Ethiopia Aid effectiveness in the health sector - Action for Global ...

Ethiopia – Aid Effectiveness in the health sector
come at the expense of the Government engagement with Parliament and
civil society. 20
The number of ‘dialogue spaces’ and donor representatives should be limited
to reduce red tape. In fact, in 2007 the Government informed the DAG that it
wanted to streamline the coordination structures and replace the TWGs with
five Sectoral Working Groups (SWGs): Rural Development and Food Security,
Private Sector, Transport, Gender, and Water. In response, the DAG has created
some SWGs, while some of the TWGs are still engaged in discussions with their
Government counterparts.
DP partners should strive to conclude these discussions as soon as possible.
However, the DAG has stated that it will continue to work internally on the basis
of the 11 TWGs. Even though this process is still at an early stage, it is difficult to
see how this reaction will help improve coordination and alignment and not
hamper dialogue. Furthermore, it has been two years since the Government
requested that the DAG streamline the dialogue spaces and this process is still
underway. This suggests that DPs are either not very keen on the process or they
have not yet managed to agree on distribution of tasks.
After the 2005 elections, DPs made significant changes to aid modalities in
Ethiopia. Many DPs moved away from budget support and decided to pool
their funds instead. Some donors who were working in Ethiopia when budget
support was on the rise mentioned that the results were far behind the
experiences of Ghana, Mozambique and Tanzania. Ethiopia is a federal
country and the Government is completely decentralised. There is only a
central budget for defence and foreign affairs and the rest of funds are
transferred to district authorities, according to rules based on population, etc.
This made it difficult for donors to track their money, especially when they had a
target sector for budget support. Even though DPs wanted to support the
health sector, in practice district authorities received their entire budget and
redistributed funds at will. Bearing in mind that there are 611 districts or woredas,
monitoring funds would have been a titanic task.
The Government is probably aware of these difficulties. In the IHP+ Compact it
states that the preferred instrument for DPs’ support to the health sector is not
budget support but a basket fund managed by the Ministry of Health (MoH),
the MDG Fund. In theory, the MDG Fund should replace the existing Protection
of Basic Services (PBS) scheme. But DPs are not very keen on this because of
the political consequences of providing direct support to the Government after
the last elections as well as the new controversial Charity Law (see below).
A major obstacle to achieving a higher degree of harmonisation in Ethiopia is
the lack of commitment from the country’s largest donors: USAID, PEPFAR and
the Global Fund. The volume of aid of all other donors to the health sector
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