In Niger, where the healthcare sector faces chronic underfunding, the Common Health Fund was launched in 2006 through a collaborative effort between the Ministry of Public Health, the French Development Agency (AFD) and the World Bank. Today, the fund unites six major donors and has channeled €91 million into healthcare initiatives between 2015 and 2019.

Designed to bolster the country’s healthcare system, particularly for women and children, the fund supports the implementation of Niger’s Health Development Plan (PDS). By pooling international resources, it enhances the government’s capacity to deliver comprehensive healthcare services nationwide.

Key evaluation findings

The assessment employed a participatory approach, engaging central and regional health officials along with all donor partners. Its findings informed the AFD’s fourth funding tranche to the initiative.

The evaluation revealed the fund’s growing relevance over time. It successfully adapted its management framework to accommodate partners’ preferences for targeted funding while maintaining alignment with national priorities. The mechanism also strengthened strategic dialogue between the Ministry and its partners, though inter-donor coordination remains an area for improvement.

Tripling healthcare budgets

Another notable achievement is the fund’s exceptional efficiency in financial management. The quality of its fiduciary processes has enabled healthcare budgets to triple in 2018-2019 compared to previous years. Clear, universally adopted procedures have enhanced the Ministry’s management capabilities. Importantly, the fund serves as a reliable and predictable funding source for regional health departments to execute their annual activity plans.

The evaluation identified critical gaps in monitoring financial flows, project implementation and outcome measurement, which complicates the assessment of targeted interventions’ effectiveness. Additionally, it highlighted systemic issues in the PDS’s planning approach, particularly its top-down structure and weak monitoring and evaluation framework.

Dr. Abaché Ranaou’s perspective

The Secretary General of the Ministry of Public Health and Strategic Coordinator of the Common Health Fund shared his insights:

« To ensure coordinated implementation of successive Health Development Plans aimed at enhancing the wellbeing of the Nigerien population, the Ministry of Public Health, in partnership with technical and financial stakeholders, established a donor common fund in 2005, operational since 2006. This mechanism fosters alignment of partner actions with national priorities, harmonizes interventions and ensures predictability and stability of international aid.

The AFD-led evaluation yielded overwhelmingly positive results. These findings reinforce donor confidence in the Ministry of Public Health and encourage renewed participation in this national initiative that benefits all citizens.

While the evaluation confirms tangible progress, it also identifies areas for enhancement, including communication, programmatic aspects, monitoring and evaluation. To further engage partners and stakeholders, it is crucial to emphasize the visibility of actions and showcase results achieved relative to allocated resources. »