregate Governance SWAP Sectorwide approach Indicators TA Technical Assistance WBDBR World Bank Doing Business Report TB Tuberculosis WHO World Health Organization TFR Total Fertility Rate x // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Executive Summary O ver the past decade governments and major development partners (DPs) in the Pacific Region have striven to improve aid effectiveness and development outcomes through the adoption of Sectorwide Approaches (SWAps) in the health and education sectors, as in other regions around the world. Notwithstanding a wide variety of SWAp definitions and interpretations, the literature is consistent in characterizing SWAps as an evolving partnership between governments, other national actors and DPs, coalescing around their joint support of nationally-defined programs, managed and implemented through increased reliance on country systems and capacities, with a strong results focus. These characteristics are consistent with aid effectiveness principles and good practices, which have emerged over the past decade or more, and to which most developing countries and DPs have committed. This desk study distills evidence from a document re- system management, quality and coverage of services, view of selected health and education SWAps ongoing in and sector outcomes. Pacific Island countries to address four questions: (i) are The Concept Note for this analysis, agreed by the the anticipated benefits of the approach being realized; four DPs which jointly produced this study,2 envisaged (ii) are the objectives of national sector programs likely the pursuit of these questions through three phases of to be achieved; (iii) how is the approach affecting sector work: (i) this present desk study; (ii) joint fieldwork with program results; and (iv) how is the approach affecting country involvement to fill information gaps and vali- the efficacy of the DPs. The conceptual framework and date/revise findings; and (iii) cross-country learning and the study questions distinguish between two types of dissemination events. This desk study has distilled the outcomes anticipated from aid effectiveness efforts un- following answers to the study questions. der SWAps, which are often confused in design docu- ments. These are: (i) the achievement of the capacity and efficiency gains anticipated from the approach itself, in terms of improved sector coordination, better harmoni- 2 Australian Agency for International Development (AusAID), zation and alignment of development assistance, and en- the New Zealand Ministry of Foreign Affairs and Trade hanced sector stewardship; and (ii) the achievement of (MFAT), the Asian Development Bank (ADB) and The World national sector program objectives, in terms of improved Bank. xi Are the anticipated benefits of the were undertaken in 2011 and relevant reports were is- approach being realized? sued only in late 2011—too late to be incorporated into this report. Some baselines and targets for these two With the exception of Samoa Health, aid effective- health SWAps were still missing or in need of revision at ness objectives and indicators under the SWAps are the writing of this report. Proactive monitoring and more implicit than explicit, making it challenging evaluation of the Vanuatu Education SWAp, just one both to define and to measure success. Even the pur- year into its implementation, and operations research pose of the approach, what it entails and guiding prin- have identified ways and means of enhancing program ciples are not fully coherent/consistent in design efficiency and results. This bodes well for the achieve- documents, causing confusion among stakeholders, ment of program goals in Vanuatu. even within the same SWAp. Anticipated benefits of the SWAps reviewed have been partially achieved to date. All SWAps developed How is the approach affecting the and used most of the key tools for improved sector man- achievement of sector program results? agement and coordination (national strategic plans, pro- grams, planning and review processes, medium-term The analysis of country experience has pointed to fac- expenditure frameworks, and the like). Some headway tors under the SWAps that may have undermined has been made in improving the harmonization and their ability to achieve national sector objectives, es- alignment of development assistance under the SWAps, pecially in the initial years. A learning-by-doing pro- especially regarding the strengthening and use of coun- cess is ongoing, and this study’s findings point to the try systems for procurement and financial management. opportunity for further improvements: Little progress has been registered to date, however, un- der these ongoing SWAps on enhancing sector steward- • First, strategic sector frameworks have exhibited ship, especially with regard to efficient use of sector some weaknesses on a number of fronts. These in- resources, greater focus on results, and strengthened ac- clude: (i) their overly ambitious nature; (ii) incom- countabilities for results. plete information on their costs and financing; (iii) uncertainty about their cost-effectiveness; (iv) their unclear sense of prioritization and phas- Are the objectives of national sector ing; and (v) an inadequate results focus. programs likely to be achieved? • Second, the use of country capacity and systems are slowly building capacity through a learning-by-do- There is uncertainty about whether sector perfor- ing process. This has, however, caused implementa- mance and outcome objectives will be achieved under tion delays due to slow procurement, and slow ongoing SWAps by the end of their program periods. replenishment of funds due to shortcomings of All SWAp-supported programs reviewed to date were some SWAps in financial management and absorp- still under implementation in 2010–11 (at the time of tive capacity. Inadequate attention to monitoring data collection and analysis), with most at, or slightly and evaluation (M&E) capacity has caused delays in past, their implementation midpoint (most are five-year the production of M&E frameworks, results chains programs). Only the Samoa Education SWAp had con- and in the assessment and strengthening of in- ducted a mid-term review (MTR) at the time of this country capacity. The planning, management and study’s data collection and analysis phase. It concluded effective utilization of technical assistance (TA) also that not all program objectives are likely to be achieved suffers from weak country capacity. by the end of the program period due to implementation • Third, stronger sector partnerships have formed delays and an overly ambitious program. Nevertheless, under SWAps, but they are exclusive of some critical many benchmarks have been/are being achieved. MTRs players (public, nongovernmental and civil society for the health SWAps in Samoa and Solomon Islands actors). There are opportunities to further analyze xii // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific and improve interaction among all DPs and their stronger demand for, learning through operations re- capacities to better support governments under a search and evaluation; and identifying opportuni- SWAp process. ties for ministries to evolve their management • Fourth, overall sector financing is not sufficiently structures and incentives to manage for results. predictable and flow of funds to implementing • Strengthening national capacities by: (i) systemati- agencies and their effective use are not well docu- cally assessing capacities against capacity needs and mented. developing holistic results-based approaches to ca- pacity strengthening that would include a range of in- terventions; (ii) strengthening procurement capacity How is the approach affecting the and facilitating a consensus and decisions on the efficacy of the Development Partners? evolution towards exclusive use of national procure- ment procedures; (iii) recognizing and addressing There is a need for further exploration of the business training/experience gaps of highly qualified, well- models of the DPs supporting the SWAps (the four trained experts in the management exigencies of a which jointly produced this study) to assess the extent SWAp, including interacting effectively with DPs; to which they are efficient and effective in meeting the (iv) reducing the ambition of the SWAps to calibrate needs and demands of countries implementing objectives with available capacity while capacity is SWAps. This was not possible to assess in the context of being built, and sequencing of the use of country this desk study, but evidence suggests that there is room systems (M&E, a priority); and (v) documenting for improvement. and exploiting more fully the capacities and potential roles of civil society for service delivery and M&E. • Strengthening the capacities, accountabilities and Lessons for Improving Performance and business models of the DPs to better meet the needs Outcomes under a SWAp of countries implementing SWAps. While these les- sons are directed at what DPs might do to improve Pacific Island countries and DPs have established many their effectiveness and capacity, an overarching important building blocks for enhancing aid effective- lesson is the important role of government in hold- ness through the design and implementation of social- ing DPs accountable to mutually agreed perfor- sector SWAps. In addition, they are acquiring experience mance standards. DPs’ efforts might include: and building their capacities in sector management and (i) strengthening their own capacities to effectively implementation through a learning-by-doing process. participate in a SWAp; (ii) ensuring that they are But weaknesses in SWAp design and implementation more strategic in their contributions to joint re- may have slowed or undermined the achievement of views, rather than focusing too heavily on inputs sector results. Lessons point to three strategic areas that and the details of implementation; (iii) encourag- have the potential to improve the effectiveness of social ing the inclusion of all DPs in joint missions, plan- sector SWAps in the South Pacific, and where countries, ning and review meetings–not just those who with the full support of DPs, might focus their efforts: signed joint arrangements; (iv) reviewing their re- spective business models and how well they re- • Strengthening the focus on results by: clearly artic- spond to the demands and needs of a SWAp; ulating SWAp-specific objectives and indicators, dis- (v) harmonizing their visions and approaches to tinct from, but linked to, sector-specific program the SWAp to present a united and supportive front objectives and indicators; providing assistance to to governments; and (vi) striking equilibrium in improve the results frameworks; encouraging the their dialogue with governments, ensuring rigor generation and use of evidence to identify and sup- and candor on technical and strategic issues, and, at port the most cost-effective, highest-impact interven- the same time, a respect of government sovereignty tions; stimulating a greater appreciation of, and a and leadership. Executive Summary // xiii As documented in various studies, the global SWAp SWAp that are specific to the Pacific Islands. Among experience and lessons appear to be very relevant to the these are: (i) the very small size of ministry staff vis-à-vis Pacific Islands SWAps reviewed, both in terms of prog- the heavy workload of SWAps; (ii) the challenges of ress in implementation and outcomes, as well as the four managing an especially large volume of TA; (iii) the rel- factors of SWAps that can have an impact on the achieve- atively smaller pool of DPs involved and the very prom- ment of outcomes. These include: (i) quality and rele- inent role played by one or two bilateral DPs; and (iv) the vance of the sector strategic framework; (ii) the strength existence of regional partnerships, structures and pro- of country capacity and incentives; (iii) the quality and grams supporting social sector development. This desk functionality of the partnerships; and (iv) the predict- study notes the limitations of its evidence base and sets ability, flow and use of assistance. the agenda for fieldwork which would collect, analyze This study has also identified that there are addi- and triangulate additional evidence—both to fill infor- tional considerations and challenges for implementing a mation gaps and to validate/refine findings and lessons. xiv // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific CHAPTER 1 Objectives, Methodology and Regional Context O ver the past decade governments and major development partners (DPs) in the Pacific Region have striven to improve aid effectiveness and development outcomes through the adoption of SWAps in the health and education sectors. While there are a wide variety of SWAp definitions, and their implementation differs across countries and sectors, the literature is consistent in characterizing SWAps as an evolving partnership between governments, other national actors and DPs, coalescing around their joint support of nationally-defined programs, managed and implemented through increased reliance on country systems and capacities, with a strong results focus (Vaillancourt, 2009). These characteristics are consistent with aid effectiveness principles and good practice, which have emerged over the past decade or more, and to which most developing countries and DPs have committed. 1.1 Objectives better understand the organizational and operation- al challenges faced by both governments and DPs;4 Four key development partners operating in the Pacific (ii) to examine how the design and implementation of Region3 decided in 2009 to launch a joint learning initia- aid effectiveness efforts (particularly under SWAps) tive to be undertaken in collaboration with four Pacific in the Pacific Region might differ from those else- Region governments: Samoa, Solomon Islands, Tonga, where and the extent to which global lessons are rel- and Vanuatu. The intention was to document lessons evant and applicable; and and experience to date in the design and implementa- tion of SWAps, in an effort to improve their individual 3 Australian Agency for International Development (AusAID), and collective effectiveness. the New Zealand Ministry of Foreign Affairs and Trade A jointly agreed Concept Note for a Review of SWAps (MFAT), the Asian Development Bank (ADB) and The World in the Pacific Region identified three key objectives: Bank. 4 This will include an examination of how DPs are currently working together and how they might enhance their effective- (i) to examine the extent to which SWAps in the Pacific ness, especially given the limited public sector management Region have achieved their intended results and capacity. 1 (iii) to provide practical guidance on the design, imple- in six countries (Vaillancourt, 2009). The use of these mentation, monitoring and evaluation (M&E) of tools for this Pacific Region Review is beneficial from two SWAps in the Pacific Region, including recommen- perspectives: (i) they are relevant to the learning agenda dations about how DPs can work together more ef- for the PIs; and (ii) their application already in six other fectively. countries in the world should facilitate the fleshing out of distinctions between the SWAp experience in the partic- The Concept Note envisaged the pursuit of these ob- ular context of the Pacific Region and experience else- jectives through three phases of work: a desk study, field- where, thus fulfilling another objective of this Review. work and learning and dissemination events. First, this The conceptual framework and the study questions desk study selectively reviews and distills relevant docu- distinguish between two types of outcomes often con- mentation on health and education SWAps in the Pacific fused in design documents: the achievement of the capac- Region, particularly in four Pacific Island (PI) countries. ity and efficiency gains anticipated from the approach It also identifies information gaps and proposes a design itself, in terms of improved sector coordination, better for fieldwork. Second, fieldwork in the four countries, to harmonization and alignment of development assis- be undertaken in collaboration with experts and author- tance, and enhanced sector stewardship (top panel of ities in those countries, was envisaged to be carried out to Figure 1-1);5 and the achievement of national sector pro- validate the preliminary findings and conclusions of the gram objectives, in terms of improved system manage- desk study, fill information gaps and deepen analysis ment, quality and coverage of services, and sector through additional data collection and analysis, inter- outcomes (bottom panel).6 views, direct observations, and discussions. Third, learn- Recognizing that the benefits of the approach alone ing and dissemination events, undertaken in partnership may not necessarily result in the achievement of nation- with all country governments and DPs involved in the re- al sector objectives, the conceptual framework posits view, were intended to provide the opportunity for cross- four factors that affect the ability of aid effectiveness ef- sectoral and cross-country learning and exchange. forts under SWAps to contribute to better sector out- comes (middle panel, Figure 1-1): • As laid out in the Concept Note, each of the three phases of the Review would seek to address four • the quality and relevance of the sector strategic questions: framework; • Are the anticipated benefits of the aid effectiveness • the strength of country capacity and incentives; efforts under the SWAp (the approach) being real- • the quality and functionality of the partnerships be- ized? tween government and the DPs, and among the • Are the objectives of the national sector strategies DPs; and and programs of work (PoWs) likely to be achieved? • the predictability, flow and use of sector resources, • To what extent is the approach facilitating the both domestic and external.7 achievement of national sector objectives? • In what ways does channeling support through a 5 Notwithstanding the lack of clarity in definition, the litera- SWAp affect the efficacy of each DP? ture and design documents reveal that SWAp objectives and/or intended benefits are quite consistent across countries (Vail- lancourt, 2009). 6 These groupings of objectives are distilled from PoWs, poli- Conceptual Framework and 1.2  cies and strategies of the six countries originally assessed and those of the PI countries covered in this study, drawing on the Methodology original country documents and on project design documents. Program and project objectives were synthesized for each of The Review’s conceptual framework (Figure 1-1) and the the PI SWAps covered in this Study (Annex 4). 7 These factors were derived from the risk assessment and mit- four underlying questions (cited above, and articulated in igation measures articulated in design documents and further the Concept Note) are adapted from a World Bank Inde- distilled from the literature, exchanges with SWAp practitio- pendent Evaluation Group (IEG) study of health SWAps ners, and the experiences documented in IEG’s evaluations. 2 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Figure 1-1: SWAp Conceptual Framework: Linking Anticipated SWAp Benefits to Sector Results Anticipated Benefits of the SWAp Approach: Country Capacity and Efficiency Objectives Establishment of Better Tools for Sector Greater Harmonization and Alignment of Coordination Development Assistance Enhanced Sector Stewardship A medium-term PoW grounded in national A country-led partnership involving internation- The efficient use of domestic and external policy and strategy. al DPs and national actors and stakeholders, sector resources in support of nationally Medium-term projections of resource within which strategic and management issues defined policies, strategies and priorities. availability and expenditure plans. are negotiated, sector resources are allocated, Greater focus on results. and sector performance is reviewed. Structures and processes for negotiating Ability to define and track accountabilities for issues, allocating resources, and reviewing The use of country systems and capacities as sector performance and results. sector performance. the common management and implementation arrangements. A plan for developing country systems and capacities for common implementation Reduced transaction costs. arrangements. The Link between the Approach and Better Sector Outcomes Quality and relevance of the Sector Strategic Framework Predictability, Strength of flow and use Results country capacity of assistance and incentives Quality and functionality of the partnership National Sector Objectives Systems Strengthening/Reform Outputs Outcomes Impacts1 Procurement, supply, distribution, management of essential consumables. Equitable access to Equitable coverage Sustained Skills development, management, distribution, supervision, performance of quality services and and utilization of improvement and human resources. essential consum- quality, high-impact greater equity in: ables. interventions. • Child health Adequacy of infrastructure and maintenance. Improved Behavior change. • Maternal health Financing, cost sharing/risk pooling, cost recovery schemes, results-based awareness, financing. • Nutritional status knowledge, use of incentives for behav- • Fertility Enhanced use/oversight of the private sector. ior change. • Learning Institutional/organizational reform, including: separation of regulation/ outcomes oversight from service delivery; decentralization or deconcentration of programs and services; redefinition of roles, responsibilities; district capacity building; restructuring of service delivery and purchasing; participatory management; performance-based management. 1 A function of sector performance and other factors. Objectives, Methodology and Regional Context // 3 While the conceptual framework guides the organi- some sector-specific data, studies, surveys on health and zation and methodology of the analysis of SWAps, this education. It also includes a few, selective interviews and Review does not measure the performance of any or all consultations with DP teams involved in the design and SWAps against generic objectives or standards. An ob- implementation of these SWAps. jectives-based methodology is employed, whereby aid This limited evidence base for the desk study could effectiveness efforts under SWAps and sector develop- be supplemented under a possible phase 2 through the ment programs are assessed against the specific objec- conduct of site visits and interviews with a wide range tives and indicators set and agreed by the relevant of stakeholders—including government officials, health country and the DPs. Organisation for Economic Co- providers, field-based DPs and civil society—as well as operation and Development (OECD) evaluation criteria direct observation of SWAp processes and the collec- will guide the Review’s analysis of the relevance, efficacy, tion of additional data. This is essential to glean the per- efficiency and sustainability of specific SWAps.8 These spectives of all key in-country stakeholders on the issues criteria will be used to shed light in a systematic way on and challenges of SWAps and opportunities to improve the design and performance of SWAps and opportuni- their performance and development impact. Fieldwork ties to improve them, but no ratings will be assigned, would permit a triangulation of the findings and an given that this Review is a learning initiative. analysis of the consistency of these findings with a plau- sible results chain, linking the SWAp approach, the na- tional strategies, program outputs and results on the Scope, Evidence Base, and 1.3  ground. Limitations This phase 1 desk study represents an effort to distill documented evidence and provides a basis for the field- 1.3.1 Scope work design. It is, however, tentative at best in attempt- ing to answer the Review questions, draw conclusions, This study covers selected health and education SWAps in and distill lessons, given the limited evidence upon some PI countries (Table 1-1). Because it is the subject of a which it is based. Furthermore, the author of this desk separate review, the Papua New Guinea (PNG) Health study did not have occasion to observe or understand SWAp is not included in this Review. But the DPs produc- first-hand the dynamics of DP coordination, communi- ing this study anticipate its findings and lessons to be of rel- cation and dialogue, or the technical quality of dialogue evance to the experience to date in PNG, and have expressed their intention to consider and share these les- 8 The OECD’s Glossary of Key Terms in Evaluation and Results sons to the extent they might be helpful to ongoing efforts Based Management (reprinted 2010) apply. Relevance: the ex- in PNG. In-depth analyses of Samoa Education, Samoa tent to which the objectives of a development intervention are Health and Solomon Islands Health are available as appen- consistent with beneficiaries’ requirements, country needs, glob- al priorities and partners’ and donors’ policies. Retrospectively, dixes to this report and provide the evidence base for this the question of relevance often becomes a question as to wheth- report. The education sectors in Solomon Islands and Ton- er the objectives of an intervention or its design are still appro- ga were also originally slated for in-depth analysis, but sub- priate, given changed circumstances. For the purposes of this sequently deferred because of time and budget constraints. study relevance of design will also be assessed. This means the extent to which the design is appropriate to the country context and capacity. Efficacy (or effectiveness): the extent to which the 1.3.2  Evidence Base and Limitations development intervention’s objectives were achieved, or are ex- pected to be achieved, taking into account their relative impor- tance. Efficiency: a measure of how economically resources/ The evidence base for this desk study consists of key inputs (funds, expertise, and time) are converted into results. SWAp—and country/region—and sector-specific docu- For the purposes of this study, the efficiency of the institutional/ ments. This includes (i) selected documents from DP organizational aspects of program design and implementation working files; (ii) national plans, programs and selected will also be assessed. Sustainability: the continuation of benefits from a development intervention after major development as- reports; (iii) joint partnership documents (partnership sistance has been completed; the probability of long-term bene- agreements and mission reports); and (iv) fits and the resilience to risk of the net benefit flows over time. 4 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Table 1-1: Health and Education SWAps in Samoa, Solomon Islands, Tonga and Vanuatu DP Cosignatories of Joint Partnership Arrangements/Harmonization Frameworks World Other Country/Sector Program Timeframe ADB AusAID NZAID Bank UN Agencies SPC DPs Samoa Second Education Sector Programme (ESPII) x x x — — — — (2006–2013) Health Sector Program (2009–2013) — x x x UNFPA — — UNICEF WHO Solomon Islands Education — x x x UNICEF — GoJ EU Health Sector Support Program (HSSP) (2008–12) — x — x UNFPA x GoJ UNICEF (space, but not WHO signed) Tonga Education Support Programme — — x x — — — (2005–10) + (2010–2011) Health No health SWAp in place at this time Vanuatu Education Road Map (VERM) (2010–2012) — x x x UNESCO x AFD UNICEF EU GoF GoJ Peace Corps Health Three-year Corporate Plan (2011–2013) Three-year Corporate Plan and Joint Partnership Agreement under development Source: Signed partnership agreements under each SWAp. Note: AFD: Agence Française de Développement; EU: European Union; GoF: Government of France; GoJ: Government of Japan; SPC: Secretariat of the Pacific Community; UNESCO: United Nations Educational, Scientific and Cultural Organization; UNFPA: United Nations Fund for Population Activities; UNICEF: United Nations Children’s Fund; and WHO: World Health Organization. and policy/strategic advice–so essential to suggesting results achieved in health and education sectors since the improvements in their support. These qualities of DP 1970s and 1980s, there was growing concern by 2005 that support are not well or fully documented. the very generous financial support available to these sectors (provided by governments and DPs) was not 1.4  Background and Regional Context 9 Annex 1 provides detail on: (i) the issues and performance of the health and education sectors in the four Pacific Island coun- tries covered in this study, which have challenged these coun- The background and regional context presented in An- tries and their DPs to consider new ways of interacting to nex 1 provide an interesting baseline for this study, de- enhance social sector outcomes; (ii) the global and regional scribing the situation in Pacific Island countries in movements, which have emerged over the past decade or more, 2005–the time many social-sector SWAps were being de- advocating and guiding greater aid effectiveness; and (iii) the challenges of improving sector outcomes and of implementing signed and launched.9 First, notwithstanding impressive aid effectiveness principles in the Pacific Island context. Objectives, Methodology and Regional Context // 5 culminating in the expected effect on sector outcomes. 1.5  Report Organization Second, the aid effectiveness agenda emerging from the global movement held interest for Pacific Island coun- The report is organized around the four Review ques- tries and appeared to address some of the concerns about tions. Chapter 2 assesses the extent to which the expect- inefficiencies in resource use in the health and education ed benefits of the approach have been realized to date. sectors. This is evident in Pacific Island countries’ atten- Chapter 3 explores the extent to which the sector pro- dance at key global meetings and their signature of aid grams supported by the SWAp are achieving (or likely to effectiveness declarations and commitments. It is most achieve) their performance and outcome objectives. evident in the articulation and adoption of region-specif- Chapter 4 assesses the effect that aid effectiveness efforts ic aid effectiveness principles and commitments (Annex- under SWAps may have had on the achievement of sec- es 2 and 3).10 Third, over and above the challenges of their tor objectives. Chapter 5 provides preliminary insights small size, isolation, cultural context, and vulnerability to on the efficacy of the DPs’ support in a SWAp mode. natural disasters, Pacific Island countries included in this Chapter 6 distills findings and lessons and their rele- Review are highly dependent on external aid, a very sub- vance to experience elsewhere in the world, while Chap- stantial proportion of which is made up of bilateral aid ter 7 proposes an agenda for fieldwork to fill information (close to 100 percent of external aid for Solomon Islands, gaps, validate preliminary findings and recommenda- Tonga and Vanuatu, and two-thirds for Samoa). This bi- tions, and weave in the perspectives of the country and lateral aid is provided by one or two countries that share of field-based DPs. a very long political and economic history with the aid recipient. Finally, the governance structures and capaci- ties of each country shape the opportunities and con- 10Most notably: the Pacific Aid Effectiveness Principles, en- straints for successful SWAps. Governance briefs (Annex dorsed in 2007 and the Cairns Compact on Aid Effectiveness, 4) provide this context. adopted in 2009. 6 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific CHAPTER 2 Are the Anticipated Benefits of the Approach Being Realized? T his chapter assesses the extent to which the objectives or anticipated benefits of the aid effectiveness efforts under the SWAp (the approach) are being achieved. It provides a quick tally of performance against the anticipated benefits of a SWAp outlined in the top panel of the Review’s analytic framework (Figure 1-1). The effect of the approach on the achievement of sector results is analyzed in Chapter 4. Program Objectives and Design: 2.1  making it unclear what the aid effectiveness efforts An Important Caveat for Assessing are trying to achieve and how to define and measure Success11 success. It is important to note, however, that an in- depth analysis and interpretation of aid effective- Annex 5 documents the difficulty of assessing the extent ness efforts under each of the SWAps (carried out in to which the anticipated benefits of the approach are be- the context of this desk study and documented in ing realized. the country/sector-specific Appendixes) shows that expected benefits (although not always well or ex- • First, SWAps reviewed to date are not fully sector plicitly articulated) do indeed respond to those wide in scope because they do not capture all sector itemized in the Review’s analytic framework. The activities being undertaken during the same time- measurement of progress against the analytic frame, nor do they capture all sources of support framework is thus in keeping with the objectives- (Table 2-1). based methodology of this study. • Second, the understanding of what a SWAp is, and what it entails, among the various actors and stake- holders involved, is not the same or entirely clear, 11 Annex 5 provides a brief overview of: (1) the scope and cov- erage of the SWAps under review; (2) the total cost of SWAps; even within the same country and the same sector, (3) how clearly aid effectiveness concepts, principles and objec- due to its incomplete treatment in key documenta- tives are articulated in SWAp design documents, and how they tion. compare with the aid effectiveness/SWAp objectives laid out in this Review’s analytic framework (Table 1-1, top panel); and • Third, and most importantly, SWAp-specific aid ef- (4) SWAp implementation arrangements. In essence, this an- fectiveness baselines and objectives (or expected nex documents the difficulty of assessing the extent to which benefits) are not systematically or explicitly stated, the anticipated benefits of the approach are being realized. 7 Table 2-1: Relationship between National Strategic Plans and Programs Supported by SWAps Programs/Projects Supported under a SWAp Total Cost/ Country/Sector Government’s Strategic Plans Project/Program Financing Pooling DPs* Samoa Education Strategic Policies and Plan: July Second Education Sector US$30.0 million AusAID, NZAID, 2006–June 2015 Programme (ESP II) (2006–2013) ADB Samoa Health Health Sector Plan: 2008–2018 Health Sector Program US$24.3 million AusAID, NZAID, (2009–2013) World Bank Solomon Islands Health National Health Strategic Plan Health Sector Support Program SI$985 million AusAID (NHSP): 2006–2010; and (HSSP) (2008–2012) [+ WB TA Project National Health Strategic Plan support of US$1.5 (NHSP): 2011–2015 million] Vanuatu Education Education Sector Strategy: 2007–2016 Education Road Map (VERM) Not available AusAID, NZAID, (2010–2012) UNICEF Source: Program Implementation Manuals. Note: See Table 4-1 for a full list of DPs (pooling and nonpooling) supporting these SWAps. Improved Sector Management and 2.2  draft MTEF is reported to have been prepared in late Coordination 2010, linked to the government’s new health plan, but it was not available for this desk study. There is no evi- All SWAps reviewed to date achieved, at least partial- dence of an MTEF or other document that estimates the ly, the goals of developing and using various tools for full costs of Vanuatu’s VERM and all sector financing. improved sector management and aid coordination All SWAps reviewed have established structures and that facilitate the aid effectiveness agenda (Table 2-2). processes for working partnerships. These are defined in All SWAps were based on a medium-term program of design documents, individual grant agreements, and work, grounded in national policy and strategy (Table 2-1). joint partnership arrangements. Most salient, and con- Some of these were not, however, fully fleshed out. While sistent across SWAps, are arrangements for regular (an- Samoa’s ESP II had a fully defined and costed program, nual or semi-annual) meetings for the joint review of its Health Sector Program was partially defined and de- annual plans programs, budgets and performance under pendent on annual plans to define more fully activities the SWAp. and their costs. Plans for common implementation arrangements for Proposed activities identified under national policy procurement and financial management are well-defined and strategy were not, however, always the most strate- for all SWAps. Two SWAps (Samoa ESP II and Vanuatu gic. Solomon Islands’ HSSP was not produced in com- VERM) do not, however, mention whether capacity as- plete and final form, with priority program costs missing. sessments were undertaken. Evidence suggests that none Vanuatu’s VERM provides the basis for a three-year roll- of the SWAps reviewed assessed M&E systems and ca- ing plan, with the first year detailed, but it is not, itself, a pacity or fully defined M&E frameworks and arrange- plan. Medium-term projections of resources and expendi- ments at the design stage. All of them noted that these ture plans were not produced under all SWAps. This was would be developed during implementation with TA. done for ESP II, but not for Samoa’s entire education M&E frameworks are reported to be available now for sector. The first sectorwide Medium-term Expenditure Samoa ESP II, Samoa Health Sector Plan and Solomon Framework (MTEF) for Samoa’s health sector estimates Islands HSSP, but this desk study had access only to the expenditures, based on projected resources, but it does one for the Samoa Health Sector Plan, which was not not estimate costs. Solomon Island’s HSSP was not fully complete. costed, and resource projections are not complete. A 8 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Table 2-2: Development and Use of SWAp Tools for Improved Sector Management Plans for common implementation arrangements, based on capacity assessments Medium-term PoW Medium-term Structures and Procurement, grounded in projections of processes for disbursement, national policy and resources and working financial Monitoring and Country/Sector strategy expenditure plans partnerships management evaluation Samoa Second Education Yes Yes: for ESP Yes Yes: but no evidence Partial Sector Project (ESP II) Partial: for the entire of capacity (2006–2013) sector assessments Health Sector Program Partial Partial Yes Yes Partial (2009–2013) Solomon Islands Health Sector Support Partial Partial Yes Yes Partial Program (HSSP) (2008–2012) Vanuatu Education Road Map Partial No Yes Partial Partial (VERM) (2010–2012) Health Three-Year Partial No Partial Partial Partial Corporate Plan (2011–2013) Source: Compiled by the author, based on country/sector studies (in Appendix). Harmonization and Alignment of 2.3  date (Table 2-3). All three SWAps (for which evidence Development Assistance is available) have achieved the goal of establishing a country-led partnership between governments and the SWAp goals of harmonization and alignment of de- DPs. The MTR on Samoa ESP II notes that the Minis- velopment assistance have been partially achieved to try of Education, Sports and Culture (MESC) has Table 2-3: Progress in Harmonizing and Aligning Development Assistance Output Achieved Partially Achieved Not Achieved Not Evaluable Country-led partnership between Samoa Education. Vanuatu Education. government and DPs. Samoa Health. Solomon Islands Health. Use of national systems/ Samoa Health. Samoa Education. Vanuatu Education. capacities for implementation. Solomon Islands Health. Reduced transaction costs. Samoa Education. Samoa Health. Solomon Islands Health. Source: Compiled by the author, based on country/sector studies (in Appendix). Are the Anticipated Benefits of the Approach Being Realized? // 9 developed significant leadership strengths in sector to undertake procurement of TA; and there have been no oversight and implementation. Under Samoa’s Health guidelines, standards, supervisions, training or audits of Sector Program, the Government of Samoa (GoS) M&E systems and capacities. chairs summit meetings and leads all aspects of pro- The extent to which reductions in transaction costs gram management and oversight. Reports on the Solo- have been achieved has not been documented. The evi- mon Islands HSSP indicate government leadership in dence is, however, clear that, while some transaction program management and oversight, but also notes the costs of interacting with DPs individually may have been government’s need for considerable technical support reduced for governments, the SWAp has generated sub- in its role. stantial incremental tasks and responsibilities for line Progress has been made in the use of national sys- ministries. The ultimate benefits of these incremental re- tems and capacities for SWAp implementation. Under Sa- sponsibilities may be even greater but this has not been moa Health the MTEF is linked with GoS’ three-year measured. planning process and the work plans use GoS budget cat- egories and cycles. National competitive bidding pro- curements rely on GoS procedures, while international 2.4  Enhanced Sector Stewardship competitive bidding procurements use World Bank guidelines. Financial management relies on the GoS Fi- This section provides a brief synopsis of progress against nance and Reporting System. ADB procurement guide- three objectives common to all SWAps reviewed: (i) effi- lines were initially used for Samoa ESP II because GoS cient use of sector resources; (ii) stronger results focus; systems and capacity were deemed to be insufficient. The and (iii) strengthened accountabilities for sector results. World Bank’s assessment of capacity, documented in the These are analyzed more in-depth in Chapter 4 and re- aide-memoire of the February 2009 Joint Review Mission flected in the lessons of this desk study (Chapter 6). (JRM), and the findings of the 2010 MTR both report im- SWAps have not yet fully achieved the goal of en- proved performance and scope for shifting to country hanced sector stewardship (Table 2-4). There is insuffi- systems. Shortcomings and inadequate alignment of fi- cient evidence to assess whether sector resources (or nancial management systems have been reported by the resources under the SWAps, specifically) have been used MTR and it is not clear to what extent the recently pro- more efficiently in support of national policy, strategy duced M&E framework will suffice. Under the Solomon and priorities. Baselines, more specific targets and indi- Islands HSSP, AusAID, which pools its funds, relies on cators, and trend data are needed across all SWAps, along country systems and capacities for procurement, finan- with more building blocks that would establish: (i) the cial management and performance monitoring. AusAID most cost-effective, highest-impact interventions; (ii) the does, however, rely on a contract management company cost of delivering these interventions/services; and Table 2-4: Achievement of Enhanced Sector Stewardship Substantially Partially Outcome Achieved Achieved Not Achieved Insufficient Evidence Efficient use of resources to support Samoa Education. national policy, strategy, priorities. Samoa Health. Solomon Islands Health. Results focus. Samoa Education. Samoa Health. Solomon Islands Health. Ability to define and track accountabilities. Samoa Education. Solomon Islands Health. Samoa Health. Source: Author’s assessment, based on country documentation. 10 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific (iii) routine public expenditure reviews and incidence still in need of capacity building to enable it to align pro- analyses to trace actual spending against priorities. gramming, resource allocation and M&E with expected SWAps to date have not incited a stronger results fo- results, grounded in a well-defined results chain. cus. A failure to report on ESP II on a strategic level, with There is some indication of accountabilities in the evidence-based results, was noted in the MTR. At the design of the Samoa Education and Health SWAps. In time of the data analysis for this study, a new M&E frame- both cases, Assistant Chief Executive Officers (ACEOs) work and reporting regime was expected to facilitate a are accountable for components, but there is no evidence greater results focus, but this had not yet happened. The of systems, capacities or practices in tracking perfor- M&E Operational Manual for Samoa Health Sector Pro- mance and accountabilities for results. Accountabilities gram proposes indicators for the Program, but some need to be defined for all those involved in sector man- baseline data, targets and a results chain are still missing. agement and service delivery. Both Samoa SWAps and There are indications that M&E is a higher priority the Solomon Islands Health SWAp highlight the need for among DPs than it is within the GoS. The Solomon Is- more clarity on the roles and responsibilities for service lands Government (SIG) commitment to a results focus delivery and oversight and systems and capacities to is captured in the dialogue and in program documents, track performances. This encompasses all levels and enti- but has not been not fully translated into reality. SIG is ties in the health system. Are the Anticipated Benefits of the Approach Being Realized? // 11 CHAPTER 3 Are the Objectives of National Sector Programs Likely to be Achieved? A ll SWAp-supported programs reviewed to date are still under implementation, with most at, or slightly past, their implementation midpoint (most are five-year programs) at the time of data collection and analysis for this study. While none can be expected to have achieved their program objectives yet, it is both timely and wise to assess their performance to date and the likelihood of achieving their objectives by the end of the program period. This chapter provides a quick overview of progress achieved to date under each SWAp. It addresses the bottom panel of the Review’s analytic framework (Figure 1-1). Samoa Second Education Sector 3.1  and across components; cost overruns of civil works Programme (ESP II) were significant; and the recurrent cost implications of some investments (especially teacher development) An MTR conducted in 2009 found that, after a slow have not been fully assessed or their financing assured. start and four years of implementation, there has been The MTR did not systematically assess ESP II’s some progress against some of the ESP II milestones, progress to date against its 2011 outcome targets or its while performance against others has fallen short of 2015 impact targets. It does note, however, that out- targets. Some progress was made on most components comes and impacts are not likely to be achieved by the (curriculum development and reform; developing ef- project’s closing date. This Review’s independent as- fective teachers; improving access to quality education; sessment of the evidence corroborates this finding, giv- research evaluation, policy analysis and planning; and en that the six-year implementation period is management and oversight of development projects), approaching its end, and considering the findings and but there are caveats. The technical quality of the work recommendations of the sixth JRM, which occurred af- undertaken was sometimes lacking; there was inade- ter the MTR. quate coordination and phasing of activities within 13 3.2  Samoa Health Sector Program data analysis phase of this report: (i) the five-year period of the NHSP (2006–2010) has come to an end, and a new At time of data collection and analysis for this study, an draft NHSP (2011–2015) has been vetted with key DPs MTR of the Health Sector Program was scheduled for and national stakeholders; and (ii) the HSSP (2008– 2011 and its thrust was expected to be more forward-look- 2012) is at its midpoint. There had been no final evalua- ing (the redevelopment of the Program) than retrospective tion of the NHSP 2006–2010, or mid-term evaluation of or evaluative. In the absence of a mid-term evaluation, this the HSSP.13 Second, while a list of indicators was estab- desk study had inadequate documentation to assess prog- lished for both NHSP 2006–2010 and HSSP 2008–2012, ress against health performance and outcome indicators.12 there was no results chain or fully developed results Nevertheless, it should be noted that the preparation and framework for either one, some baseline data were miss- publication of the Demographic and Health Survey (DHS) ing, the indicators were not fully commensurate with is a significant achievement of the SWAp. Carried out by stated objectives and priorities within each document, Macro International in conjunction with Samoa’s Nation- and core indicators were not coherent across the two al Bureau of Statistics, the learning-by-doing process built documents. Third, the Health Information System is in substantial capacity for Samoa to take on a similar exercise need of improvement. It is currently unable to generate in the future with more independence. The quality of the timely, key information to facilitate the strategic man- DHS is substantial, and it provided evidence that facilitat- agement and evaluation of sector performance. Fourth, ed a critical dialogue about the overall strategies and pri- this desk study does not have knowledge of, or access to, orities of the health sector. provincial-level trends or evaluations of service delivery Samoa is on track to achieve most health-related performance and outcomes. There is, apparently, good Millennium Development Goals (MDGs), having made health data and trends in the country, according to vari- substantial gains in maternal and child health (MCH) ous surveys, analyses and other sources, that might be and in the fight against communicable diseases. It is un- more fully exploited. dergoing an epidemiological transition, with lifestyles Nevertheless, background work supporting the and noncommunicable diseases (NCDs) assuming in- preparation of the new NHSP (including the work on fi- creasing prominence, both in the country’s disease pro- nancing options by the Bank) does provide some in- file and in the health strategic framework. Nevertheless, sights on health sector performance. Current services the DHS results have pointed to an unfinished agenda appear to be delivered very equitably, compared to simi- with regard to MCH and communicable diseases. This lar low-income countries. Specific achievements report- evidence is critical for substantiating the policy dia- ed by the Ministry of Health and Medical Services logue in the context of the SWAp and for refining prior- (MHMS) during the September 2010 Joint Review in- ities, plans and expenditures with a view to enhancing clude relatively high levels of antenatal visits and super- expenditure efficiency supportive of this unfinished vised deliveries, reduced maternal mortality, and agenda, as well as the NCD/lifestyle agenda. A joint improved tuberculosis (TB) and malaria outcomes. The aide-memoire issued after DHS results became available MHMS also cited challenges at the September Joint noted the possibility of adjusting priorities in light of DHS findings. This responds to the essence of the SWAp 12 In December 2011 a year-long SWAp redevelopment paper rationale. was issued by GoS, the culmination of a year-long MTR pro- cess (Ministry of Health. 2011. Redevelopment of the Health SWAp Program. Final Draft, December). While worth noting, this paper became available too late to be taken into account Solomon Islands Health Sector 3.3  for the purposes of this study. Support Program (HSSP) 13 Well after the data collection and analysis phase of this study a review of the Health SWAp was undertaken as part of the It is not possible to assess the extent to which health sec- 2011 JAPR (Tyson, S. 2011. Solomon Islands Health Sector Wide Approach, Progress Review 2008–2011. Final Report, Oc- tor objectives have been, or are being, achieved, especial- tober 5). While worth noting its existence, this document was ly in the context of a desk study. First, at the time of the not available in time for its incorporation into this study. 14 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Review, especially the need to: (i) sustain recent good quality of education. Problems with overcrowded class- levels of immunization coverage and other primary rooms, a shortage of trained teachers and learning mate- health care activities; (ii) address the challenge of grow- rials have been exacerbated by the infusion of additional ing lifestyle diseases (diabetes and cardiovascular diseas- students. In schools (especially in rural, remote areas) es) and associated risk factors (adult obesity, smoking, where teachers (many of them temporary and un- betel nut chewing and related mouth cancers, and phys- trained) are obliged to teach multiple grades on the basis ical inactivity); and (iii) significantly improve access to of a 1:30 teacher-to-student ratio, the enrollments of ad- safe water and sanitation services. ditional children pose significant challenges. Especially challenging is the incorporation of new students, who are substantially older than their classmates because Vanuatu Education Road Map 3.4  they had previously dropped out or never attended. (VERM) There is scope for using school grants to address some of these quality issues. Although VERM has only been under implementation The School Grants Scheme has supported the since 2010, there is evidence of progress against a num- achievement of Strategic Goal 3—to improve and ber of program indicators as a result of: (i) proactive im- strengthen the management of the education system in plementation of the universal primary enrollments Vanuatu. It has set up a system whereby grant funding is policy and school grants scheme, which are among disbursed directly into school bank accounts and man- VERM’s highest priorities; and (ii) monitoring and eval- aged by the schools. It has also provided training and uation of their effectiveness. In support of Strategic manuals for school-level financial management, and Goal 1, the School Grants Scheme has reduced, albeit support to school plan design and implementation. Ex- not eliminated, primary school fees paid by parents, and perience has shown, however, that school-level financial it has led to increased enrollments. Primary enroll- management capacity is still in need of strengthening, ments in 2011 have increased by an average of 10–15 and there is scope for simplifying the guides and manu- percent over the previous year, with variations across als. Follow-up training and capacity building for school provinces. Enrollments in urban schools are higher record-keeping is also needed. There is also scope for than those in rural schools. Evidence suggests, however, clarifying roles and responsibilities of parents, commu- that there are still other barriers to access that are caus- nities and school administrators in relation to grant ing some school-age children to stay out of school, in- management. cluding: transport costs; school distance; parental All in all, the implementation of the School Grants perceptions on the quality, relevance and value of edu- Scheme has had an efficient and positive start. Thanks to cation; poor infrastructure; and unpaid fees from previ- early and rigorous M&E efforts, opportunities for en- ous years. hancing the achievement of strategic goals have been Increased enrollment has provided added challeng- identified, thus enhancing the prospects of achieving es to the achievement of Strategic Goal 2–to improve the program objectives within the expected timeframe. Are the Objectives of National Sector Programs Likely to be Achieved? // 15 CHAPTER 4 How is the Approach Affecting Sector Program Results? T his chapter explores four factors that affect the ability of SWAps to contribute to better sector outcomes (middle panel of the Review’s analytic framework— Figure 1-1): (i) the quality and relevance of the sector strategic framework; (ii) the strength of country capacity and incentives; (iii) the quality and functionality of the partnerships; and (iv) the predictability, flow and use of sector resources. The observations in this chapter are provided in the spirit of supporting governments and DPs in their proactive quest to learn and fine-tune the SWAps as experience unfolds. In fact, it addresses DPs original motivation for the commissioning of this study: to assess and address what elements of the SWAp might be undermining the timely and successful implementation of the highest-priority, highest-impact interventions, with a view to enhancing the efficiency and impact of collective efforts on social-sector outcomes in Pacific Island countries. Quality and Relevance of the 4.1  this document review has uncovered a number of issues Strategic Sector Framework related to the quality and relevance of the sector strategic frameworks that may have undermined the efficiency The strategic sector framework is made up of a number and success with which governments have been able to of building blocks. These include (in various subsets and articulate and carry out their work programs and achieve forms across the SWAps reviewed): general development their sector objectives. objectives; national medium- to long-term sectorwide Strategic sector frameworks reviewed have been strategies and plans; shorter-term multiyear programs; overly ambitious, in terms of the number of activities, medium-term costs and resource projections; and re- level of targets, and complexity of reforms envisaged sults frameworks capturing baselines, goals, targets and against the apparent limits of their timeframe. The hu- performance indicators. It is a significant, positive step man and financial resources for implementation of medi- that countries have prepared a number of documents to um-term programs also appear to be underestimated and/ frame and facilitate the SWAp (Chapter 2). Nevertheless, or not fully assessed. Regarding the Samoa Education 17 SWAp, both MESC’s Strategic Policies and Plan: July 2006- An MTEF was produced in February 2010 but was fo- June 2015 and ESP II are very ambitious. Each of the 18 cused on schools, and so did not assess the costs of sec- strategic components of the Plan itemizes numerous strat- torwide plan implementation against available financial egies for achieving sector goals. In total, there are 197 resources. Neither Samoa’s Health Sector Plan, nor its strategies to be implemented over three three-year phases. Program, was fully costed. Annual plans are costed, but Of these, 159 (or 81 percent) were slated to start in Phase are not sufficiently strategic or results-based. SWAp fi- 1 (July 2006–2009) overlapping with ESP II; 160 would be nancing of these activities is perceived to be more sup- under implementation in Phase 2 (July 2009–2012) over- plemental than integral to normal activities and lapping with ESP II; and 121 in Phase 3 (July 2012–2015). financing. The first (and only) health MTEF appears to The timeframe for achieving major, long-term education be more resource-based, than needs- or results-based. sector reforms that would lead to learning improvements Solomon Island’s HSSP five-year program was never ful- appears to be underestimated and there is no assessment ly costed; and the original, partial draft of the MTEF was of MESC capacity for its implementation. Likewise, ESP II never finalized, due to the absence of full costs and to is also very ambitious in terms of its targets, reform agen- difficulties in obtaining five-year horizon resource pro- da and objectives, and implementation plan, especially in jections from SIG and DPs. It is, however, understood, at light of constraints imposed by limited human resources the writing of this report, that an MTEF linked to the in MESC, a fixed envelope of financial resources and a six- new NHSP 2011–2015 is seeking to address these issues. year timeframe. Coherence across the various building blocks of The feasibility of implementing Samoa’s Health Sec- the strategic sector framework–policy, strategy, medi- tor Plan in light of available human and financial re- um-term plan, and program–is sometimes lacking. In sources was not fully assessed. Neither does the Health Samoa’s education sector, the links between MESC’s Plan Sector Plan articulate the challenges of its implementa- and ESP are not fully established. JRMs have noted that tion through the new institutional and organizational ESP II is regarded as a separate program, rather than a framework for the health sector (particularly the split re- source of support to MESC’s Plan implementation. The sponsibilities between the Ministry of Health (MoH) MTR notes that ESP II needs to be more overtly linked and National Health Service (NHS)—a reform promul- to MESC’s three-year Corporate Plans and to its annual gated in 2007 at the program’s outset)—nor does it pro- plans. Samoa’s Health Sector Program covers a five-year vide guidance on how this would play out in practice, be horizon and constitutes a subset of activities to be imple- evaluated, and fine-tuned. For the Solomon Islands mented under the first half of GoS’s Ten-year Plan. It SWAp it does not appear that an assessment of MHMS thus excludes all other activities to be implemented dur- capacity was undertaken to manage, oversee and deliver ing that timeframe covered by all financing sources, ad- the programs and services envisaged under the NHSP or ditional to the three pooled funders and GoS counterpart the HSSP, leaving in question the extent to which their financing. Annual plans prepared and supported under commitments exceed the capacity to deliver them, and, the Program are perceived (and conceived) to be more in the case of inadequate capacity, what measures would supplemental than integral to their normal activities and be taken to ensure the feasibility of plans. financing. While Solomon Islands’ HSSP is intended to The absence of adequate information on the costs be a prioritized subset of activities drawn from the of plan and program implementation and on the NHSP, the relationship and distinction between these availability of financing to cover those costs have in- two documents is not entirely clear. The process of the hibited efforts to reconcile costs and available resourc- HSSP preparation (reported to be largely–and rapidly– es and to prioritize the financing of the highest-impact prepared by consultants) raises questions about its own- interventions. The 197 strategies of Samoa MESC’s ership and the strength of its link to the country’s needs Strategic Policies and Plan were not translated into an and vision. implementation plan, nor were they costed. Despite the The results focus of sector strategies, plans and initial costing of ESP II, various new reforms and frame- programs appears to be weak, attributable to a failure to works emanating from this project have not been costed. articulate at the outset: results chains (which define and 18 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific link inputs, outputs, outcomes and impacts); appropri- the fight against communicable diseases. It points to an ate indicators with quantified baselines and targets; and unfinished agenda for these areas of public health and M&E plans and frameworks. Except for enrollment and primary health care, providing a basis for reshaping the retention targets, MESC’s Strategic Policies and Plan does work plans and priorities for the remainder of the Pro- not systematically lay out strategic outcome targets and gram period. There is some information and data on life- their baselines. Neither MESC’s Strategic Plan nor ESP II styles and behaviors and on the growing prevalence of articulates a results chain to underpin the program logic. NCDs, but the content of the action plans under the At the outset of both the Plan and ESP II there was no Health Sector Program do not appear to include the M&E framework, but one that was subsequently estab- most cost-effective interventions–both prevention and lished is meant to serve both the Plan and ESP II. While treatment–to address the growing NCD agenda. Neither not available for this Review, the MTR indicates that it is is it clear to what extent Solomon Islands NHSP and not fully functional, and is lacking baselines and appropri- HSSP interventions are prioritized based on evidence, ate tools to monitor, measure and evaluate the extent and especially with regard to lifestyle and behavior change sustainability of reforms. The MTR also notes the need to interventions and incentives. develop an M&E system that would be aligned with the Corporate Plan and meet the needs of ESP II. Samoa’s Health Sector Plan (2008–2018) is broad; Strength of Country Capacity and 4.2  and its numerous outputs and indicators under each of Incentives its six objectives are a mix of actions, outputs and out- comes, which are not clearly defined. It does not articu- The use of country systems and capacities is an impor- late a coherent results chain, appropriate indicators, nor tant tenet of the SWAp, especially for three key func- did it establish baselines and targets. The M&E frame- tions: (i) procurement; (ii) financial management; and work, produced in draft in 2009, also does not articulate (iii) strategic sector management (planning, program- a results chain with indicators, or include a full set of ming, budgeting, and M&E). The use of country systems baselines and targets that would reveal or guide priority- under the SWAps reviewed represents a radical change setting around results. The Health Sector Program sets and a rather sudden, substantial additional burden on good SWAp and health-related objectives and indica- the health and education sectors’ systems and capacities. tors, but does not articulate a results chain. The goals, Before the SWAp, bilateral donor-funded projects, rep- objectives and indicators in the Solomon Islands strate- resenting the lion’s share of external assistance, were im- gic documentation14 are not fully consistent across doc- plemented through management contractors. Obviously, uments, which is likely to cause confusion about what the successful move toward reliance on country systems the priorities are, and how they will be measured. The and the strengthening of these systems and capacities absence of an M&E framework, including a results takes time. This section takes a look at the status quo and chain, for either the NHSP or the HSSP, has left the un- points to issues that may have slowed implementation derlying program logic ill-defined, providing less direc- and that might be addressed midstream to improve tion to those responsible for implementing, both at prospects of achieving sector objectives. national and provincial levels. An M&E framework was Limited procurement capacity caused implementa- being developed as part of the new NHSP 2011–2015. tion delays and risked undermining the achievement of The evidence base of the strategic sector frame- sector objectives during the initial years of the SWAps, works is not always strong, thus compromising the but gradual improvements are noted in program review ability to identify, prioritize, phase and finance the documentation, largely through learning-by-doing. most cost-effective, highest-impact interventions. An Reasons for limited capacity and performance under the important breakthrough for Samoa Health is the prepa- Samoa Education SWAp, which followed ADB and ration of the DHS, which has helped to establish base- lines, trends, prospects and challenges in the achievement 14See Table 2-1. More detail on strategic documentation is of goals associated with MCH and undernutrition, and provided in Appendix 3. How is the Approach Affecting Sector Program Results? // 19 government guidelines, include: (i) the unprecedented size issues related to financial management capacity and per- of procurement responsibility compared with pre-SWAp formance under the Samoa Health SWAp. Overall finan- arrangements; (ii) delays in the finalization of procure- cial control of project finances is very weak under the ment guidelines; (iii) lack of coordination of bidding doc- Samoa Education SWAp, because of the large number of uments preparation by ADB, GoS and AusAID; and people involved, untrained staff and unclear roles and (iv) procedures and approval processes requiring clear- responsibilities. There is no effective monitoring of fi- ance by both ADB and GoS systems. There were also issues nancial performance of individual contracts and no associated with (i) the lack of capacity of technical experts quality control of performance on consultancy con- (component managers) to participate in the procurement tracts. The weaknesses in program financial manage- activities (particularly in the preparation of technical spec- ment and lack of quality control of contracts create a risk ifications/Terms of Reference [ToR], evaluation of tenders so substantial that it could lead to the program failing to and in contract negotiations); and (ii) the lack of rigor and meet its objectives, if not corrected. Slow preparation of results-focus in the management and oversight of consul- quarterly reports has caused delays in DPs’ ability to de- tant contracts. All of these compromised the quality and posit funds into the Special Purpose Account (SPA). De- efficiency of procurement activities and outcomes. lays in the preparation of withdrawal applications have Under the Samoa Health SWAp, which used GoS undermined ADB’s ability to reimburse expenditures. and World Bank guidelines, procurement issues were re- The appropriate institutional home for ESP II financial ported to be an important drag on program implemen- management and the integration of ESP II financial tation, consuming the bulk of time and efforts under the management functions within the wider MESC financial SWAp and causing major delays in the acquisition of management process are two issues cited by the MTR as goods and services needed to achieve objectives. Under- needing to be addressed. Financial management under lying reasons were both systems- and capacity-related. Samoa’s Health SWAp is carried out using government Some noted that the use, in effect, of two procurement financial management systems, and is closely supervised systems (GoS and World Bank) causes delays for reviews by the Bank. Reviews of performance under this SWAp and approval and there is a call to review the feasibility have not noted any financial management issues. Finan- of transitioning to the use of GoS systems only. The in- cial management issues were not raised in Solomon Is- ternational procurement advisor in the SWAp Coordi- lands Health documentation reviewed. nation Unit (SCU) was not performing well and has SWAps have built on countries’ systems and pro- since been replaced by a national advisor, who supports cesses to strengthen strategic sector management, but a local procurement expert. As is also the case for Samoa inadequate attention to assessing and addressing weak Education, component heads, responsible for preparing capacity—especially for M&E—has undermined a re- technical documents for procurement, do not have the sults focus. Planning, programming, reporting, and capacity or experience to carry this out expeditiously or monitoring and review of implementation progress have well. Procurement capacity is weak in the NHS, but the been occurring regularly in Samoa Education, Samoa SCU has not provided NHS with sufficient support. The Health and Solomon Islands SWAps, due to the regular Corporate Services Division of MoH has procurement occurrence of planning and review meetings that are an capacity and experience, but to date SCU has not sought integral part of the SWAp designs and of partnership ar- its assistance. Likewise, procurement procedures under rangements. However, the quality, rigor, overall strategic the Solomon Islands Health SWAp (under which Aus- content and results focus of these routine tasks and AID is the only pooler) have caused implementation de- products are lacking. All three SWAps report that these lays as a slow learning-by-doing process unfolds. meetings and reports focus much more on financial re- The Samoa Education SWAp documents serious porting and implementation issues (largely inputs and shortcomings in financial management capacity and processes, and to some extent outputs), and not enough performance that are undermining value for money on progress in achieving outcomes and impacts. and implementation pace and risking considerable Procurement and financial management capacities cost overruns. In contrast, there do not appear to be any and systems were assessed and addressed during the 20 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific design of the three SWAps, and reinforced through the formation gathered with some modest analysis on a provision of TA, training, guidelines and supervision. In number of fronts: (i) who is in the partnership; (ii) what contrast, M&E capacities and systems were not systemat- are the functions of the partnership; (iii) how do the ically assessed or addressed during design; frameworks partners interact; and (iv) do the DPs have the capacity were produced only at or past the midpoint of implemen- to adequately accompany governments undertaking tation. An M&E framework and reporting system (not SWAps. It is evident that interviews and firsthand ob- available for this desk study) has recently been produced servations in the field will be necessary for an in-depth for Samoa Education, but the MTR reports that it is still assessment of this very important criterion of SWAp not being used for quarterly reports. An M&E frame- success. work has also been produced for Samoa Health, but its quality is lacking. The 2010 JRM on the Solomon Islands 4.3.1  Who is in the partnership? Health SWAp notes that an M&E framework is being produced as a tool for the new NHSP. All three SWAps Donors supporting the sectors where there are SWAps include components or subcomponents to strengthen are classified into three categories: (i) those providing M&E, but–with the exception of Samoa Education/ESP pooled support to the SWAp; (ii) those participating in II which specifies the support of operations research and the SWAp, but providing project support; and (iii) those evaluation to support strategic sector management–the operating outside of the SWAp. Table 4-1 provides a pre- focus is largely on monitoring, and not evaluation. liminary overview of the clusters of donors by category. The planning, management, oversight, effective A closer look at the four DPs sponsoring this study re- utilization, and evaluation of TA have been raised as veals that: (i) AusAID provides pooled funding across issues. Under all three SWAps, there is a very substantial the board and provides by far the largest share of exter- amount of TA that is being programmed to strengthen nal financing; (ii) NZAID provides pooled funding for and supplement management and technical capacity in all three of the SWAps it is supporting; (iii) the ADB sup- the sector ministries. The issues raised include: (i) the ports one of the four as a pooler (Samoa Education); and supply-driven nature of some of the assistance; (ii) the (iv) the World Bank supports two of the four, one as a lack of quality of some of the assistance; (iii) govern- pooler and one through a TA project. It is also interest- ments’ inability to effectively plan, prepare the ToR, man- ing to note that the SPC is a signatory to the Solomon Is- age, oversee and evaluate the assistance; (iv) inadequate lands Health SWAp and the Vanuatu Education SWAp, results focus or accountabilities of the assistance; (v) lack but not the others. of clarity about roles and responsibilities of the assistance SWAp partnerships also involve other segments and the staff/divisions they serve; (vi) poor communica- and sectors of government and civil society, but there is tion between assistants and their direct clients/beneficia- considerable scope for their greater involvement. Doc- ries; and (vii) conflicting advice of different assistants. uments reviewed do not provide an indication of the SWAp participants mentioned–and this desk study ob- extent to which regional bodies (SPC and the Pacific served–that the planning and programming of TA is not Forum) are involved in the SWAp. SWAp Program usually undertaken in synergy with other (planned or Steering Committees, responsible for the strategic over- needed) capacity-building interventions, such as plans sight of SWAp performance and outcome, provide a fo- for training, reform of systems and structures. rum and structure for the participation of critical elements of government and civil society (Table 4-2). All four of the SWAps reviewed involve the Ministry of Fi- Quality and Functionality of the 4.3  nance (MoF) while one (Vanuatu Education) involves the Partnership Prime Minister’s office. A quick look at public sector agen- cies’ membership indicates that some key agencies that It is not possible to assess the quality and functionality might contribute to sector outcomes that would require of the various partnerships involved in the SWAp on multisectoral support have been omitted (for example the the basis of a desk study. This section presents some in- Ministry of Labor to ensure that the education sector How is the Approach Affecting Sector Program Results? // 21 Table 4-1: Signatories and Nonsignatories to Partnership Arrangements Signatories Nonsignatory DPs Supporting the SWAp Poolers Nonpoolers Sector Samoa Education AusAID, NZAID, Canada, China, EU, JICA, Germany, SPC, ADB UNDP, USA, WHO Samoa Health AusAID, NZAID, WHO,UNICEF, Italy, Japan World Bank UNFPA Solomon Islands Health AusAID World Bank (through TA project), JICA, GFATM, Oxfam International, Save the UNFPA,UNICEF Children, UNIFEM, UNDP WHO, Japan (shown as signatory, but no signature) Vanuatu Education AusAID, NZAID, EU, France, Japan, UNESCO, World Bank, ADB, Spain UNICEF Peace Corps, SPC Sources: Joint Partnership Arrangements for various SWAps, other SWAp documentation, and www.aiddata.org. Very provisional information, which will need field validation. Note: GFATM: Global Fund to Fight Aids, Tuberculosis and Malaria. JICA: Japan International Cooperation Agency. UNIFEM: The former United Nations Development Fund for Women (now UN Women). prepares students for the needs of the labor market; and Education does note among its principles that “…devel- ministries responsible for food, nutrition, and trade to en- opment assistance will be provided in ways that build able affordable healthy lifestyles). sustainable national capacity, including civil society Only two of the four SWAps (Samoa Health and (and) NGOs…� it does not include NGOs, civil society Solomon Islands Health) provide for civil society repre- or communities as members of its Steering Committee. sentation in their Steering Committees. While the Part- Involvement in all six JRMs to date was limited to repre- ner Harmonization Framework (PHF) for Samoa sentatives of signatory DPs, and five of the six missions Table 4-2: SWAp Program Steering Committee Membership SWAp Government DPs Civil Society Samoa Education Government Ombudsman (Chair), Ministry of Coordinating DP — (Project Administration Education (CEO), MoF, Ministry of Foreign Memorandum) Affairs, Public Service Commission, Samoa Qualifications Authority, Ministry of Works, National University of Samoa, and others to be determined. Samoa Health MoF (Chair); Ministry of Health; National Health DP representative Samoa Family Health (Program Operational Manual) Service; Ministry of Women, Community and Association, Medcen Hospital; Social Development; Ministry of Education, Samoa Red Cross; National Sports and Culture Council of Churches Solomon Islands Health Ministry of Health, Department of Finance and DPs involved in health NGOs, CBOs and Churches (bi-monthly Executive Special Treasury, Department of National Planning and sector development involved in health sector Sessions equivalent to Steering Aid Coordination, Ministry of Education development Committee functions) (Program Implementation Plan) Vanuatu Education Ministry of Education (Chair), Ministry of Representative(s) from - Finance and Economic Management, and Office pooling donors and a of the Prime Minister representative from a nonpooling partner Source: Compiled by the author, based on design documents. 22 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific did not meet with any representative from civil society cused more on the details of project inputs and imple- or with any other DP supporting the sector. The excep- mentation than on more strategic, sectorwide issues, tion was the third JRM (February 2008), during which a evidence and policies. The sixth JRM for Samoa Educa- meeting of all DPs and the Samoa Umbrella for NGOs tion has noted, nevertheless, a move toward a more stra- (SUNGO) was convened to discuss how better to coor- tegic focus to JRMs, but it also points to the potential for dinate and target their collective assistance. Another more sectorwide, policy-level discussions and advocates meeting with the broader network of sector DPs was the opening up of these discussions to nongovernmental convened during the MTR mission in 2009, and the fol- schools and civil society organizations. The focus of DPs’ lowing year it was agreed to invite a wider representation dialogue and scrutiny at the level of input quantities and from DPs to attend monthly informal meetings. Inclu- activity details is thought to be inappropriate by DPs and sion of civil society representation is not explicit. GoS alike and there is consensus that DPs would do best Based on documentation reviewed, it appears that to focus on policy/strategic discussions. Documents do nonsignatories to the Samoa Health Joint Partnership indicate, nevertheless, that the DHS results prompted Arrangement (JPA) are not routinely invited to joint strategic discussions, but there is also indication that meetings and reviews. The November 2009 JPR on the planning and review of sector performance discussions Solomon Islands Health SWAp notes that partnerships are not sufficiently focused on policy and strategy. Solo- need to be further strengthened and acknowledges on- mon Islands documents acknowledge the contributions going efforts to this end, with government agencies and of the SWAp partners in the development of the new with international and civil society partners. SIG recent- NHSP at the midpoint of HSSP implementation. ly signed a Memorandum of Understanding (MoU) sig- The efficient allocation of financial and technical nalling its commitment to establish an effective resources has not yet been achieved. This is due in part development partnership with civil society, which may to the absence of essential, sectorwide building blocks open opportunities for close collaboration under the for this task: the full costing of priority activities; medi- Health SWAp. um-term projections of resource availability; tracking of actual expenditures and their links to sector results; as 4.3.2  To do what? well as guidelines and criteria for resource allocation. Joint mission reports on Samoa Health note that plans This review looked at how three key functions of the and resource allocations in the SWAp are not yet made partnership are being carried out: (i) the review/negoti- in the context of overall sector priorities and all funds ation of evidence-based policy and strategy; (ii) the allo- available to the sector as a whole. Regarding the Solo- cation of all technical and financial support to the sector mon Islands Health SWAp, aside from agreement on in line with national priorities; and (iii) the periodic re- general principles to allocate more available sector fi- view of sector performance and outcomes. nancing to primary and preventive services and to prov- There is evidence that SWAp partners have been inces, there is no guidance, formula or criteria to help involved in, and/or have supported in some capacity, SIG and its partners set and achieve sound resource allo- the review/negotiation of evidence-based policy, espe- cation goals. All SWAps are working towards the setting cially in the context of major multiyear strategic plan- of goals and guidelines for the more effective planning ning exercises. Virtually all the sectoral medium-term and management of TA. strategies and plans issued by governments have ac- Joint reviews of sector performance are undertak- knowledged the support and influence of the major de- en on a regular basis, but their focus is largely on mon- velopment partners. There is, however, little detail in the itoring of implementation and not on the assessment of documents reviewed about the value, nature, technical overall sector performance and results. It is not clear to and economic rigor, weight or impact of these various what extent annual reviews are results-focused, especially contributions. given the absence (or weakness) of results frameworks There has been a tendency within the SWAps for the and M&E plans. The Samoa Education SWAp’s recent dialogue, support and exchanges with partners to be fo- MTR was the most extensive review to date and did focus How is the Approach Affecting Sector Program Results? // 23 on both SWAp implementation issues as well as progress understanding of the policies, pressures and contexts against sector benchmarks set under the project. The Sa- within which each DP functions. Among these issues moa and Solomon Islands Health SWAps are also past are: (i) the significant leverage of AusAID, given its his- their mid-term points, but, as noted earlier, their MTR re- torical/political relationship with the Pacific Islands (one ports were issued too late to be incorporated into this example being the Regional Assistance Mission to the study’s analysis. The end of the NHSP in Solomon Islands Solomon Islands–RAMSI) and its importance as the coincides with the midpoint of the SWAp, but it is not main financier of the health sector (as well as other key clear that there will be an end-of-Plan evaluation. sectors of the country); (ii) the Bank’s limited presence in the field; (iii) the skills available through the DPs and 4.3.3  How do they interact? the match of these skills with the needs of the country; (iv) the complementarities of DPs (in terms of skills, ex- The nature and quality of interactions cannot be accu- perience, mandate) and the extent to which they are ex- rately gleaned from a desk review, and thus will be an ploited through partnerships; (v) the technical rigor of important focus of fieldwork; however a number of policy dialogue and its balance with principles of coun- preliminary observations emerge. AusAID serves as try ownership and sovereignty; and (vi) how DPs man- Coordinating Development Partner (CDP) for five age conflict among themselves. SWAps, and NZAID for three (Table 4-3). This function revolves around the coordination and facilitation of in- Do Development Partners have the 4.3.4  formation exchange among the DPs participating in the requisite capacity? SWAps, and between the DPs and government. Joint planning, resource allocation and review meetings pro- It is not clear to what extent DPs bring the right knowl- vide a vehicle and a structure for interaction among edge, skills and capacities to support governments in SWAp DPs and between DPs and government. Those op- the SWAp process and to carry out a sufficiently rigor- erating outside of the SWAp are not, however, included in ous, evidence-based, technical and operational dia- these meetings. There does not appear to be a formal logue–individually and collectively. This might be structure or mechanism that would routinely bring to- further analyzed through fieldwork, drawing on the per- gether all DPs supporting the sectors, whether operating spectives of both national actors (public and civil society) inside or outside of the SWAp. The three pooling partners and DPs. for the Samoa Education and the Samoa Health SWAps meet informally and often with government. In the case of Solomon Islands Health, AusAID is the lead CDP, the Predictability, Flow and Use of 4.4  largest financier, and the only DP pooling its support. Sector Resources A number of issues and questions have emerged from this desk review, but their full analysis can only be Overall sector financing is not sufficiently predictable effectively pursued through fieldwork and a better for the three SWAps reviewed. The predictability of fi- Table 4-3: Coordinating Development Partners for Social Sector SWAps Country Health Education Samoa NZAID/MFAT AusAID Solomon Islands AusAID NZAID/MFAT Tonga AusAID NZAID/MFAT Vanuatu AusAID AusAID Source: Compiled by the author, based on discussions with DPs. Note: Shaded gray areas are SWAps covered to date in this desk study. 24 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific nancing, both for ESP II and for Samoa’s entire education line services. The flow of funds from ESP II DPs to the sector, has been uncertain at best. ESP II documentation Special Project Account has been slowed somewhat be- clearly spells out the project costs and formalizes the cause of slow turnaround of quarterly financial reports funding commitments of GoS and the three DPs to fi- and statement of expenditures and withdrawal applica- nance, together, 100 percent of these costs. But the MTR tions for reimbursement. There is little indication, how- reveals that its objectives will not be achieved within the ever, of how funds flow from the Special Project Account original six-year implementation period, due to delays in to entities implementing project activities. implementation, overly ambitious targets and objectives, The flow of funds within and outside Samoa’s Health and significant cost overruns on civil works. The costs of SWAp gives cause for tension and confusion. Within the implementing sectorwide plans have not been calculated, Health SWAp, MoH manages and oversees all pooled so the adequacy and use of DP support outside of ESP II support to the Health Sector Plan, including the sub- have not been assessed. stantial share allocated to the NHS. Outside of the Within Samoa’s Health Sector Program, financing of SWAp, MoF allocates recurrent budget funds directly to the GoS and the three DPs is defined and predictable. Out- NHS, bypassing MoH. This arrangement has caused ten- side of the Program, however, the predictability of external sions between MoH and MoF, and between MoH and funding, provided through a range of projects and pots of NHS, which could affect implementation performance assistance (including those financed by pooling DPs) is and efficiency. The desk study did not find any evidence not firm. A whole-of-sector SWAp (and MTEF) would on how funds flow to service facilities and other imple- help. While the budget/planning process for Solomon Is- menting agencies and how they are managed. Provincial lands Health is increasingly aligned with the country’s health offices in the Solomon Islands are slated to as- budget cycle, other factors supporting predictability are sume more responsibility for the planning, budgeting, not yet in place, notably: an MTEF; specification of total implementation and review of provincial health plans and annual commitments of SIG and all DPs; and financial and to receive a larger share of sector resources to man- plans with transparent criteria governing the allocation of age and use to this end. However the desk study did not funds. Unstable macroeconomic conditions are also un- find any documentation on how funds flow to the prov- dermining the predictability of domestic financing. inces, or how they are managed. Flow of funds, in terms of DPs’ disbursements to There is little indication of the effective use of government, depends on the timely production of ad- funds, especially at the level of implementing agen- equate financial reporting, clearly defined in the cies and decentralized levels of sector ministries. Reg- SWAp documentation. It is less clear how funds flow ular public expenditure reviews would be helpful in this to the various implementing entities, especially front- regard. How is the Approach Affecting Sector Program Results? // 25 CHAPTER 5 How is the Approach Affecting the Efficacy of the Development Partners? P erformance and accountabilities of individual DPs need to be assessed against: (i) joint commitments and aid effectiveness principles committed to under the various SWAp agreements; (ii) DPs’ own respective policies, strategies and performance criteria; and (iii) (especially) the real, unfolding needs of the country implementing the SWAps. The review of documents did not uncover adequate responses to this evaluation question. Analysis of DP efficacy will require more engagement with the four sponsoring partners of this study, including their staff based in-country, and especially the perspectives of governments and other national stakeholders. Field visits (to the countries and to each of the DPs’ headquarters) could examine these questions in a more systematic way. The four DPs sponsoring this study are united in their impacts. Each agency is obliged to respond to the poli- support of the aid effectiveness principles underlying the cies and practices of its respective head office, but they SWAps, but these agencies may share somewhat differ- also need to unify, collaborate, and adapt their agendas ent visions of how to move forward to actually achieve and policies, to the extent possible, to present a unified improved aid effectiveness. AusAID envisages evolving front in support of national policies, priorities and prac- its health sector assistance to budget support. NZAID tices. Fieldwork might better assess the extent to which emphasizes the importance of prioritizing and linking the right equilibrium has been achieved. financing to results, and is thus interested in moving to- This desk study raises a question about the rele- ward a results-based financing approach. The World vance of the business models of the DPs. From govern- Bank continues its support of implementation capacity ments’ perspective, SWAps represent a quantum leap strengthening (especially procurement and financial from the previous way of doing business (projects were management) and its technical advice and assistance on largely managed by contractors hired by DPs) to the as- sector financing and economics for enhancing sector sumption of lead responsibility for: sectorwide strategic 27 management (policy making, planning, programming, guidance and support. A second phase of this study needs budgeting, and M&E), effective resource use and ac- to take a hard look–within and across agencies–to assess countability (procurement, financial management); and their current business models and levels of support the coordination of financial and technical support of against the needs and learning-by-doing approach gen- DPs. While this is desirable to both governments and erated by a SWAp. Focusing on the four DPs jointly pro- DPs, it is difficult, if not impossible, to achieve all at once. ducing this study, the adequacy and availability of their The governments’ business models for working with respective technical and operational capacities would be DPs have changed significantly with the onset of the an important topic to pursue. The costs and benefits of SWAp, but the business models of the DPs may not have new, better DP models that would provide for capable adapted themselves to new and emerging needs generat- people on the ground to accompany governments on the ed by the SWAp. Governments will need substantial SWAp journey are important to understand. 28 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific CHAPTER 6 Findings, Counterfactual, Lessons, and Their Relevance to Global Experience 6.1 Findings benefits or expected outcomes. All of this gives cause for confusion on what the SWAp is and what it is trying to Chapter 2 (and Annex 5) documented that the SWAps achieve. reviewed to date are not fully sector wide in scope be- Chapter 2 has also documented that the anticipat- cause they do not capture all sector activities being un- ed benefits of the aid effectiveness efforts under the dertaken during the same timeframe, nor do they SWAps reviewed have been partially achieved. All capture all sources of support. Rather, with the exception SWAps developed and used most of the key aid effec- of Vanuatu Education, they support a project or a pro- tiveness tools for improved sector management and co- gram, which is a subset of activities envisaged under ordination. Some headway has been made in improving government’s sectorwide plans. They also show that the harmonization and alignment of development assis- understanding of what a SWAp is among the various ac- tance. There is, however, little progress to date against tors and stakeholders involved is not the same or entire- the objective of enhancing sector stewardship, especial- ly clear, even within the same country and the same ly with regard to the efficient use of sector resources, a sector, giving cause for confusion. SWAp descriptions greater focus on results, and strengthened accountabil- and operating principles are articulated quite extensive- ities for results. ly, but differently across the various documents describ- Chapter 3 has documented uncertainty about ing the same SWAps. While they are not conflicting, they whether sector performance and outcome objectives are not systematic in their description and stated expec- will be achieved under these ongoing SWAps by the end tations of a SWAp. of their program periods. Implementation delays, espe- With the exception of Samoa Health, SWAp objec- cially in the initial years, are likely to result in delays in tives and indicators are more implicit than explicit, mak- achieving sector targets. The MTR of ESP II notes that ing it challenging to measure success. The links between outcomes and impacts are not likely to be achieved by SWAp objectives and program outcomes is assumed, but the project’s closing date. The MTR reports on Samoa not well established in the design documents. While, for Health and Solomon Islands Health were not available in each respective SWAp reviewed, all design documents, sufficient time to incorporate into this study. Proactive taken together, do respond to this study’s analytic frame- M&E of Vanuatu Education has documented good prog- work’s summary of SWAps’ expected benefits or out- ress against some objectives, just one year into VERM comes, no one document fully articulates all of these implementation, and operations research has identified 29 ways and means of enhancing program efficiency and can be useful for pointing both to progress to date and to results. This bodes well for the achievement of program opportunities to improve their design and performance, goals in Vanuatu. where SWAps risk falling short of satisfying these crite- Chapter 4 has identified factors under the SWAps ria. that are likely to have undermined their ability to achieve national sector objectives. First, strategic sector frameworks have exhibited some weaknesses on a num- 6.2 Counterfactual ber of fronts, including: (i) their overly ambitious na- ture; (ii) incomplete information on their costs and The analysis of program/sector performance in the ab- financing; (iii) uncertainty about their cost-effective- sence of a SWAp is difficult to assess because of the con- ness; (iv) their unclear sense of prioritization and phas- fusion about what constitutes a SWAp, even among ing; and (v) an inadequate results focus. Second, the use stakeholders participating in the same SWAp. Further- of country capacity and systems are slowly building ca- more, a SWAp is based on a set of aid effectiveness prin- pacity through a learning-by-doing process, but this has ciples: country ownership; harmonization and alignment caused implementation delays due to slow procure- of development assistance (including the strengthening ment, and slow replenishment of funds due to short- and use of country systems as common implementation comings (of some SWAps) in financial management arrangements and alignment of financing around na- and absorptive capacity. Inadequate attention to M&E tionally set priorities); delivering and accounting for re- capacity has caused delays in the production of M&E sults; and mutual accountability for the use of aid. It is frameworks, results chains and in the assessment and unrealistic to imagine a counterfactual of not supporting strengthening of in-country capacity. The planning, any of these good practices. Various counterfactual sce- management and effective utilization of TA also suffers narios might instead be constructed around the se- from weak country capacity. Third, stronger sector part- quencing and pace of the adoption of these good nerships have formed under SWAps, but they are exclu- practices. An exhaustive analysis of numerous scenarios sive of some critical players (public, nongovernmental goes beyond the limits of this desk study. Nonetheless, and civil society actors), and there are opportunities to some of the lessons speak to the advisability of sequenc- further analyze and improve interaction among DPs ing and to a clearer articulation of the description, ob- and their capacities to better support governments un- jectives and performance indicators of the SWAp. der a SWAp process. Fourth, overall sector financing is Fieldwork will attempt to explore more systematically not sufficiently predictable and flow of funds to imple- the counterfactual through interviews with key stake- mentation agencies and their effective use are not well holders and the “unbundling� of the aid effectiveness documented. principles and other design features associated with a Finally, Chapter 5 points to the need for further ex- SWAp. ploration of the business models of the DPs supporting the SWAps (the four jointly producing this study) to as- sess the extent to which they are efficient and effective in Lessons for Improving Performance 6.3  meeting the needs and demands of country clients un- Under a SWAp der a SWAp. This was not possible to assess in the con- text of this desk study. Table 6-1 provides a synthesis of This study has found that, with the support of DPs, Pacif- these findings through the lens of OECD/Development ic Island countries: (i) have established many important Assistance Committee (DAC) evaluation criteria on rel- building blocks for enhancing aid effectiveness through evance, efficacy, efficiency and sustainability. No evalua- the design and implementation of social-sector SWAps; tion ratings are assigned because these SWAps are still in and (ii) are acquiring experience and building their ca- process. Furthermore, this study is a learning initiative pacities in sector management and implementation rather than an evaluation. In this spirit, a brief look at the through a learning-by-doing process that applies to DPs, SWAps’ performance against each evaluation criterion as well as country partners. The experiences, 30 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Table 6-1: Relevance, Efficacy, Efficiency and Sustainability of SWAps Reviewed to Date Evaluation Criteria Samoa Education Samoa Health Solomon Islands Health Relevance of ESP II objectives were drawn from the The Health Sector Plan is aligned with SWAp and health sector objectives of objectives GoS’ Strategy for the Development of GoS’ overall development policy (SDS), NHSP and HSSP are broadly aligned Samoa (SDS) and strategic plans and articulated around same six goals. The with national development plans and supportive of DPs’ respective policies Program supports the Plan but not with sector development strategies of and evolving approaches to education. necessarily emphasizing highest-impact the main DPs. But some of the targets But objectives were overly ambitious. interventions. The Health Sector Plan and indicators are not fully reflective of and, to a lesser extent, the Program are the epidemiology, priorities and ambitious. challenges of the sector (for example lifestyles). The relationship between NHSP and HSSP is not entirely clear. Program is ambitious. Relevance of Components are generally supportive of Design distinguishes between SWAp Distinction and links between SWAp design objectives, but absence of results and health objectives, but does not lay and health sector objectives not explicit framework. Pilot nature of SWAp design out a results chain. Key programs and and results chain not clearly articulated. was never fully defined in terms of its services addressing greatest disease Design appears to be ambitious relative objectives, learning agenda and burden not fully costed. Institutional/ to country capacity. Roles, responsibili- evaluation process and design. organizational framework and capacity ties, accountabilities, and capacity for Capacities not fully assessed or for program implementation not fully strategic management and service addressed. assessed. delivery not fully defined. Efficacy (to date) MTR notes that sector objectives not No MTR to date. No trend data to Reporting notes good performance of likely to be achieved by end of project, assess the extent to which health health services (before and during HSSP but could be achieved over a longer objectives have been achieved to date. implementation), but attribution to HSSP timeframe with continued support and SWAp objectives partially achieved and is not established. Achievement of improved capacities. SWAp objectives in process. SWAp objectives could soon be partially achieved and in process. assessed as more substantial if MTEF, NHSP 2011–15 and M&E framework are issued soon and of good quality. Efficiency Insufficient data to assess the extent to Indications that resources for the Basic package of highest-impact, most which expenditures have been devoted Program are not used optimally. PoWs cost-effective services, delivered to the highest-impact interventions. are not sufficiently results-based or through the lowest level of services and Efficiency of implementation suffers strategic and do not consistently focus their costs have not been defined. No from slow procurement, inadequate on the highest-impact interventions. criteria/targets yet developed for financial management, low absorptive Unclear institutional/organizational tracking spending efficiency. Capacity capacity, neglect of M&E, and framework and capacity constraints also constraints undermine implementation inadequate results focus. undermine efficiency. efficiency. Sustainability Financial sustainability of investments Financial sustainability will be Financial sustainability will be highly and benefits flow will depend on dependent on continued availability of dependent on continued availability of continued financial support from DPs. donor financing, especially AusAID. DP financing, especially AusAID and on Sustainability of reforms will depend on Sustainability of SWAp reform efforts to reconcile planned investments the effective management and use of TA dependent on ability to expand its with ability to finance incremental and the building of MESC capacity. coverage to whole sector and all major recurrent costs. stakeholders and on its alignment with respective roles and responsibilities of MoH and NHS. Source: Compiled by the author on the basis of country- and SWAp-specific studies in Appendix. documented in this study, point to weaknesses in SWAp improve the effectiveness of social-sector SWAps in the design and implementation that may have slowed or un- South Pacific: (i) the focus on results; (ii) national capac- dermined the achievement of sector results. Lessons em- ity; and (iii) the capacities, accountabilities, and business anating from this desk study’s findings point to three models of the DPs to better meet the needs of countries strategic areas that, if strengthened, have the potential to implementing SWAps. Findings, Counterfactual, Lessons, and Their Relevance to Global Experience // 31 6.3.1  Results Focus operations research and evaluation might be devel- oped. This might clarify that operations research and • The clear articulation of aid effectiveness (capaci- evaluation can serve as tools to improve efficiencies ty and efficiency) objectives and indicators under and outcomes. More regular and in-depth public ex- a SWAp, and the establishment of their links to penditure reviews including incidence analysis would sector-specific program objectives and indica- be important to consider among other studies to tors, are likely to result in the enhanced design, enable the linking of resources with results. more efficient implementation and meaningful • Governments and DPs might garner information evaluation of a SWAp. This is especially important and resources to identify opportunities to evolve in the context of Samoa’s ESP II, which is conceived management structures and incentives to manage as a pilot SWAp. The analytic framework of this for results. This would warrant analysis and a prag- study (Figure 1-1) might serve as a useful tool for matic, incremental approach, coherent with the op- vetting, articulating and linking the sets of aid effec- portunities and constraints of countries’ governance tiveness and sector objectives and indicators, and structures. Results-based financing initiatives may for building a program logic that would clarify what hold promise, but they require substantial systems the SWAp involves and what it is trying to achieve. reform, and their widespread effectiveness cannot • Improvements to the results framework for the be currently confirmed because they represent a programs supported by the SWAp and for the fairly new initiative, whose design and implementa- entire sector should drive, and render more co- tion vary across different country settings. herent, the entire national strategic framework. A fleshed-out results chain will allow the clarification 6.3.2  National Capacity Building of the “missing middle,� which should provide the underlying logic of how inputs and activities are This study has shown that capacities are being strength- translated into outcomes, and facilitate the M&E of ened through a learning-by-doing process, but they still each of the links in the chain. fall short of the needs and demands of an ambitious sec- • The generation and use of evidence to identify–and tor agenda implemented through a SWAp: then to support–the most cost-effective, highest- impact interventions are likely to improve efficien- • The development of national systems and capaci- cy and outcomes. Working backwards from the ties could be better supported, nurtured and accel- highest-order goals and objectives, the identification erated. There is a need for: (i) the more systematic and support of the most cost-effective, highest-im- assessment of capacities against capacity needs (in- pact interventions will enhance the results focus of re- cluding an assessment of the allocation of roles and source allocation and of all collective efforts. It might responsibilities within government structures and also stimulate more cross-sectoral work. An impor- across various national actors); and (ii) the develop- tant case in point is the opportunity for cross-sectoral ment of a holistic, results-based approach to capacity reflection and interventions to improve healthy diets. strengthening that would include a range of inter- • The stimulation within government and among ventions including: (a) well-designed, well-managed DPs of a greater appreciation and stronger demand TA with strong accountability for results built in; for institutional learning could cultivate more reg- (b) review/revision of management systems to ular undertaking (or commissioning) of opera- ensure their coherence, links and efficiency; (c) revi- tions research and evaluation that could be effective sion of roles and responsibilities of individuals and instruments of strategic sector management. Most institutional entities; (d) training; (e) supportive su- discussion and efforts devoted to “M&E� are largely pervision; and (f) performance management and ac- limited to monitoring. DPs might seize the opportu- countability systems. These interventions might be nity to support governments in developing an explic- applied to SWAp-specific capacities (planning, bud- it agenda for learning, on which basis a program of geting, procurement, financial management and 32 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific M&E) as well as to technical/sectoral capacities and capacity and effectiveness under a SWAp, as they, too, learn they might extend beyond central government to en- from experience. The effectiveness of DPs cannot be easily compass the provincial and community levels, as well assessed in the context of a document review. Nonetheless, as the nongovernmental sector and civil society or- this desk study has uncovered a few points that could be ganizations. the focus of initial reflection among the DPs and of more • Capacity assessments and capacity-strengthening in-depth analysis through fieldwork, a crucial component plans would do well to embrace the existing and of which will be the countries’ own perspectives of DPs’ ef- potential roles of the nongovernmental sector, fectiveness and capacity vis-à-vis their needs. While these both for service delivery and for sector monitor- lessons are directed at what DPs might do to improve their ing and evaluation. effectiveness and capacity, an overarching lesson is the • Needed strengthening of procurement capacity important role of government in holding DPs accountable and critical path decisions on the evolution to- to mutually agreed performance standards. wards exclusive use of national procurement pro- cedures could be facilitated by donor support and • DPs need to strengthen their own capacities to ef- donor consensus. fectively participate in a SWAp. This means listen- • SWAp capacity-building efforts might better con- ing and responding to the needs of countries and, in sider that highly qualified, well-trained national particular, ensuring that DP teams–whether field- technical experts are not necessarily well trained based or HQ-based–bring the expertise and experi- or experienced in the management exigencies of a ence needed for an effective contribution. Such SWAp or in dealing with DPs. The training/orien- expertise might be technical, operational, manage- tation of key staff to this end could help prepare rial, or a combination of these, and it should be as- them to be more effective. sessed and strengthened in light of the whole range • Reducing the ambition of the sector program of expertise (and gaps) across all DPs participating agenda is an important and complementary way in a SWAp. Experience means that DP teams should of calibrating existing capacity and demands on be seasoned and able to add value. capacity, but it is often neglected. Governments • Pooling DPs have expressed the desire to be more and DPs could collaborate to reduce both SWAp- strategic in their discussions during Joint Re- and sector-related objectives to match existing ca- views, rather than getting too immersed in the pacity, while capacity is being built. Efforts could details of inputs and actions in the annual plans. start with the identification and elimination of un- This elevation of the dialogue would be highly ap- necessary, duplicative tasks. propriate. It also depends, at least in part, on the • The prioritization, phasing and sequencing of the availability of baseline and trend data to enable a capacities and systems being built is yet another strategic results focus. way to calibrate capacity demands and existing • Pooling DPs have also expressed their desire to capacity. Experience in other regions has revealed include all DPs, and not just those who signed that starting first with M&E capacity and systems joint arrangements, in joint missions and plan- strengthening and focusing efforts in a second ning and review meetings. Pooling DPs could phase on procurement and financial management assist governments to invite, coordinate and institu- can lead to considerable success and strong nation- tionalize this process as the SWAp is expanded to al ownership under a SWAp. the entire sector. • DPs would do well to review their respective busi- Development Partners’ Effectiveness 6.3.3  ness models to examine whether they are able to and Capacity under a SWAp provide the right assistance at the right time. This means assessing their skills and knowledge mix, Capacity building and learning-by-doing are not limited to their availability and accountability to government, countries. DPs must also assess and strengthen their own and the costs of doing business under a SWAp. Findings, Counterfactual, Lessons, and Their Relevance to Global Experience // 33 Government perspectives on this would be an im- context; and (ii) any particular considerations and chal- portant input to this review. lenges of a SWAp in the Pacific Island context (Table 6-2). • DPs have the opportunity to harmonize their vi- First, the four factors of a successful SWAp (in terms of its sions and approaches to the SWAp to present a effect on sector outcomes) are fully relevant to the con- united and supportive front to governments. This texts of the Pacific Islands studied. Experiences emanating would mean the delicate work to reconcile their ob- from the Samoa, Solomon Islands and Vanuatu SWAps in- ligations to HQ and HQ policies with the needs and deed corroborate the importance to sector outcomes of: demands of governments, for example, agreement the quality and relevance of the sector strategic frame- on procurement procedures, and on modes and work; the strength of country capacity and incentives; the models of development. quality and functionality of the partnerships; and the pre- • DPs are challenged to strike the right equilibrium dictability, flow and use of assistance (Chapter 4). Second, in their dialogue with government, ensuring rigor this desk study has identified that there are indeed addi- and candor on technical and strategic issues, and, tional considerations and challenges in implementing a at the same time, a respect of government sover- SWAp particular to the Pacific Island context. They are eignty and leadership. Increased generation and listed in Table 6-2 against the success factor that they most use of evidence for strategic choices and decision directly influence, presenting an agenda for ensuring that making are likely to help enormously in this regard. the design and implementation of SWAps take them into full consideration. Over and above these considerations, another one emerges, which potentially affects all success Relevance of South Pacific Findings 6.4  factors–the very high cost (and opportunity cost) to DPs and Lessons to the Global of doing business in the Pacific Islands. Experience This study has considered the distilled SWAp experience 6.5  Additional SWAp Guidance in six other countries around the world (Vaillancourt, 2009) and attempted to assess: (i) the relevance of the find- Because SWAp findings and lessons emanating from this ings and lessons of this experience to the Pacific Island desk study are consistent with global experience, the Table 6-2: Relevance of South Pacific Findings and Lessons to the Global Experience Applicability of Success Factor Factors to PIs Additional Considerations/Challenges for South Pacific Context Quality and Fully applicable • Challenges of a multiple agenda: MDGs + NCDs Relevance of the • Risk of natural disasters causing changes to plans Strategic Framework Strength of country Fully applicable • Very small size of ministry staff, vis-à-vis heavy workload of SWAp capacity and • Very large volume of technical assistance, some of it supply-driven, some of it of unsatisfactory incentives quality, most of it inadequately managed Quality and Fully applicable • Smaller pool of DPs functionality of the • Very prominent role played by one or two bilateral DPs (financial, political, economic) partnership • Difficulty of UN/multilateral agencies attracting and paying for senior staff to be posted in field • Extent of decentralization, and involvement of decentralized/deconcentrated local authorities in the SWAp • Regional partnerships, structures, programs supporting social-sector development: SPC, Pacific Forum Predictability, flow Fully applicable • Higher resources per capita than for most developing countries, emphasizing the importance of and use of efficient use of resources assistance • Relatively more security in longer-term support from bilaterals Source: Compiled by the author. 34 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Pacific Islands undertaking SWAps, along with the DPs • World Bank. 2007. Project Performance Assessment supporting them, might benefit from a number of Report, Ghana. Second Health and Population Proj- SWAp-specific lessons and operational guidelines avail- ect (Credit No. 2193) and Health Sector Support Proj- able to the public. ect (Credit No. 2994). Washington D.C. World Bank. A few operational guidelines worth highlighting as • World Bank. 2006. Project Performance Assessment being particularly relevant are the following: Report, Bangladesh. Fourth Population and Health Project (Credit 2259-BD) and Health and Population • International Health Partnership and Related Ini- Program Project (Credit 3101-BD). Washington tiatives (IHP+) publications and guidance on health D.C. World Bank. sector SWAps (www.internationalhealthpartner- • World Bank. 2008. Project Performance Assessment ship.net), notably: Report, Kyrgyz Republic: Health Sector Reform Proj- • WHO. 2009. Monitoring Performance and Eval- ect (Credit No. 28600) and Health Sector Reform uating Progress in the Scale-Up for Better Health. Project 2 (Credit No. 35060). Washington D.C. A Proposed Common Framework. Geneva: World Bank. World Health Organization. • Monitoring Country Health Systems and Their Annex 6 also provides checklists and descriptions of Performance: An Outline Plan of Action, Report good practices under a SWAp mode, one for each of the of a WHO Technical Meeting Held at the Rocke- four critical success factors. These checklists were com- feller Centre, Bellagio, Italy, 28–30 October 2008. piled from a review of SWAp literature undertaken in • Monitoring Performance and Evaluating Prog- 2008, and updated on numerous occasions to take into ress towards the Health MDG. account new information generated since, notably: the • WHO. 2010. Monitoring and evaluation of results of IEG’s six-country SWAp review (Vaillancourt health systems strengthening. Geneva: World 2009); the latest literature and guidance produced by Health Organization. IHP+ working groups;15 and, finally, the incorporation • IHP. 2009. Joint Assessment of National Health of insights and lessons and South Pacific-specific context Strategies and Plans: Combined Joint Assessment gleaned from this desk study (these latter updates shown Tool and Guidelines. in bold/italics). The costs and benefits of learning • The World Bank’s Independent Evaluation Group’s through networks might also be explored, at the region- (IEG’s) evaluations of social-sector SWAps (www. al level (through SPC and the Pacific Forum), and at the worldbank.org/ieg), notably: global level (through IHP+ and possibly other net- • World Bank. 2009. Do Health Sector-Wide Ap- works). proaches Achieve Results? Emerging Evidence and Lessons from Six Countries. Washington D.C. World Bank. 15 www.internationalhealth_partnership.net Findings, Counterfactual, Lessons, and Their Relevance to Global Experience // 35 CHAPTER 7 Information Gaps and an Agenda for Fieldwork C hapter 1 is clear in noting the limitations of the evidence-base of this Washington- based study, and, along with the Concept Note, highlights the importance of fieldwork for collecting, analyzing and triangulating additional evidence. This additional evidence would include direct observations, interviews with key stakeholders, locally available data and trends, which would both fill information gaps and validate/refine findings and lessons. Engagement of countries in this learning initiative has the potential to be as valuable as its outcome. Table 7-1 summarizes the extent to which the desk study has been able to answer the Review questions and, in line with this study’s mandate, proposes an agenda for fieldwork. The purpose of the proposed fieldwork then is to vali- 7.1 Approach/Steps date/revise/update this study’s evidence, analysis, find- ings and lessons through: (i) review of additional It is suggested that the field visits, observations, inter- documentation available in-country; (ii) field visits to views and other validating actions be conducted as observe/understand SWAp design, implementation, is- follows: sues and its impacts at central and decentralized levels of sector administration and at the level of front-line ser- Step One: Prepare for Country Visits vices; and (iii) interviews with a wide range of actors and • Send desk study’s country-specific Appendixes to stakeholders. government and DPs, with the main synthesis (in- The final product would follow the design and or- cluding the proposal for field work). ganization of this desk study, which could be consid- • Agree on: ered a rough draft of the final report. Thus it would • mission timing (possibly linking with JRMs?); consist of standalone country studies (one on each of • participation (by key government officials and the SWAps in process) and a main report synthesizing by relevant DPs); and the country studies (same Table of Contents as for the • general approach/methodology. desk study). 37 Table 7-1: Unfinished Agenda of the Desk Review and the Proposed Focus of Fieldwork Review Question Desk Review Findings Agenda for Fieldwork 1. Were the anticipated benefits of the This question answered: to be validated. Validate findings: direct observation of SWAp and its approach realized? functioning and interviews. 2. Were (are) the objectives of the Partially documented: to be validated. Partial Validate partial findings and supplement with national health strategies and because programs are still ongoing. additional information/data/trends from decentralized programs of work (PoWs) (being) and front-line services and through interviews. achieved? 3. Did the approach facilitate the Documented, but with some gaps: to be Themes to be addressed in further depth: achievement of national sector validated/expanded. • M&E and results management: capacity and objectives? practice • Quality of strategic framework • TA planning and management in broader context of • Country capacity and incentives capacity needs, other capacity strengthening (including design/management of interventions, incentives TA) • Procurement, financial management and links to • Quality of partnership national systems/governance; comparing/ • Predictability, flow and use of funds contrasting different procurement, financial management designs and experience (ADB, WB, NZAID, AusAID models) • Comparative advantages of DPs; roles of DPs operating outside SWAp; role of regional entities 3.a Are there any other SWAp factors Draft list to be validated: Open-ended question to capture and address South that facilitate/undermine the (Small size of civil service, large quantity of TA; Pacific-specific characteristics and challenges. achievement of national objectives? region-level opportunities and constraints given isolation of islands; political economy of DP roles/interaction; high cost of doing business for DPs) 4. How did the SWAp affect DPs’ Inability to respond to this question through a Solicit views of countries and of DPs (both HQ- and efficacy? desk study. field-based). Relevance Documented: to be validated Validate/expand on assessment of relevance. Review risk assessments. Efficacy Documented (for SWAp): to be validated. Validate/expand on assessment of efficacy. Partially documented (sector): to be validated. Efficiency Efficiency of SWAp documented: to be Validate/expand on assessment of efficiency. validated. Sustainability Sustainability of SWAp documented: to be Validate/expand on assessment of sustainability. validated. What are the main findings and Draft lessons prepared, but will be subject to Validate/expand on draft lessons. lessons and what is their relevance change through the fieldwork: to be validated/ Intra-country synergies/lessons across the health to the global experience? revised. and education sectors. Open-ended questions about lessons. Step Two: Conduct Country Visits • solicit general feedback to validate/challenge • Central-level discussions to launch the study: preliminary conclusions and lessons; and • present study methodology, findings from orig- • present/revise mission work/field studies, spec- inal study of six countries; ifying participation. • present preliminary findings of South Pacific • Interviews with central-level actors and stakehold- Desk Study (country-specific and synthesis of ers (government ministries of Finance, Health, Ed- preliminary lessons); ucation; participating DPs; other DPs; and civil 38 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific society). Provides opportunity to examine cross- Step Four: Prepare Final Draft sectoral coherence, lessons, and synergies. • Main Report: Thematic Chapters on Cross-Country • Field visits. Findings • Return to central level to do follow-up interviews • Appendixes on Country-Specific Studies and discuss findings/revised recommendations. • Send for final comment/clearance Step Three: Conduct Postcountry Visits Step Five: Hold Cross-country Learning/Dissemination • Visits to the HQ of four sponsoring DPs to solicit Event feedback on desk study and to address Question 4 • Staffing, budget and timetable would be determined (efficacy of DPs under a SWAp) more in-depth; and on the basis of countries’ demand for such work and • Visit to regional entity/ies (SPC which is joining the availability of DPs’ commitment and resources. some SWAps). Information Gaps and an Agenda for Fieldwork // 39 Annex 1. Background and Regional Context Health and Education in the Pacific countries with abundant aid (Madagascar, Uganda, and Islands: Generous Financing, Modest Zambia at US$23). Results16 The effectiveness in delivering strong outcomes has, however, lost momentum. An assessment of three di- Education and health services have been an important mensions of government effectiveness (service expan- priority for government and donors for many years in sion, sector management, and broader governance the Pacific and collective efforts have culminated in reforms) suggests the importance of accountability for many impressive results in health status and educational improved outcomes. Service expansion accountabilities assessments since the 1970s and 1980s. However, contin- center largely on input management. Sector manage- ued momentum in these achievements has met with ment accountabilities center on techniques to get more some evolving challenges. Although most children are out of existing resources (delegation of responsibilities enrolled in primary school, there are concerns about to local providers, setting standards, targeting services to those still left behind, and those attending low-quality those in need, staff incentives and allocating resources to schools. Enrollments at secondary levels of education priorities). have stagnated and equity issues have appeared, particu- Governance initiatives, regulated by government as larly in secondary education, as poorer children dropped a whole, include information gathering and use, trans- out, or were squeezed out of the system. Public sector parent processes, information sharing, service decentral- health systems continue to face a demanding epidemio- ization to local governments, partnerships with the logical profile that is characterized by a prevalence of private sector, and community mobilization and partici- both communicable and (increasingly) NCDs that are pation. A distillation of the challenges and strategic more expensive to treat, along with emerging communi- choices facing Pacific Island countries in their quest to cable diseases such as HIV. Recognizing the many chal- enhance social-sector outcomes is synthesized in lenges faced by small island states in providing adequate Box 1A-1. service delivery, funding from donors and governments This analysis culminated in the identification of continued to flow into the social sectors. Nevertheless, three cross-sectoral strategic actions, aimed at achieving this financial support has not achieved the expected ef- more efficient management and use of sector resources. fect on sector outcomes. First, better public expenditure management was rec- Government and donor resources for education and health in Samoa, Solomon Islands, Tonga and Vanu- 16 This summary is drawn largely from Opportunities to Im- atu have attained high levels, averaging US$149 per cap- prove Social Services, Human Development in the Pacific Is- lands, The World Bank, 2006. But its analysis and messages are ita during 1997–2003. This level is almost equivalent to consistent with the views of countries in the South Pacific Re- the average in other small and island countries (US$185), gion and of DPs supporting these countries, as documented in and is more than six times the average for low-income the literature reviewed. 41 Box 1A-1: Challenges and Strategic Choices for Enhancing Sector Outcomes Education Health Challenges: Challenges: • How to ensure that every child completes the basic education • How to achieve better health outcomes through a health services delivery cycle of adequate quality. system that would effectively address the challenges of countries • How to ensure access to an equitable and quality secondary undergoing an epidemiological transition: education for a rising proportion of children. • the unfinished agenda of the MDGs, high fertility rates, continued prevalence of communicable diseases and the emerging threat of HIV and AIDS; and Strategic Choices: • rapidly rising NCDs. • Develop and refine the strategic policy and financing framework. • Strengthen and refine partnerships with private sector and community in increasing both the supply and the quality of Strategic Choices: secondary education within a coherent policy and regulatory • Ensure better alignment of resources, both government and donor funds, framework. toward achieving desired health outcomes as prioritized in country sector • Focus on issues that would facilitate school to work transition strategies. and meet the needs of the economy. • Diversify sources of finance from public revenues to encompass • Move to more delegation of accountability for delivery of school risk-sharing mechanisms and individual payments. services to those delivering services on the ground. • Delegate accountability to those delivering services on the ground, and • Put in place surveillance systems that allow policy makers and include all parts of the delivery system in health systems work. education managers to track progress, including strengthening • Develop financial and nonfinancial incentives for service providers to and developing Education Management Information Systems. ensure the delivery of quality services and for service users to ensure their • Alleviate constraints on poor people’s participation in education appropriate utilization. through innovative programs such as conditional cash transfers, • Support initiatives that encourage people to lead healthy lifestyles. inclusive or special needs education for children with disabili- • Document, and incorporate into service delivery design, information about ties, revising school fee structures, and using appropriate household and community demand for services, their actual utilization and pro-poor targeting mechanisms in the allocation of secondary the costs incurred by such use. scholarships. Source: Opportunities to Improve Social Services, Human Development in the Pacific Islands (The World Bank, 2006). ommended to ensure that resources would be targeted outcomes) created increased momentum in the ongoing towards priority social outcomes and needs identified in (global and regional) movement to improve social out- country strategies and plans. It was recognized that this comes through programmatic, or sectorwide, support would possibly require institutional and management (Box 1A-2). reforms such as improved public expenditure manage- Annex 2 provides a general timeline of key events ment systems, improved financial and procurement sys- which marks the history of the SWAP and aid effective- tems and delegation of accountability to lower levels of ness movements, both worldwide and within the Pacific government, as appropriate. Second, better systems for Region. In summary, in 1997, the first donor meeting to information collection, analysis and use were recom- discuss the sectorwide approach took place in Copenha- mended to facilitate more effective sector management gen, cohosted by Denmark and The World Bank, focus- and the systematic tracking of progress on social-sector ing specifically on the health sector. Later that same year outcomes. Third, closer alignment of sector and na- A Guide to Sector-Wide Approaches for Health Develop- tional policy priorities with the service delivery chal- ment, commissioned by WHO (and others also attend- lenges on the ground was also recommended. This ing that meeting), was issued. Starting in the new strategic action encouraged government and DPs to ex- millennium, a series of international meetings focusing ploit the synergies of cross-sectoral action to achieve so- on the topics of managing for results and aid effective- cial-sector outcomes, linking issues of youth with family ness took place: the International Conference on Fi- planning, employment, job market relevance of second- nancing for Development (Monterrey, 2002); the First ary education, and health behaviors, among other ex- International Round Table on Managing for Develop- amples. This analysis (and many other corroborating ment Results (Washington, 2002); the First High-Level analyses of the challenges of achieving social-sector Forum on Harmonization (Rome, 2003); the Second In- 42 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Box 1A-2: Leveraging all Resources to Improve Outcomes Through Programmatic Support The following key principles could build on efforts already underway to introduce more policy and strategic coherence and to align all resources and incentives to achieve sector outcomes: • Existence of a coherent strategy for the human development sectors; • Government ownership and accountability of the strategy being supported; • A focus on outcomes and prioritization of expenditures and scarce administrative capacities in support of the outcomes to be achieved, rather than just on input management (that is all inputs should be judged in terms of their contribution to improved outcomes); • Programmatic, organizational and management reforms to enable the outcomes to be improved; • Increasing the use of core government systems (a “whole of government� approach) to manage resources and the supported programs (including through strategic partnerships with the private, church and NGO sectors); • Developmental and recurrent support of programs to be supported within a medium-term fiscal or budget framework with a focus on sustainability; • Stakeholder inclusiveness in design and implementation of strategies; and • Transparency and probity in all processes including through sound financial and procurement management. Source: Opportunities to Improve Social Services, Human Development in the Pacific Islands (The World Bank, 2006). ternational Round Table on Managing for Development The Challenges of Implementing Aid Results (Marrakech, 2004); the High-Level Forum on Effectiveness Principles in the Pacific Aid Effectiveness (Paris, 2005); the Third Round Table on Island Context Managing for Development Results (Hanoi, 2007); the launch of the International Health Partnership and Re- In order to be credible and useful, it is important for this lated Initiatives (IHP+); and the High-Level Forum on review of social-sector SWAps in the Pacific to consider Aid Effectiveness (Accra, 2008). the special challenges of its very specific context. The Many countries in the Pacific Region, and some of general challenges of the Pacific Island region, the exog- their DPs, attended these meetings and signed inter- enous factors, include: (i) its remoteness and isolation, a national declarations on aid effectiveness with the Pa- factor of its geography; (ii) the legacy of its colonial ex- cific Region also issuing its own region-specific perience stretching back over 200 years and involving declarations (Annex 3). In 2007 the Pacific Aid Effec- many countries in Europe, the Pacific Region, and North tiveness Principles were developed by the Pacific Islands America; (iii) its communally focused cultural norms, Forum, and endorsed at a regional meeting in Palau. and strong indigenous culture; (iv) its susceptibility to Based on the Paris Declaration, they were conceived to natural disasters; (v) its reliance on natural resources; reflect Pacific goals, challenges and ideals. They empha- and (vi) its overall high dependency on external aid size country ownership, donor alignment and harmoni- (World Bank, 2005). zation with government planning and budget cycles, use Table 1A-1 provides data on overseas development of local systems and multiyear commitments for en- assistance. This shows: (i) how substantial this assistance hanced development effectiveness. is; and (ii) the very substantial portion which is made up In 2009, the leaders of the Pacific Islands Forum of bilateral aid (close to 100 percent of ODA for Solo- met in Cairns, calling for a new compact to drive more mon Islands, Tonga and Vanuatu, and two-thirds of effective coordination of available development assis- ODA for Samoa). Table 1A-2 shows how prominent Au- tance. Among the principles of the new compact are: sAID assistance is across all four countries, making up country leadership; mutual accountability and mutual the lion’s share of all ODA. It is especially high for Solo- responsibility between countries and DPs; the need to mon Islands where it is supporting RAMSI. draw on international best practices, as expressed in the More specific challenges include the countries’ gover- Paris Declaration and Accra Agenda for action; and a re- nance structures, processes and capacities which are intri- vitalized commitment to the achievement of the MDGs. cately connected to their ability to successfully implement Annual progress reports on the implementation of this under a SWAp mode. Table 1A-3 provides country perfor- compact were envisaged. mance assessment (governance) ratings assigned to each Background and Regional Context // 43 Table 1A-1: Overseas Development Assistance (ODA) in the Pacific (2006–08) Country Samoa Solomon Islands Tonga Vanuatu Net ODA (US$ millions) 2006 47 205 21 49 2007 37 246 31 57 2008 39 224 26 92 Bilateral Share (gross ODA) 2006 81% 88% 87% 85% 2007 78% 95% 86% 92% 2008 68% 97% 93% 97% Share of Total ODA going to: Health 21% 4% 3% 8% Education 6% 7% 12% 34% Source: OECD, World Bank: www.oecd.org/dac/stats of the four countries in the same year. It is interesting to performance, as SWAp principles are linked to a number note that ADB and World Bank ratings for Samoa and Sol- of governance issues including: the involvement of civil omon Islands vary significantly, whereas ratings for Tonga society; information availability and sharing; fiduciary ex- and Vanuatu represent almost a consensus. The table pro- igencies; accountability; and budget and planning cycles. vides an important context for assessing SWAps’ Annex 4 presents country governance briefs. Table 1A-2: Top Ten Donors of Gross ODA (2007–08 average) (in US$ million) Donors Samoa Solomon Islands Tonga Vanuatu Australia 13 193.8 11.1 24.5 New Zealand 7 19.8 9.1 9.0 Japan 7 12.4 4.2 11.4 European Commission (EC) 6 5.2 0.5 4.6 International Development Association (IDA) 5 — 2.6 — Asian Development Fund (ADF) 3 6.2 0.6 0.2 United States 1 — 0.8 14.1 Arab agencies 1 — — — UNDP 1 — — — United Nations Technical Assistance (UNTA) 0 0.5 — 0.6 Canada — 0.6 0.3 0.9 Italy — 0.3 — — Republic of Korea — 0.3 — — United Kingdom — 0.3 — 0.1 Turkey — — 0.3 — France — — — 11.4 Source: OECD, World Bank: www.oecd.org/dac/stats 44 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Table 1A-3: Country Performance Assessment Ratings of ADB and World Bank (2009) Policies for Public Sector Country/Source of Economic Structural Social Inclusion/ Management and Ratings Management Policies Equity Institutions Overall Rating Samoa ADB 3.2 4.0 3.5 4.0 3.5 World Bank 4.3 4.2 3.9 4.0 4.1 Solomon Islands ADB 3.5 3.3 2.9 3.0 3.5 World Bank 3.0 2.8 2.6 2.6 2.8 Tonga ADB 3.2 3.8 3.1 3.9 3.5 World Bank 3.0 3.8 3.4 3.6 3.5 Vanuatu ADB 3.8 3.3 2.8 3.1 3.5 World Bank 4.0 3.3 2.9 3.3 3.4 Source: ADB and World Bank data. Background and Regional Context // 45 Annex 2 General Timeline of Initiatives to Improve Aid Effectiveness 47 Year Global Events South Pacific ADB AusAID NZAID World Bank WHO Possibly earlier years? 1995 World Bank defines a new lending instrument, the Sector Investment Program (SIP), which advocates that projects are more sectorwide in scope, based on national policy and strategy, run by local stakeholders, supported by all main donors and increasingly reliant on local capacity for implementation. (Source: Harrold and others, 1995). 1996 1997 First donor meeting to discuss the sectorwide approach takes place in Copenhagen, cohosted by Denmark and The World Bank, focusing specifically on health. (Source: Vaillancourt, 2009) A Guide to Sector-Wide Approaches for Health Development, by Andrew Cassels is issued by WHO and others. 1998 1999 2000 (continued on next page) 48 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific (continued) Year Global Events South Pacific ADB AusAID NZAID World Bank WHO 2001 Joint 2001 Australia and New Zealand report on harmonizing donor policies and practices in the Pacific Region highlights some of the rationale for greater collaboration between donors: “harmoniza- tion is an issue that needs to be considered in the Pacific context because the small island states of the Pacific have limited management and technical resources.� (Negin, 2010a.) 2002 Monterrey International Confer- ence on Financing for Development calls for increased aid effectiveness and the need to measure and demonstrate results. First International Round Table on Managing for Development Results in Washington D.C. highlights need to build demand and increase capacity for results-based approaches and for DPs to harmonize approaches to results. 2003 First High-Level Forum on Harmonization in Rome commits to improving the management and effectiveness of aid, including harmonization of efforts adapted to country context and alignment of DP assistance with recipient priorities. 2004 Second International Roundtable on Managing for Development Results in Marrakech endorsed a set of principles on supporting countries’ efforts to manage for results. General Timeline of Initiatives to Improve Aid Effectiveness // 49 (continued on next page) (continued) Year Global Events South Pacific ADB AusAID NZAID World Bank WHO 2005 Paris Declaration is endorsed World Bank issues by the High-Level Forum on Aid Opportunities to Improve Effectiveness, committing to Social Services, Human further: country ownership, Development in the Pacific harmonization and alignment of Islands, which advocates the development assistance, leveraging of all resources managing for development to improve social outcomes. results and mutual accountabil- This includes coherent, ity for the use of aid. results-focused, prioritized social-sector strategies, a medium-term expenditure framework including donor resources, aligned with national priorities, government ownership, use of government systems and local partners, stakeholder involvement, and transpar- ency and probity in all processes. 2006 AusAID’s 2006 policy The World Bank’s Pacific for development Regional Engagement assistance in health Framework for 2006–2009 heralded the adoption highlights the importance of of SWAps as a core improving the effectiveness platform for aid of public expenditure in the delivery (Negin, social sectors through 2010b.). strategic partnerships with key development partners (Negin, 2010b.). 2007 Third Roundtable on Managing for Development Results in Hanoi reaffirms the Paris Decla- ration, calling for all countries and donors to improve their resource management to achieve better, verifiable results, guided by a commit- ment to mutual accountability. (continued on next page) 50 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific (continued) Year Global Events South Pacific ADB AusAID NZAID World Bank WHO The International Health Developed by the Partnership and related Pacific Islands Forum initiatives (IHP+) is launched, Secretariat, the seeking to achieve better Pacific Aid Effective- health results by mobilizing ness Principles are donor countries and other endorsed at a development partners around a regional meeting in single country-led national Palau. Based on the health strategy, guided by the Paris Declaration they principles of the Paris reflect Pacific goals, Declaration on Aid Effective- challenges and ideals. ness and the Accra Agenda for They emphasize: Action (September). country ownership, donor alignment and harmonization with government planning and budget cycles, use of local systems and multiyear commitments for enhanced develop- ment effectiveness (Negin, 2010b.). 2008 Accra High-Level Forum on Aid The Secretariat of the Effectiveness reviews progress Pacific Community made against Paris Declaration (SPC) and WHO start commitments and points to to introduce the vision three challenges: strengthening of “two organizations, country ownership; building one team, and 22 ben- more effective and inclusive eficiary island partnerships; and delivering countries and and accounting for results. territories� to signify a commitment to greater harmonization and collaboration, now being called “2–1-22.� (Negin, 2010a.) (continued on next page) General Timeline of Initiatives to Improve Aid Effectiveness // 51 (continued) Year Global Events South Pacific ADB AusAID NZAID World Bank WHO 2009 The leaders of the AusAID establishes an Pacific Islands Forum Office for Development meet in Cairns, calling Effectiveness (Negin, for a new compact to 2010a.). drive more effective coordination of available develop- ment assistance. Among the principles of the new compact: country leadership, mutual accountability and mutual responsibility between countries and development partners; the need to draw on international best practices as expressed in the Paris Declaration and Accra Agenda for Action; and a revitalized commitment to achievement of MDGs. Annual progress reports on compact implementa- tion are envisaged. 2010 Food Security & Nutrition Symposium. 52 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Annex 3 Matrix of Pacific Island Countries and Donors Attending/Signing Declarations of International Conferences Calling for Aid Effectiveness 53 Pacific Island Country Donor Forum Attended Signed Attended Signed International Conference on Samoa Australia Financing for Development Solomon Islands New Zealand Monterrey 2002 Tonga ADB (Monterrey Consensus) UNDP UNICEF UNFPA UNIFEM UNAIDS WHO World Bank IMF EC First International Round Table on ADB Better Measuring, Monitoring, and World Bank Managing for Development Results Washington D.C. 2002 First High-Level Forum on Vanuatu Vanuatu ADB ADB Harmonization Australia Australia Rome 2003 IMF IMF (Rome Declaration on Harmonization) New Zealand New Zealand Pacific Islands Forum Pacific Islands Forum UNDP UNDP USA USA World Bank World Bank Second International Roundtable on None World Bank Managing for Development Results UNICEF Marrakech 2004 (continued on next page) 54 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific (continued) Pacific Island Country Donor Forum Attended Signed Attended Signed High-Level Forum on Aid Papua New Guinea ADB Effectiveness Samoa GAVI Alliance Paris 2005 Solomon Islands Education for All-Fast Track (Paris Declaration on Aid Effectiveness) Tonga Initiative (EFA-FTI) Vanuatu GFATM IMF Pacific Islands Forum Secretariat World Bank UNDG Third Roundtable on Managing for Vanuatu ADB Development Results Australia Hanoi 2007 IMF New Zealand UNDP United Nations Social and Economic Commission for Asia and the Pacific (UNESCAP) UNFPA UNICEF UNIFEM UN World Food Programme USA WHO World Bank (continued on next page) Aid Effectiveness Conferences and Commitments // 55 (continued) Pacific Island Country Donor Forum Attended Signed Attended Signed High-Level Forum on Aid Papua New Guinea Papua New Guinea Australia ADB Effectiveness Samoa Samoa USAID GAVI Alliance Accra 2008 Solomon Islands Solomon Islands ADB EFA-FTI (Accra Agenda for Action on Aid Vanuatu Tonga European Commission GFATM Effectiveness) Vanuatu GAVI Alliance IMF GEF Pacific Islands Forum Secretariat GFATM World Bank IMF Pacific Islands Forum Secretariat UNAIDS UNESCO UNDP UNFPA UNICEF UNIFEM WHO World Bank International Health Partnership Plus — None — Australia European Commission UNAIDS UNICEF World Bank UNDP UNFPA WHO GAVI Global Fund 56 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Annex 4 Country Governance Briefs17 GOVERNANCE CONTEXT SUMMARY: term. The legislature is unicameral with 49 seats. Only SAMOA chiefs (Matai) affiliated to village-based electoral dis- tricts may stand for election in 47 of these seats. The oth- I. Introduction er two seats are reserved for election by nonSamoans or part Samoans who have no chiefly affiliations. The exec- The political system of Samoa is a unique mix of a west- utive comprises the head of state, a prime minister ap- ern democracy intertwined with traditional governance pointed by the majority party and a 12 member cabinet arrangements. The country has been politically stable appointed by the head of state on advice of the prime since the early 1980s following the emergence of a domi- minister. Separation of judiciary from interference by nant political party and more stable coalitions. Samoa the executive or legislature is strong, but the dominance suffered severe external shocks in the early 1990s from of the ruling party and the recent appointment of 20 ‘As- two consecutive cyclones and a failure of the taro crop, an sociate Ministers’ risks inhibiting the separation of exec- important export. Recovery was constrained by a sluggish utive and legislature (PIFS, 2010). Local government at economy dominated by poorly performing and corrupt district and village level is based strongly on traditional state-owned enterprises (ADB, 2009b). In recent years Sa- governance systems. moa has experienced strong social stability based on The economy has a narrow base and is strongly de- steady economic growth and governance reforms com- pendent on remittances from overseas workers and for- bined with the retention of traditional cultural values. eign aid. Between 1999 and 2007 GDP growth ranged Samoa currently scores above the Pacific average for from 1.0 percent to a peak of 7.0 percent (2007) and aver- all World Bank Aggregate Governance Indicators (WBA- aged 4.3 percent. Tourism-related business has been a sig- GI)(World Bank, 2012a). Stability and growth has led to nificant driver of this growth. The global financial crisis significant progress in human development. Samoa is impacted significantly on the Samoan economy, primari- well advanced in achieving the MDGs and poverty has ly through a reduction in remittances. GDP contracted by fallen faster than the targeted rate. There have been re- 3.4 percent in 2008 and 0.8 percent in 2009 and the fiscal cent setbacks due to the global financial crisis and a seri- deficit grew significantly. Although the tsunami caused an ous tsunami in 2009. Not all Samoans have participated estimated US$106 million in damage, reconstruction ef- in, and shared the benefits of, growth; hardship, inequity forts now appear to be lifting economic activity. The debt- and poverty of opportunity remain persistent in some to-GDP ratio is high and, although it is likely to rise areas (ADB, 2008c). temporarily in the wake of the recent events, Samoa is at The government is structured as a parliamentary democracy which was, until recently, headed by para- 17 This Annex was commissioned by the ADB to provide this mount chiefs appointed for life. Since 2007, the head of desk study with needed context on the governance situations state has been elected by the legislature for a five-year in each of the PI countries. 57 low risk of debt distress. The human development index until recently, capacities of the Office have been weak. rose from 0.69 in 1985 to 0.77 in 2010. There is no output-based audit and most audits on pub- lic bodies are outsourced to external auditors. Backlogs II.  State Capability in presentation of the accounts to the legislature have been considerable but there have been recent improve- Public Administration ments. The Public Accounts Committee does analyze au- As in other small Pacific economies, the public sector is dit reports, but there is little evidence that audit findings quite dominant (40 percent of both GDP and total em- are followed up with meaningful responses. ployment in 2005) with state-owned enterprises (SOEs) Samoa has undertaken wide-ranging tax and tariff continuing to absorb state expenditures (IMF, 2005). Ex- reforms that have improved the efficiency of the taxation tensive reforms have resulted in a generally competent system while maintaining a solid tax base. The main civil service, although efficiency and effectiveness could sources of tax revenue are a Value-added Goods and be improved. A Public Service Commission, established Service Tax (34 percent), excise duties (27 percent), im- under the Constitution and the Public Services Act 2004, port tariffs (14 percent), corporate tax (14 percent) and has adopted a more strategic approach to human re- income tax (11 percent). Tax administration has im- sources development and a process of departmental re- proved as a result of institutional strengthening and organization and realignment has recently been carried there has been progress on simplifying administrative out to maximize the use of relatively scarce skilled labor systems. The Ministry of Revenue website provides and improve service provision through more coherent needed information for taxpayers to comply. structures for planning and management. Despite these efforts, staff shortages remain acute. Public sector hiring Service Delivery and Responsiveness is primarily merit based; there is a code of conduct gov- The vision of the SDS 2008–2012 is ‘sustaining econom- erning civil servants and corruption is very limited. The ic and social progress’ and its priorities include pro-poor civil service is perceived as being honest and fraudulent objectives such as macroeconomic stability, employment practice is pursued vigorously. Progress in reform and creation, improved health and education outcomes and privatization of SOEs has slowed in recent years and, de- community development (ADB, 2008c). Public expendi- spite the establishment of a strong legal framework, the tures are generally aligned to poverty reduction goals, al- political will for reform is lacking (ADB, 2011a.). though expenditure linkages to the SDS need to be According to the 2006 Public Expenditure and Fi- strengthened. The Ministry of Women, Community and nancial Accountability (PEFA) Report, Samoa has a Social Development leads the development of programs model budget process with few shortcomings. All expen- for the extremely poor and vulnerable, but support for ditures are reported, revenue is budgeted conservatively these groups is mostly dealt with through traditional and the risks associated with SOEs included (GoS MoF, support structures. 2010). The process is orderly and includes consultation There are targeted pro-poor interventions such as with line ministries from an early stage. The Public Fi- subsidies on water and electricity for the poorest users. nancial Management Act (PFMA) 2001 provides a com- In response to the global economic crisis, the govern- prehensive framework for effective fiscal management. ment has implemented a school fee relief scheme which Under this Act output budgeting was introduced, but shifts the burden of payment for primary school fees lack of skills and failure to understand the benefits has from parents to the government. Taxes are generally eq- led to a continuing struggle with the approach (Laking, uitable; income tax is considered progressive with a tax- 2010). Since 2008–09 the budget has been prepared free threshold; fresh food, medical and educational fees, within an MTEF with explicit linkages to the priorities public transport and utility costs are exempt from the of the Strategy for the Development of Samoa (SDS) and Value-added Goods and Services Tax. sector plans, but further strengthening of these linkages In the last two decades the government has given pri- is required. The Office of the Controller and Chief Audi- ority to expenditure on the health and education sectors. tor (CCA) is not fully independent (PIFS, 2010) and, This has been effective, but there are concerns that gains 58 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific may be leveling off or even declining (AusAID, 2009d), moa ranks 61 of 183 countries in the World Bank Doing especially for those experiencing hardship (ADB, 2002). Business Report (2011) and shows substantial recent im- Access to health services is good and relatively equitable; provements in the time and costs of starting a business all citizens of Samoa are covered for primary and special- and registering land. The majority of the population has ist medical care with minimal fees. The national health access to formal sector financial services and Samoa has policy and government oversight are appropriate (ADB, an electronic payments system and manual clearance 2011b). Samoa has already reached MDG targets for child system which are moderately developed and functional. and maternal mortality rates. There are concerns about Procedures for enforcing contracts are lengthy and cum- the shortage of primary health care professionals and ris- bersome. The trade regime in Samoa is considered among ing levels of NCDs (AusAID, 2009d). Samoa is well on the most open in the Pacific with low tariff rates, minimal track to reach the MDG education targets with a primary nontariff barriers and no export taxes, but the procedures enrollment rate of 97 percent in 2008, and secondary ed- and time involved in importing and exporting are bur- ucation quality is high and access equitable. There is a sec- densome. The market for land is highly distorted with 80 tor strategy and education SWAp supported by donors. percent under customary ownership, 16 percent state- Retention of teachers, premature school leavers and ad- owned and 4 percent freehold. Customary land issues are dressing special needs are emerging concerns. difficult and sensitive and government has moved cau- Customary laws accord women prestige, and mod- tiously on addressing them. Property rights are protected ern laws largely guard against gender inequity and the under the Constitution, and land and property rights are rights of women are protected under the Constitution. reasonable defined. The government has ratified CEDAW (United Nations, 2012) but implementation by the Division for Women Accountability, Transparency and Oversight remains a challenge due to limited resources, traditional Samoa performs strongly compared to other Pacific attitudes and misinterpretation of the treaty. Policies that countries for rule of law (World Bank, 2012a). The judi- specifically address gender equality in access to health ciary is independent and upholds the right to a fair trial and education are broadly observed. In 2005 Samoa (Freedom House, 2009); independence is underpinned ranked 77 of 157 countries in the Gender-Related Devel- by statutory funding. Bribe seeking by judges or clerks is opment Index and the gross educational enrollment ra- rare and laws and regulations are publicly available and tio (all levels) was 76 percent for females and 72 percent not changed arbitrarily. Samoa is generally safe; the ca- for males (UNDP, 2005). pacities of the police have improved considerably Differences in workforce participation are pro- through donor (AusAID) support (Laking, 2010). The nounced, with a labor force participation rate in 2010 of village council (fono) provides oversight for law and or- 42 percent for females and 80 percent for males (UNDP, der at community level and has the authority to impose 2010). There are no gender differences in laws relating to penalties. While, in general, there are good partnerships property ownership or inheritance rights. Large gender between police and communities, the jurisdiction be- disparities exist in political participation at national level tween the police and village fono can sometimes be un- because there are fewer women Matai title holders eligi- clear (PIFS, 2010) and there have been some examples of ble for election. There has been some progress in the last abuse of power and excessive punishment by village fo- 10 years and women now occupy 8 percent of seats in nos (Freedom House, 2009). parliament and a number of senior positions in the pub- In Samoa freedom of assembly and association are lic sector (ADB, 2011b). There are also elected women’s respected in practice, and human rights groups operate representatives at village level to oversee women’s devel- freely. The country is classified as ‘free’ by the Freedom opment initiatives. Violence against women is a crime House Survey 2010 and scores highly for both political but is often dealt with by traditional governance mecha- rights and civil liberties (Freedom House, 2009). Free- nisms and this issue remains a significant problem. dom of speech and the press is generally respected, but The direction of the legal and regulatory framework there are weaknesses in the legal framework supporting for private sector development is generally positive. Sa- press freedom. A significant proportion of the media Country Governance Briefs // 59 operates outside of government influence and provides prevention and elimination efforts (ADB, 2011b). An some deterrent against unethical behavior. The overall ombudsman was established in 1991 to investigate com- perception is that the media is independent and plays a plaints by citizens against government agencies and has significant role in political checks and balances. The been working with significant impact. press is classified as ‘free’ in the Freedom House survey 2010. Accountability and transparency in government is good, public sector decision making is generally trans- GOVERNANCE CONTEXT SUMMARY: parent and the government attempts to distribute infor- SOLOMON ISLANDS mation to the public through the internet, radio, newspapers and TV (ADB, 2011b). I. Introduction Civil society in Samoa is quite vibrant and dynamic, comprising both informal and formal membership and Between 1998 and 2003 the Solomon Islands experi- nonmembership organizations. Informal organizations enced a destabilizing conflict rooted in a complex mix of such as women’s groups, church-affiliated groups and tra- development and ethnic issues. The conflict, between ditional associations predominate at the grassroots level, loosely aligned ethnic factions from Malaita and Gua- but more formal development NGOs have emerged in re- dalcanal, was intermittent but disruptive with factions cent decades. Churches generally play a less significant increasingly using their military power to threaten the role in Polynesian societies, (Laking, 2010) but are impor- state. By 2003 the state could no longer function effec- tant service providers in the education and social welfare tively and the prime minister sought assistance from sectors. NGOs in Samoa are mainly active in social devel- Australia to restore law and order. The outcome of this opment, but there are a number of good governance and request was RAMSI, a Pacific-wide response funded by human rights NGOs working on issues such as CEDAW Australia and New Zealand. RAMSI has been instru- implementation, domestic violence, and budget account- mental in restoring law and order, rebuilding the state, ability.18 An active umbrella organization (SUNGO) is and re-engaging in meaningful development partner- recognized by government and provides capacity build- ships (ADB, 2011c). The Solomon Islands performs be- ing and advocacy support. The government has increas- low the Pacific average on WBAGI except voice and ingly engaged with NGOs, village-level institutions and accountability and rule of law (World Bank, 2012a). churches in collaborative and transparent working rela- The Solomon Islands is a parliamentary democracy tionships and the legislative framework is conducive to an with a unicameral legislature comprising 50 representa- effective and functioning civil society (Lidimani, n.d.). tives; there are nine provincial assemblies plus the town Samoa scores highly amongst Pacific countries for council of Honiara, state and provincial legislatures are control of corruption (World Bank, 2012a) and ranks 62 elected by popular vote. The combination of a Westmin- of 178 countries in the Transparency International Cor- ster-style democracy and traditional society has pro- ruption Perceptions Index 2010 alongside Croatia and duced an unstable mixture of weak parties, independent Ghana. Samoa has established effective rules and pro- parliamentarians and coalition governments that divide cesses to guard against corruption, but there is a need to political spoils (Fukuyama, 2008). Separation of powers ensure these are effectively implemented and monitored. is provided for in the Constitution, but financial con- Corruption risks remain, given the overwhelming polit- straints may affect the autonomy of the judiciary (PIFS, ical dominance of the governing party, combined with 2010) and constituency development funds may breach traditional pressures to contribute to cultural functions the principle of separation. Kastom (traditional culture), which could lead to the misuse of public resources. Sa- and the church, continue to play an important part in or- moa has endorsed and actively engaged with the ADB/ dering the lives of Solomon Islanders (Menzies, 2007) OECD Anti-Corruption Initiative for Asia and the Pacif- and overlays of colonial-style local government have not ic, and completed self-assessments of corruption. It has, succeeded in establishing the authority of formal however, yet to establish a specialist anticorruption agency or unit responsible for coordinating corruption 18 http://www.rrrt.org 60 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific government or extending services to villages, and no at- The 1978 Public Finance and Audit Act and associ- tempts have been made to formalize traditional authori- ated Financial Instructions set the legal framework for ty (Laking, 2010). public financial management (PFM). The recurrent bud- The Solomon Islands experienced strong economic get and development budget are prepared separately growth from 2003 to 2008 which was initially fuelled by with little coordination between the agencies involved the aid-driven services sector and later by the primary (ADB, 2010). The quality of PFM has improved in recent sector, particularly logging. This growth has provided years, but compliance with budget processes remains apparent macroeconomic stability in recent years. Weak- poor (Pretorius et al, 2008). In particular, expenditure, ened demand and overexploitation of forests has led to especially aid expenditure, can be entered into the devel- lower recent growth. For three decades the economy has opment budget with little consideration of the implica- been characterized by high and erratic inflation which tions and much aid expenditure (including RAMSI) is reached 19.1 percent in 2008. A RAMSI-supported debt made outside the budget process and not adequately re- management unit is in place and debt-to-GDP ratios ported. The government does not have a medium-term have declined from 40 percent in 2007 to an estimated framework for budgeting but does produce a set of for- 27 percent by the end of 2009. Recent analysis suggests ward estimates in respect of funding priority programs. that about 11 percent of the population is experiencing Oversight of PFM has improved significantly through hardship in meeting the costs of a minimally nutritious capacity-building efforts under RAMSI. In the past three diet, and that almost 23 percent of the population faces years the Office of the Auditor General (OAG) has effec- difficulties in meeting their basic needs. tively addressed a huge backlog of audits and has been assessed as having a ‘rigorous and transparent audit pro- II.  State Capability cess in place’ (ADB, 2010). Reports of the OAG are pub- licly examined by parliament’s Public Accounts Public Administration Committee. The Solomon Islands has a large public sector that in- The main sources of tax revenue are income tax, cludes SOEs; employing around 25 percent of the formal goods tax, import duties and logging tax. Tax laws are workforce and consumes approximately one-third of the complex and dated, incentives for investors exist, but recurrent budget. The Public Services Act (1996) confers there are also provisions for discretionary concessions powers on the executive to regulate service terms and without clear processes in law. It is widely believed that conditions. The Public Service Commission is nominal- business interests have captured government which, in ly independent but poorly resourced. The poor quality of turn, provides them with concessions and exemptions public administration is acknowledged; administrative (ADB, 2010). Tax administration has been gradually structures are fragmented, business processes largely in- strengthened over the last five years with Pay-As-You- effective and responsibilities of ministries frequently Earn (PAYE) made a final withholding tax. There have overlap. As a result, there are delays and transaction also been efforts to improve compliance through educa- costs for the government and ultimately inefficient ser- tion, enforcement and increasing the taxpayer base and, vice delivery (ADB, 2011b). Recruitment is formally as a result, tax revenue has been improving and in- merit-based but there is extensive patronage and the civ- creased by 20 percent in 2008 (ADB, 2011b). il service is essentially politicized (PIFS, 2010). Bribe seeking is accepted behavior and the probity of public Service Delivery and Responsiveness servants threatened by opportunities for corrupt prac- Until recently, public expenditures had been unevenly tice. The impact of decentralization, overlaying a formal aligned with poverty reduction priorities and little provi- government structure on largely traditional societies, sion had been made to target public expenditure to poor has led to complex devolved structures and unclear areas or people. The government’s Medium-Term Devel- functions and roles. Inadequate resources have contrib- opment Strategy 2008–2010 has poverty reduction as a uted to capacity limitations and deterioration in service cross-cutting priority and explicitly endorses commit- delivery (Laking, 2010). ments to achieving the MDGs. The National Educational Country Governance Briefs // 61 Plan has a clear goal to provide equitable access to educa- (ADB, 2011b). In education female to male ratios in tion and the Health Sector Plan is strongly oriented to- 2007 were 89:100 for primary and 79:100 for secondary. wards MDG achievement. Assessing the linkages Adult literacy rates in 2002 were 88 percent for females between these policies and actual expenditure is chal- and 95 percent for males. Violence against women is a lenging because of the inadequacy of available informa- serious issue, with the Solomon Islands Family Health tion (SIERA, 2010). Personal tax is generally progressive and Safety Study in 2009 estimating that 64 percent of and equity of the tax system has been improved by broad- women aged 15–49 had experienced physical or sexual ening of the revenue base and the removal of tax exemp- violence or both from an intimate partner (JICA, 2010b). tions. Revenue generation is generally consistent with The commercial legal framework in Solomon Is- poverty reduction priorities, for example the removal of lands limits private sector development. The laws gov- all duties and taxes on rice (ADB, 2011b). erning company formation, contracts, dispute resolution Service delivery is challenging given the remoteness and insolvency are outdated and SOEs crowd out the and underdevelopment of rural areas, the rapidly rising private sector in some sectors. The government is mod- population and the financial and social constraints of re- ernizing and has made progress in attracting foreign in- cent history. The health situation has significantly im- vestment, developing an asset registry and establishing proved in recent years through RAMSI and other donor community enterprises (ADB, 2010). Access to credit is support; the government is on track to meet MDGs for poor, especially in rural areas because of the cautious ap- reduced child mortality and maternal health. The inci- proach of banks, systemic difficulties for all types of col- dence of TB is increasing, but treatment is successful. lateral and large infrastructure gaps. About 87 percent of Malaria remains a problem, with mortality rates well land is under customary tenure and considered a major above the regional average and there is concern that HIV constraint to private sector development since disputes and AIDS may be underreported. The education service over ownership delay access to land. This issue may be has improved and a strategic plan developed for reform less serious for agriculture (ADB, 2010). A land tenure and rehabilitation of the sector. Participation rates at all reform program recognizing and securing the rights of levels of education are among the lowest in the Pacific; in traditional landowners is under process. Recent reforms 2006 net enrollment ratios was 91 percent for primary in the tariff system have reduced the average applied tar- and 24 percent for secondary, with an overall literacy rate iff rate to 10 percent. There are no significant nontariff of 76 percent. Standards for teacher qualification are low, barriers although the weak capacities of relevant author- but a program of field training is ongoing. In 2008 the ities and a degree of red tape effectively represent barri- government introduced universal free primary educa- ers to trade (ADB, 2011b). In the World Bank Doing tion, but the financial sustainability of this is uncertain. Business Report (2011), Solomon Islands ranks 86 of Gender relations are influenced by matrilineal and 183 countries for trading across borders. patrilineal cultural patterns, but decision making and control of resources is biased, favoring men across all Accountability, Transparency and Oversight groups. The strong traditional obligation system under- The Solomon Islands indicator for rule of law is lower mines individual control of resources and exacerbates than for most Pacific countries (World Bank, 2012a), but women’s lack of economic power (ADB, 2011c). There is has shown steady improvement since the inception of universal suffrage, but participation and representation RAMSI. RAMSI’s participating police force has im- of women in politics is very low; there are currently no proved capacity building of the SI police and strength- female members of parliament. Employment of women ened the correctional and justice systems.19 The judiciary in the formal sector (public and private) is also low and enjoys a reputation for probity and integrity, political of- there is no legislation on equal opportunity or equal pay ficeholders are barred from being appointed to the Judi- (JICA, 2010b). The Solomon Islands is a signatory of cial and Legal Services Commission and judges cannot CEDAW and is one of the few to have signed the CEDAW be removed without review by a tribunal of retired operational protocol, but this has not been translated into agency planning and lacks legislative authority 19 www.ramsi.org. 62 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Commonwealth judges (ADB, 2010). Rural systems are There are little or no civil society pressures on govern- weaker, but provincial circuit judging is improving and ment to improve service provision although the govern- expatriate judges and lawyers are being replaced by lo- ment recently signed an MOU signalling its commitment cals (Laking, 2010). The main risk to the judicial system to establish an effective development partnership with is weak capacity which has been constrained by the po- civil society (ADB, 2010). litical environment and the lack of attention to career Reports on corruption in the public service persist; development which has led to difficulties in retaining elected and other public officials regularly have private qualified and experienced personnel. interests that conflict with their professional duties and Universal human rights are protected under the implementation of laws and policies is often distorted by Constitution; the government generally recognizes free- corruption. The country’s indicator for control of cor- dom of assembly and workers are free to organize and ruption compares unfavorably with those of Samoa and strikes are permitted. In 2009 a Truth and Reconciliation Vanuatu, but is better than Papua New Guinea, Tonga Commission was launched to investigate and address and Fiji (World Bank, 2012a). In the RAMSI People’s human rights violations committed during the tensions. Survey 2008, 81 percent of respondents believed there The country is classified as partly free by the Freedom was dishonest behavior or misuse of power by senior House Survey (Freedom House, 2012a). Freedom of ex- members of the community—a considerable increase pression and of the press is generally respected; the press from 2007 (54 percent) (ADB, 2010). The Leadership is classified as free by the Freedom House Survey. The Code Commission has a mandate to investigate abuses media–newspapers, radio (government owned) and, to a by politicians but its powers to investigate and prosecute limited extent, television–are playing an increasingly im- are not completely clear. The Office of the Ombudsman portant role in promoting good governance. Some min- has a mandate to investigate abuses by public servants istries use radio to communicate and explain reform but deals mainly with internal complaints of public ser- activities and publicize expenditures. The government vants. Both offices have been strengthened with donor communications office provides regular press releases, support but remain starved of resources. although there are reports of increasing political pres- sure on communications. There is no freedom of infor- mation legislation and public decision making continues GOVERNANCE CONTEXT SUMMARY: to lack transparency. Information availability is also con- TONGA strained by weak government capacities (including for data management). I. Introduction NGOs in Solomon Islands comprise membership and nonmembership organizations established for ei- Tonga is a hereditary constitutional monarchy unique in ther mutual or public benefit. Many community-based the Pacific; it was not formally colonized and has re- organizations are informal and linked to the church or tained much of its indigenous governance practices. In have their roots in Kastom rather than external models recent years pressure for political reform has intensified of organization. The church is an important provider of and, in 2006, a National Committee on Political Reform social services, particularly education and, to a lesser ex- recommended increased representation of the people in tent, health but does not engage significantly in policy the legislature and referendums on key issues. Anticipat- dialogue or comment on government performance in ed rejection of the committee’s findings led to serious ri- these sectors. Since the end of tensions, the churches oting in November 2006 and social capital has been have also been increasingly involved in peace building diminished as a result (ADB, 2011c). Following elections and reconciliation activities (Joseph and Brown Beu, in 2008 the government established a Constitutional and 2008). Recent increases in aid flows have led to an ex- Electoral Commission (CEC) to examine almost all as- pansion of local development NGOs, however emphasis pects of political reform and new elections (scheduled remains on social development and capacities for advo- for 2010) aimed to increase the number of parliamentar- cacy and demand for good governance remain weak. ians elected by popular vote. The World Bank indicator Country Governance Briefs // 63 for political stability and absence of violence has de- failed to gain support of the public service unions and, creased from 0.8 in 2004 to 0.2 in 2009 and Tonga scores following the long civil service strike in 2005, the gov- poorly (below zero) for the other World Bank Aggregate ernment raised public sector wages by 60–80 percent. Governance Indicators (World Bank, 2012a). The resulting fiscal management problem was addressed The executive comprises the reigning monarch (he- through a significant downsizing of the civil service by reditary), the prime minister and deputy prime minister 18 percent in 2006. One outcome has been a drain of ex- (appointed by the monarch) and a 14 member cabinet. perienced and qualified management from the civil ser- Ten of the cabinet members are appointed by the mon- vice which has exacerbated the effects of the already arch for life and four are appointed from among the serious ‘brain drain’ problem in Tonga. elected members of the legislature. The legislature is uni- Public sector capacity continues to limit develop- cameral with 32 seats, 14 for ex-officio cabinet members, ment, implementation of the reform agenda and deliv- nine members selected by nobles and nine elected by ery of core services (ADB, 2008d). Under the Public popular vote for three-year terms. Reforms that came Services Act 2002 management of the civil service was into force in 2010 devolve key powers from the monarch transferred from the executive to a Public Service Com- to the cabinet, make the cabinet answerable to the legis- mission established in 2003. This has been a major step lature, increase the number of people’s representatives in addressing favoritism and nepotism and improving and give the prime minister a mandate to govern. Given transparency. Performance standards have been intro- the dominant role of the monarch, separation of the duced to link remuneration with performance and CEOs powers of the state has been problematical and govern- have been put on fixed-term performance contracts. ment interference in the judiciary is a recurring issue. Hiring and promotion are now largely merit-based and Tonga has a small economy heavily reliant on remit- corruption is rare. tances and foreign aid. Aggregate growth has been slow The Public Finance Management Act 2002 provides and erratic in recent years and further contraction of the the legal framework for fiscal discipline; but implemen- economy due to the global financial crisis is expected. tation, although supported by donors, has only been Macroeconomic stability was under threat on occasion partially successful due to resource constraints and lack during the 1990s and early 2000s (ADB, 2011c). Fiscal and of political will (ADB, 2009d). The budget provides an monetary expansions have placed pressure on the balance adequate picture of government activities by economic, of payments, and restoration of fiscal discipline has in- administrative and functional classifications and presen- volved control of nonwage expenditure which, in turn, has tation of information on resources (government and do- constrained the efficiency and effectiveness of public ad- nor), and their allocation, has improved. Linkages ministration and implementation of aid funded projects. between the budget and programs to achieve national Tongan external debt distress has been high for some time development goals (including monitoring) have re- and will remain so–the external debt-to-GDP ratio has mained weak, but adoption of a Medium-Term Budget- been above 30 percent for the last four years and, at the ary Framework is in progress (Partnership Tonga, n.d.). writing of this report, was projected to rise above 40 per- Internal audit has been strengthened (Public Audit Act cent in 2010. Standards of living have improved consider- 2007) and the Auditor General reports annually to the ably in recent years and Tonga ranks 55th in the UN prime minister and to the legislature. There have been HDI–the highest of any Pacific Islands state. An estimated long delays in tabling and approval of audit reports by 23 percent of the population lives below the poverty line.20 the legislature although a backlog was recently cleared. Scrutiny by the legislature is limited as only summary II.  State Capability audit activities are tabled. According to the Global Integ- rity Report, the office of the Auditor General is general- Public Administration ly effective and transparent (Fonua, 2008). In Tonga the state plays a prominent, even dominant, role in the economy and the state wage bill is 15 percent of GDP. Initial efforts at ‘rightsizing’ the public sector 20 www.who.int/countries/ton/en 64 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific In the past, discretionary interventions have created to medical services through a network of hospitals and a nontransparent, confusing and widely criticized set of health centers. Infant mortality is low and immunization tax policies in Tonga. Tax revenues have been heavily de- rates high. Infection rates and rates of HIV/AIDs, TB and pendent on international trade as a source and current malaria are low. Tonga has long since achieved universal tax revenue is around 20 percent of GDP. The Revenue primary school enrollment and the majority of students Services Administration Act 2000 provides the founda- continue on to secondary level education. Responsibility tion for a modern system of revenue administration for delivery is shared between government and churches. based on self-assessment and voluntary compliance. The The quality of basic education has improved significantly process was automated in 2004 with the introduction of in recent years through the NZAID/AusAID/World the Revenue Management System. Further reforms in Bank Tonga Education Support program. Tertiary educa- 2008 introduced a simplified taxation system. The most tion is developing strongly, although vocational training recent PEFA Report indicated that taxpayers have easy remains weak. access to comprehensive, user-friendly and up-to-date Tonga has the highest HDI score in the Pacific– information on tax liabilities and administrative proce- demonstrating a good level of equality, especially in re- dures for all major taxes. spect of attainment of health and education indicators. There is, however, a strong paternal culture and wom- Service Delivery and Responsiveness en’s participation in decision making outside the home Tonga’s Strategic Development Plan 8, which ended in or in equitable control of economic assets remains low. June 2008, focused on the Government of Tonga’s com- Women cannot inherit land and can only access it as a mitment to achieve MDGs, including promoting sus- leaseholder which inhibits their ability to start a busi- tained private sector-led growth, reducing hardship, ness. Women remain underrepresented in politics and improving health and education standards, and promot- positions of authority although opportunities are slowly ing cultural development (AusAID, 2009d). In 2009 the improving (ADB, 2011b). Government awareness of government reverted to a longer-term strategic ap- gender issues is poor, the issue is not addressed in the proach through a National Strategic Planning Frame- NSPF and, until now, Tonga has failed to ratify CEDAW– work (NSPF) which has a stronger focus on outcomes probably because it would require amendment of land and a five to ten year outlook. The objectives of the NSPF ownership laws (JICA, 2010a). A policy on gender and encompass community development, private sector development exists (2001, 2005) but has not been im- growth, constitutional reform, infrastructure develop- plemented due to inadequate provision of resources. ment, vocational training, improved health and environ- Domestic violence is believed to be seriously underre- mental sustainability (Kingdom of Tonga, 2010). ported, awareness of this issue is extremely low and Alignment between the strategic plans and budgetary al- there is no legislation prohibiting such violence (JICA, locations has been weak, but the government is now ad- 2010a). dressing this issue (ADB, 2011b). There are no regressive There are significant gaps in the commercial legal taxes, income tax is pro-poor and progressive and reve- framework; contract laws are outdated and there is no nue receipts are used to subsidize access to health and contract law for the sale or exchange of goods. This in- education services. creases risk and uncertainty in business and adds to Improving the effectiveness and efficiency of service costs. Tonga has performed well in the World Bank Do- provision has been hampered by a rigid culture of hierar- ing Business Report (WBDBR) in recent years, but its chy in the civil service (AusAID, 2010) which has also ranking for ease of doing business has dipped in 2011 to limited the impact of training-based capacity develop- 71 of 183 countries. Freedom to start, operate and close ment. The government’s meager resources have limited a business is respected, but actual procedures can be progress on improving and maintaining service levels. burdensome. Small and medium-size businesses have Despite this, Tonga has, by most estimates, already met reasonable access to finance. The government estimates most of the MDGs (AusAID, 2010). Almost the entire that around 80 percent of the population has access to population, except for the most remote islands, has access formal credit. Country Governance Briefs // 65 A significant decrease in the number and complexi- available both in hard copy and on the Internet. Judicial ty of tariff bands has increased transparency and the decisions are publicly available. There is lack of transpar- country has moved to an average customs rate of 15 per- ency in budget execution due to the limited information cent and there are no export taxes. Tonga ranks 51 of 83 on actual government performance on implementing countries on the WBDBR indicator for trading across budgets and maintaining fiscal discipline. borders. All land in Tonga is the property of the crown, The main civil society organizations active in Tonga selling land is illegal but there is a leasehold market. include churches, church-based educational providers, There is also an active market in informal land transac- development NGOs (including human rights groups), tions that functions through the transferring or leasing community-based organizations and trade unions. The of land in exchange for a ‘gift’ of the equivalent value. The church is heavily involved in education and the NGO process of identifying and negotiating a property lease is sector is predominantly service-oriented, although this cumbersome. is changing. The civil service strike of 2005 became a fo- cus for civil society pressure for political reform and, al- Accountability, Transparency and Oversight though social capital in the immediate aftermath was The state is generally able to protect the lives and prop- damaged (ADB, 2007), the experience encouraged a erty of most citizens from crime and violence. The judi- broad coalition of civil society organizations to get in- ciary is independent and conducts fair public trials, but volved in campaigning against Tonga’s WTO accession, the Global Integrity Report (Fonua, 2008) notes that se- raising public understanding of the issues considerably lection of judges is not transparent and conflict of inter- (ANU, 2012). The level of effective input by civil society est regulations do not cover the judiciary. The legal into public policy has been low but the government is in- system is fairly efficient and protects property rights, but creasingly consulting and accepting civil society inputs. resolving conflicts through the law can be a lengthy and Community and NGO consultation and engagement is expensive process. This situation has been addressed an integral part of the NSPF (Laking, 2010). through recent efforts to cut existing case backlogs, in- Tonga scores significantly lower than most Pacific troduce prelitigation mediation and expand the jurisdic- countries, except PNG and Fiji, for control of corrup- tion of magistrates’ courts (PIFS, 2010). Some ministries tion (World Bank, 2012a) and the country ranks 99 of apply rules and procedures based on custom or past 180 countries in the Transparency International Cor- practice rather than strict legal interpretation which can ruption Perception Index (TI, 2012) with a score of 3 increase regulatory uncertainty and costs. Police are out of 10. The Global Integrity Report highlights the se- largely trusted and viewed as reliable but capacity gaps rious lack of conflict of interest legislation in Tonga and remain. the limited channels for safe reporting of corruption Freedom and rights are protected by the constitu- (Fonua, 2008). Respect relationships and gift-giving are tion and freedom of assembly is generally upheld, al- prominent aspects of Tongan culture, but there is in- though public protesters have faced government creasing awareness amongst educated people that gifts harassment (PIFS, 2010). Tonga is classified as ‘partly can be construed as bribery and that nepotism and fa- free’ by the Freedom House Survey (Freedom House, voritism can lead to conflict of interest and corruption 2012a) and scores poorly for civil liberties. The indicator (James and Tufui, 2004). Both Transparency Interna- for ‘voice and accountability’ is one of the lowest in the tional and Global Integrity have emphasized the need Pacific (World Bank, 2012a). Press freedom is rated as for anticorruption guidelines that appropriately address ‘partly free’ and appears muzzled to some extent, either these cultural perspectives. The Commissioner for Pub- by government interference or by self-censorship. It is lic Relations established in 2001 under the Public Rela- not obvious that the press plays any significant role in tions Act is, in effect, an ombudsman and has been holding government to account. Decision making in somewhat effective but requires greater independence Tonga is generally transparent and information on gov- and powers (ADB, 2007). An Anti-corruption Commis- ernment policies and outcomes is available. Laws and sion was set up in 2008, but no anticorruption strategy regulations are not changed arbitrarily and are publicly is yet in place. 66 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific GOVERNANCE CONTEXT SUMMARY: Vanuatu experienced little adverse effect from the global VANUATU financial crisis. Macroeconomic stability has been main- tained through prudent fiscal and monetary policies, I. Introduction and small fiscal surpluses have been recorded since 2004. The debt-to-GDP ratio has declined from over 40 per- The political system in Vanuatu is generally described as cent in 2002 to less than 18 percent in 2009 (Govern- unstable and fragmentary, with political competition ment of Vanuatu, 2009b). Growth has reduced the based on patronage rather than competing policy plat- incidence of poverty from 40 percent in 1998 to forms (Cox et al, 2007). As a result, governments have 15.9 percent in 2006 but the incidence remains high in been characterized by fierce infighting and unstable coali- urban areas. Many people suffer from “poverty of oppor- tions, with 13 changes of government between 1992 and tunity�, that is a lack of access to basic services, jobs, and 2004. Since 2004 the political situation has stabilized and education (ADB, 2009c). the ruling coalition was re-elected in 2008 and has sur- vived numerous no-confidence votes. The WBAGI rating II.  State Capability for political stability and absence of violence was above the average of Pacific countries in 2009 (World Bank, Public Administration 2012a) and Vanuatu performs better than the Pacific Is- The public sector is large (27 percent of formal employ- lands average for all six of the World Bank indicators and ment) and costly (55 percent of the recurrent budget). positive trends in governance are discernable (ADB and The Public Service Act (PSA) 1998 has ensured that the AusAID, 2009). Nevertheless, Vanuatu remains a fragile state civil service is largely free from political interfer- country that has high exposure to natural disasters, polit- ence and generally coordinates policy effectively. Hu- ical instability, and global market volatility. man resource planning is weak, staffing gaps and low The Vanuatu legislature is a unicameral body com- capacities reduce the quality of services and morale of prising 54 representatives and there are six autonomous the civil service and there is a continuing dependence on provincial councils, each of which is elected every four foreign advisers. In the past, provincial governments years by popular vote. The national executive comprises have been inefficient and contributed little to develop- the prime minister and a council of ministers. Separa- ment (Laking, 2010). With few exceptions local govern- tion of powers of the state is enshrined in the constitu- ment officers are political appointees, often without tion, but in small, island societies effective separation appropriate training and qualifications and open to ex- can be difficult and judicial intervention in parliamenta- ternal influence. ry process occurs (USP, 2012). Westminster-style de- There is a serious absence of coordination mecha- mocracy overlays, and is permeated by, Kastom nisms between central government agencies and pro- (traditional culture). The influence of Kastom can be vincial governments. Donors have been supporting overt and formal–for example through the national and improvements at provincial level; AusAID and the EU local councils of Chiefs–but, more importantly, is em- are strengthening provincial-level public financial bedded in a local understanding of correct action and management, an ongoing sectorwide approach (SWAp) behavior. The state is often viewed as a distant ‘big man’ in education has already contributed to improvements with elected politicians expected to provide material in the education sector, and legislation is under consid- benefits to their constituents. This can lead to weak in- eration for all local government officers to be appoint- centives for the delivery of national development policy ed under the PSA. and the politicization of local services (World Bank, The PFEM Act 2000 provides for effective economic, 2012b). fiscal and financial management by the government. As- Economic performance has remained strong in re- sistance provided by AusAID in the first half of this de- cent years. GDP growth was 3.8 percent in 2009 and av- cade was successful in revitalizing the Ministry of Finance eraged 5.7 percent over the last three years driven and Economic Management (MFEM). According to the primarily by tourism, construction and aid inflows. 2009 PEFA, this progress has been sustained and the Country Governance Briefs // 67 principles set out in the PFEM Act are adhered to. Links not made overall satisfactory progress towards achieving between national and sector priorities and the budget re- MDGs (ADB, 2011b). Primary health is free to ni-Vanu- main relatively underdeveloped, but there have been im- atu but there are charges for inpatient care and access to provements in some sectors–for example education due hospitals is strongly skewed toward urban centers. Im- to an ongoing SWAp. The government’s ability to monitor plementation of the MoH corporate plan to improve ac- the fiscal risk of SOEs and subnational entities remains cess to primary health care has been constrained by weak and the latter could impact on decentralization ef- limited recurrent funding and staffing and management forts. External scrutiny and audit mechanisms continue capacities. Infant mortality at 27/1,000 births has not de- to be weak, the lack of an Auditor General and audited ac- clined in recent years. School attendance is poor due to counts seriously undermines the MFEM’s timely presen- long distances, poor quality of teaching, irrelevant cur- tation of its financial statements, the Public Accounts riculum and poor conditions of school facilities, and Committee’s (PAC) ability to carry out its role, and the many school leavers do not have the necessary skills for government’s commitment to greater transparency and productive work or self-employment. Only 59 percent of accountability. primary and 68 percent of secondary teachers are quali- The primary source of revenue is VAT (38 percent) fied. Public spending on education is high at 28 percent and import duties (30 percent) although VAT receipts of total government expenditure and development part- have diminished due to the global economic crisis. Van- ners play a major role in financing expansion of the sys- uatu remains reliant on this narrow consumption base tem. for its income but there is no indication that income tax Traditional attitudes regarding male dominance will be introduced in the near future. According to the and customary familial roles hamper women’s participa- PEFA report, all tax revenues are paid in to Treasury- tion in economic and political life. Women have equal managed accounts. No reconciliation takes place of tax voting and legal rights to representation. There are only assessments, arrears and transfers to Treasury. The gov- two women MPs and no women in the cabinet. Quotas ernment is heavily reliant on overseas grants which have have been discussed but not yet introduced. Vanuatu is a increased from 6 percent to 27 percent of revenues in the signatory to CEDAW, but has not established any na- last six years. tional bodies and/or machinery to monitor implementa- tion or foster the advancement of women. The existence Service Delivery and Responsiveness of legal pluralism may run contrary to CEDAW as tradi- Vanuatu’s “Priorities and Action Agenda for 2006–2015� tional practices can be discriminatory. Boys tend to re- embodies broadly pro-poor policies. These include ex- ceive more education than girls and fewer girls go on to panding the productive sector; maintaining a macroeco- higher grades. nomic balance; raising public service performance; Many rural women in particular have little or no ed- cutting utility and transport costs; and improving access ucation and limited literacy and other skills. Women to basic services for health and education. Links be- make up only one-third of formal sector employees and tween these policies, sector policies and the budget re- do not enjoy equality in relationship to ownership, ad- main undeveloped and, as a result, there is limited direct ministration, enjoyment and disposition of property linkage between budget allocations and support for which is mostly controlled by men. Inheritance law ap- identified groups or areas at risk. The limited revenue plies equally to men and women except for land. Do- base also continues to constrain government efforts to mestic violence remains widespread–while there is deliver services and some service costs effectively act as legislation on sexual assault, there is inadequate protec- regressive taxes. tion for the range of sexual violations perpetrated and With a high rate of population growth and narrow Vanuatu has not yet incorporated domestic violence of- economic base, the distribution of the benefits of growth fences into its criminal law. remains narrow. The provision of opportunities and ser- The commercial legal framework in Vanuatu is vices to the 80 percent of the population who live outside complex, costly to access and does not encourage busi- urban areas is a formidable challenge and Vanuatu has ness transactions. Competition law is inadequate and 68 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific there is only limited legislation for consumer protection Act and public access to information is generally limited. or rights. Regulations for starting a business are burden- Decision making in Vanuatu is not transparent and public some and involve considerable duplication of effort lead- dissemination of information on government policies and ing to delays and high costs. Vanuatu is ranked 60 of 183 outcomes remains a low priority. countries for ease of doing business in the WBDBR Civil society in Vanuatu is made up of a multilay- (2011). Regulation of foreign investment has been inef- ered array of groups that have evolved over different pe- fective for a number of years. Licenses and other compli- riods of history (Howell and Hall, 2010). The church and ance requirements have been opaque and costly but chiefs are prime institutions of both authority and civil there has been recent improvement by the introduction society in rural areas, while modern development NGOs of IT-based processes. are concentrated in urban areas, mainly Port Vila. NGOs Tariff rates have been reduced although they still re- have focused much more on service provision than ad- main high by regional standards. There is also common vocacy and, to date, play a limited role in enforcing ac- use of nontariff barriers which has significantly impact- countability (ADB, 2009c). Chiefs have roles in local ed on freedom of trade scores from external organiza- dispute resolution–especially on customary land–and, tions–the WBDBR ranking for trading across borders, through local and national councils, advise government for example, is 142 of 183 countries. About 97 percent of on issues of tradition and Kastom. land is under customary tenure, with the exception of Churches have traditionally had a strong role in the Port Vila and Luganville where most of the land is legal- provision of education and health services but with little ly owned and leased out for up to 75 years by the govern- dialogue or coordination with the state. The Vanautu As- ment, although some is privately owned. Land sharing sociation of NGOs (VANGO), recognized by the gov- under customary tenure is enshrined in the constitution, ernment in 2004 (Laking, 2010), acts as an umbrella making it difficult for land to be used as collateral. The organization aiming to support capacity building and uncertainty surrounding land tenure rights is a major coalition building amongst mainly development NGOs. concern for foreign and local businesses. While chiefly organizations have formal relations with the state, there are few avenues of formal engagement Accountability, Transparency and Oversight between NGOs and the state. The state has an ambiva- Vanuatu performs better than most Pacific countries for lent approach to different parts of civil society–with re- rule of law (World Bank, 2012a). The judiciary is inde- ports of some intimidation and harassment of groups pendent, but the legal system is slow due to both the critical of politicians. complexities of the legal system and weak institutional Vanuatu ranks significantly higher than other Pacif- capacities. Legal sector reform has been strongly sup- ic countries for control of corruption (World Bank, ported by donors but experiences have emphasized the 2012a). The Global Integrity Report (2007) shows that importance of government ownership, the limitations of Vanuatu has continued to make progress on combatting using expatriate advisors and the need for a holistic in- corruption, with anticorruption policy rated as very stitutional approach to capacity development. strong, anticorruption agencies rated as moderate, but Vanuatu has been classified as ‘free’ by the Freedom law enforcement as weak. Perceptions of corruption re- House survey since 1990 and scores highly for both polit- main quite high (ranked at 95 of 180 countries on the ical rights and civil liberties. The indicator for voice and Transparency International index)(TI, 2012) and, in this accountability has been above 0.5 since 2005 (World Bank, regard, corruption in Vanuatu needs to be viewed 2012a). There is a small but vibrant private press, classified through the lens of the patrimonial system as a systemic in the 2008 Freedom House survey as ‘free’. Freedom of problem, rather than simply individual misconduct. The expression is protected under the constitution, and this dispensing of largesse is seen as a legitimate means of right is generally respected in practice, however journal- obtaining status and influence. While some forms of ists have been censored or intimidated on occasion (Free- corruption in Vanuatu carry heavy costs for the public, dom House, 2012b). The state owns the only radio and most ni-Vanuatu do not recognize it as affecting their television stations. There is no Freedom of Information personal interests (Cox et al, 2007). Country Governance Briefs // 69 Annex 5 Sectorwide Program Objectives and Design T his Annex provides a brief overview of: (i) the scope and coverage of the SWAps under review; (ii) the total cost of SWAps; (iii) how clearly SWAp concepts, principles and objectives are articulated in design documents, and how they compare with the SWAp objectives laid out in this Review’s analytic framework; and (iv) SWAp implementation arrangements. Scope and Coverage and programs supported under a SWAp. The total esti- mated cost of each project/program is equal to the total Most of the SWAps reviewed to date are not fully sector available financing (the sum of government’s contribu- wide in scope because they do not capture all sector ac- tion plus the contributions of the pooling DPs). Because tivities slated to be undertaken within a given timeframe the costs of strategic plans have not been assessed, it is (that is all activities envisaged in government strategic not possible to calculate what share of strategic plans plans and/or all activities supported by DPs not partici- these SWAp-supported projects/programs represent. pating in the SWAp). Nor do SWAps reviewed capture all sources of support. With the exception of Vanuatu Edu- cation, which appears to include all financiers and all ac- SWAP Definitions, Principles and tivities envisaged in a three-year time slice, the other Objectives SWAps support projects or programs that are subsets of Analysis documented in each of the country studies (in activities envisaged under government sectorwide plans, Appendix) reveals that the understanding among the and include only the financial support of DPs financing various actors and stakeholders involved of what a those particular projects or programs. SWAp is, what it aims to do, and how it will be imple- mented is not consistent or entirely clear, even within Cost the same country and the same sector, giving cause for confusion. SWAp descriptions and operating principles Table 5A-1 shows the timeframes of government strate- are articulated quite extensively, but differently, across gic plans and those of the programs/projects supported the various design documents describing the same under a SWAp, as well as the total costs of the projects SWAps. While they are not conflicting, neither are they 71 Table 5A-1: Relationship Between National Plans and Programs summary, all designs Supported designate the lead sector ministry by SWAps (health or education) as the implementing agency, re- Programs/Projects Supported Under a SWAp Government’s sponsible for program management, procurement, fi- Country/Sector Strategic Plans Project/Program Total Cost/ Financing Pooling DPs* nancial management, and oversight of sector institutions Samoa Education Strategic Policies and Plan: July Second Education Sector responsible for US$30.0 million implementation. The AusAID, NZAID, Ministry of Fi- 2006 – June 2015 Programme (ESP II) (2006– ADB 2013) nance has an oversight role concerning the fiduciary ob- ligations of government under the SWAp, especially Samoa Health Health Sector Plan: 2008–2018 Health Sector Program US$24.3 million AusAID, NZAID, (2009–2013) financial reporting, auditing and the use of resources World Bank for Solomon Islands Health National Health Strategic Plan: their Health Sector Support intended purposes. To SI$985 million the extent possible, AusAID country 2006–2010; and Program (HSSP)systems, processes (2008–2012) and [+ WB guidelines TA Project are used for procure- support National Health Strategic Plan ment and financial of US$1.5 million] management, but reliance on ADB or (NHSP): 2011–2015 World Bank guidelines is required when these systems Vanuatu Education Education Sector Strategy: Education Roaddo Map not (VERM) Not available meet minimum standards. TheAusAID, NZAID, exception is the 2007–2016 (2010–2012) UNICEF Solomon Islands Health SWAp, in which neither ADB Sources: Program Implementation Manuals. nor Note: *See Table 4–1 for a full list of DPs (pooling and nonpooling) supporting these the Bank provides pooled support. SWAps. Capacity is supplemented and strengthened through a combination of: the use of in-house capacity; the re- systematic in their descriptions and stated expectations cruitment of staff and local and international experts; of a SWAp. and supervision and quality assurance by DPs. All With the exception of Samoa Health, SWAp (capac- SWAps reviewed have some kind of partnership ar- ity and efficiency) objectives and indicators are more im- rangements or agreements which define a process of reg- plicit than explicit, making it extremely challenging for ular meetings (some annual, some semi-annual), aligned the other SWAps to define and measure success. This is with government cycles, to accommodate joint reviews/ especially problematic for the Samoa Education SWAp, discussions of annual or rolling plans, programs, bud- which was conceived as a pilot to test the SWAp ap- gets and financing and annual performance reviews. proach. The links between SWAp objectives and pro- These implementation arrangements are inherent to the gram outcomes is assumed, but not well-established in SWAp design and aid effectiveness principles and are the design documents. While, for each respective SWAp discussed in more detail in Chapter 4. reviewed, all design documents, taken together, do re- spond to the analytic framework’s summary of SWAps’ expected benefits or outcomes used in this study, no one document fully articulates all of these benefits or expect- ed outcomes. All of this gives cause for confusion on what the SWAp is and what it is trying to achieve. Table 5A-2 illustrates how only the Samoa Health SWAp articulates SWAp-specific objectives and distinguishes them from sector-specific objectives. Implementation Arrangements Implementation arrangements are defined in detail in each of the country/sector studies (in Appendix). In 72 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Table 5A-2: Distinction Between SWAp-Specific and Sector Objectives SWAp SWAp-Specific Objectives Sector Objectives Samoa — Goal: to help GoS establish a more equitable and effective education system that Education enhances learning outcomes of young people for further study, work and adult life. Expected impacts by 2015: • increased enrollment at all levels; • equal participation and performance by boys and girls; • improved functional literacy rates; and • increased employment rates of high school graduates. Expected quality improvements by 2011: • a new national assessment system; • improved capacity and performance of teachers; • improved learning outcomes; and • reduced dropout rates. Samoa To improve the effectiveness of the GoS in To improve access to, and utilization of, effective, efficient and quality health Health managing and implementing the Health Sector services to improve the health status of the Samoan population. Component-specif- Plan, using results from sector performance ic objectives are to: monitoring. Component-specific objectives are support the transformation of the health sector from a medical model towards to ensure: wellness orientation and health promotion; • that policies/plans are implemented in line improve the quality of health services through strengthened human resources, with priorities; standards, supplies, equipment and infrastructure; and • greater efficiency in resource use; improve policy, monitoring and regulatory oversight of the health sector. • national ownership and commitment to health sector program; • results of performance monitoring are used to shape program implementation; and improved health sector governance. Solomon — Goal: To support the SIG in achieving improvements in priority health outcomes for Islands the population through effective, efficient and equitable services that are Health responsive to the population’s health needs. Strategic objectives: • to raise service performance; • improve the long-term financial sustainability of public services; and • improve the management of the public health system at central and provincial levels. Impact indicators focus on declines in Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR) and Total Fertility Rate (TFR). Key Performance Indicators focus on service performance, Contraceptive Prevalence Rate (CPR), measles immunization, treatment of hypertension and diabetes; malaria case fatality; TB and STIs); financial sustainability (health expenditure, revenues, costs); and management (drug stockouts and community outreach programs). Sectorwide Program Objectives and Design // 73 Annex 6 Checklists, Guidelines, Good Practices under a SWAp This Annex presents checklists and descriptions of good account new information generated since, notably: the practices under a SWAp mode, one set for each of the results of IEG’s six-country SWAp review; the latest liter- four critical SWAp success factors (middle panel of ana- ature and guidance produced by IHP+ working groups; lytic framework–Figure 1-1). These checklists were com- and, finally, the incorporation of insights and lessons and piled from a review of SWAp literature undertaken in South Pacific-specific context gleaned from this desk 2008, and updated on numerous occasions to take into study (these latter updates shown in bold/italics). Box 6A-1: Characteristics of a Good Medium-Term Program of Work/Sector Strategic Framework • Strategic relevance: coherence with macroeconomic, multisectoral and health policy, and with economic development and poverty reduction objectives; • Relevance of objectives and design; • Rigorous appraisal from technical, economic, financial, institutional, political, equity, and social (or demand-side) perspectives; strength of its evidence base; and cost-effectiveness; • Adequate reflection of issues, challenges, needs, perspectives, and priorities of front-line services and decentralized/deconcentrated entities and other key actors and stakeholders, implying a participatory process; • Clear results orientation and accountabilities: coherent results chain-linked with development objectives, appropriate indicators, established baselines and targets, specificity about equity issues and goals and how they will be measured, an M&E strategy and plan, and mechanisms for tracking accountabilities; • Sound assessment of political and other risks and a plan for their mitigation; • Implementability: fit with available capacity and financing; clearly stated priorities and appropriate, strategic sequencing of actions (from political, technical and capacity perspectives; • Plan to strengthen implementation capacity, based on capacity assessments that would embrace a holistic and synergistic approach to capacity building, including a results-based detailing of all essential inputs together: technical assistance, training, performance monitoring, pedagogical supervision, and systems strengthening; and • Viable estimates of implementation costs,* medium-term projections of resource availability, an MTEF and annual budget that are reflective of sector priorities. Source: Author, drawing on various sources including: Cassels (1997); IHP’s Guidance Notes on Country Compacts and Joint Assessments of National Strategies (www.internationalhealthpartnership.net/en); Vaillancourt (2009). Note: * IHP IHP+ guidelines recommend the costing of three scenarios: needs-based, results-based, and resources-based. 75 Box 6A-2: Checklist for Strengthening Country Capacities, Systems and Incentives Capacity Building Areas:* • Policy making, strategic planning, programming, budgeting, allocation of resources; • Procurement; • Disbursements and financial management; • Expenditure efficiency/tracking and analysis of sector expenditures; • Monitoring and evaluation; and • Use of data for decision making. Capacity Building Activities: • Assessment of systems, capacity, incentives: • In the broader context of national public sector systems, capacity, incentives; • Against minimum standards for use; • Ensuring coherence and synergies of the management systems within the sector, and with other relevant government agencies; • Development of a holistic design/plan for strengthening systems, capacity, incentives, weaving together all essential capacity-build- ing inputs: technical assistance, training, performance monitoring, performance incentives, pedagogical supervision, systems strengthening, and contracting out of nontechnical functions; • Implementation of the design/plan, using a phased approach; and • Focus on peripheral-level, as well as central-level capacities, systems and incentives. Source: Author, drawing on various sources including: Cassels (1997); IHP’s Guidance Notes on Country Compacts and Joint Assessments of National Strategies (www.internationalhealthpartnership.net/en); Vaillancourt (2009). Note: * Essential capacities listed here are limited to capacities for SWAps/management. They do not include capacities for service delivery, which is a sector-specific issue dealt with inside of the medium-term PoW. Box 6A-3: Components of a Good Partnership Under a SWAp Who Is in the Partnership? National actors and stakeholders: • Government (central, regional, peripheral levels, parliament) • Sector ministry • Cross-cutting ministries: Finance, Civil Service, Local Government • Other relevant sectors: Social Development, Nutrition • Nongovernmental • For-profit and not-for-profit service providers • Other civil society organizations All external development partners, no matter the modality of their support • Bilateral, multilateral • Regional (SPC, Pacific Forum) To Do What? To What End? • Negotiate evidence-based policy/strategy ===> Coherent, coordinated sector policy • Allocate resources to sector priorities ===> Rational/equitable resource allocation • Review/evaluate sector performance/outcomes ===> Greater focus on results How Do They Interact? • Government in a leadership position, with adequate capacity and stability to fulfill its role; • DPs in a supportive position, with clearly defined roles, responsibilities, accountabilities and capacities; • Dialogue and decisions based on the generation of evidence, rather than conditionality; • Mutual accountability of all partners for results, based on performance benchmarks for each partner (or group of partners); • Clear guidance and mechanisms for managing and resolving disputes; and a level playing field, among DPs; and • Coordination/collaboration around one national health plan, one M&E framework, one review process. Source: Author, drawing on various sources including: Cassels (1997); IHP’s Guidance Notes on Country Compacts and Joint Assessments of National Strategies (www.internationalhealthpartnership.net/en); Vaillancourt (2009). 76 // In Sweet Harmony? Review of Health and Education Sectorwide Approaches (SWAps) in the South Pacific Box 6A-4: Factors Facilitating Predictability, Flow of Funds and Budget Execution and Use Predictability of Overall Sector Funding Generic factors: • A phased budget based on PoW cost scenarios that identify the financing gap – MTEF; • Inclusion of the nongovernmental sector in cost and resource envelope estimates; • Specification of the total and annual financial commitments for the sector of the government and all other financiers; and • A sufficiently strong budget and planning process, aligned with the country’s budget cycle. Factors specific to domestic/government financing: • Stable macroeconomic conditions; and • Firm government commitments to increase domestic budget allocations to the sector at the outset of the PoW. Factors specific to external financing: • Firm commitment of DPs’ funding (amount, modality and timing) at the outset of the PoW; • Agreed disbursement schedule linked to the PoW and national plan, and aid flows reported in national budgets; • Annual releases of funding in line with commitments at the time of the annual budgeting exercise; • Alignment of donor planning cycles, among themselves and with country planning and budgeting cycles; • Commitment to predictable medium-term and long-term financing; • Responsiveness to financing gaps identified in budget scenarios and the MTEF; • Availability of resources in the timeframes described in the country health strategy and budget; and • Timely information on annual DP commitments and disbursements for monitoring accountabilities. Flow of Funds To Implementing Entities: • Timely disbursements to districts and implementing agencies in the amounts committed and budgeted; • Simplified disbursement and financial management reporting and adequate capacity to implement it; and • Systematic measurement of capacity to manage and coordinate aid flows. Budget Execution and Use: • Systematic measurement of budget execution rate to monitor implementing entities’ absorptive capacities; • Systematic measurement of the use of funds against national and local priorities; and • Link expenditures to results achieved. Source: Author, drawing on various sources including: Cassels (1997); IHP’s Guidance Notes on Country Compacts and Joint Assessments of National Strategies (www.internationalhealthpartnership.net/en); Vaillancourt (2009). Checklists, Guidelines, Good Practices under a SWAp // 77 Bibliography ADB. 2000. Samoa 2000. Pacific Studies Series, November. ——— 2011a. Finding Balance 2011: Benchmarking of the ——— 2002. 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