Education and Health in Sub-Saharan Africa: A Review of Sector-Wide Approaches (Africa Region Human Development Series)

151 Pages·2003·0.66 MB·English

by  Africa Regional Office World Bank

Education and Health
in Sub-Saharan Africa
A Review of Sector-Wide Approaches
World Bank Group
Human Development
Africa Region
Copyright © 2001 The International Bank for Reconstruction
and Development / THE WORLD BANK
1818 H Street, N.W.
Washington, D.C. 20433, USA
All rights reserved
Manufactured in the United States of America
First printing January 2001
1 2 3 4 03 02 01 00
The findings, interpretations, and conclusions expressed in this book are entirely those of the authors and
should not be attributed in any manner to the World Bank, to its affiliated organizations, or to members of its
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racy of the data included in this publication and accepts no responsibility for any consequence of their use.
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ii
EDUCATION AND HEALTH IN SUB-SAHARAN AFRICA
Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Summary of Main Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
1. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Situation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Project Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Program Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
The Development of Sector-Wide Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
The Roots of Sector Investment Programs (SIPs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
SIP Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Innovations in SIPs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Purpose of the Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2. MEETING THE PRECONDITIONS TO START THE PROCESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3. ESTABLISHING A COLLABORATIVE PROCESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Developing Donor-Government Partnerships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Using National Leadership to Build Ownership and Support . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Forging Donor Coordination: Working Together under Government Leadership . . . . . . . . . 10
Common Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Common Procedures (or “Harmonization”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Instruments for Coordination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
4. DEVELOPING A POLICY FRAMEWORK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Requirement 1: Definition of Appropriate Program Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Requirement 2: Strong Analytical Underpinnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Requirement 3: Consultation with Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Requirement 4: A Flexible, Ongoing Process of Policy Development . . . . . . . . . . . . . . . . . . . . 19
iii
CONTENTS
5. DESIGNING APPROPRIATE FINANCIAL PARAMETERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Setting the Sector within the Macroeconomic Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Building a Medium-Term Expenditure Program for the Sector . . . . . . . . . . . . . . . . . . . . . . . . . 22
6. DESIGNING IMPLEMENTATION SYSTEMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Analyzing Institutional Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Monitoring Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Information Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Joint Reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Providing Adequate Resources for Monitoring Implementation . . . . . . . . . . . . . . . . . . . 29
Financial Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Budgeting and Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Pooling of Donor Funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Lender of Last Resort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Procurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
7. MAIN FINDINGS AND RECOMMENDATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Successes of the Sector-Wide Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Weaknesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Design of Sector Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Implementation of Sector Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Recommendations for Best Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
A. Meet the Preconditions for Starting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
B. Establish A Collaborative Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
C. Establish a Comprehensive Policy Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
D. Develop Financial Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
E. Build Management Systems and Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Annex 1: List of World Bank Staff Interviewed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Annex 2: Ethiopia Health Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Annex 3: Ghana Health Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Annex 4: Senegal Health Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Annex 5: Zambia Health Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Annex 6: Ethiopia Education Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Annex 7: The Gambia Education Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Annex 8: Mozambique Education Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Annex 9: Zambia Education Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
iv
EDUCATION AND HEALTH IN SUB-SAHARAN AFRICA
Foreword
Dissatisfaction with traditional project approaches Bank with this approach. The commitment to Edu-
and a recognition of the limitations of the sector cation for All reaffirmed by all partners at the World
adjustment programs led to the development of new Education Forum in Dakar, April 2000, and the ur-
lending instruments to improve the impact of de- gency of an acceleration of education development
velopment assistance on the sector as a whole. The in Sub-Saharan Africa make the search for more ef-
social sectors have been at the vanguard of these in- fective ways of working together for education de-
novations in several countries. Within the Africa Re- velopment an inescapable imperative.
gion of the World Bank, the most commonly used This is especially important as the Bank2 and
such new instrument to provide support for a more several bilateral agencies have explicitly indicated
comprehensive sector development program has their intention to use this approach to channel their
become known as “Sector Investment Program” support for education development. While the SWAP
(SIP).1 Other agencies have used different names for is not without problems and is not suitable in all
this approach. For example, under the leadership of countries, some adaptation of the SWAP is likely to
the European Union, a group of European bilaterals become the most important instrument used by
worked along similar lines and developed a strategy external agencies to support accelerated education
known as “Sector Wide Approach” (SWAP). development in the Africa region. This paper sum-
In recent years this approach—characterized by marizes the lessons we in the Africa Region have
a government-led partnership with key external part- learned so far, identifies the strengths and weaknesses
ners, based on a comprehensive sector policy and of this approach, and provides advice and guidance
expenditure framework, and relying on government to operation staff in the Bank, partner agencies, and
institutions and common procedures for implemen- governments who will be involved in sector-wide
tation—has been used by the World Bank for about approaches in the years to come.
a dozen operations in the health and education sec- This paper was prepared by Richard Johanson
tors in Sub-Saharan Africa. under the supervision of Adriaan Verspoor, Educa-
This paper is a most welcome review of the ex- tion Lead Specialist in the Africa Region of the World
perience to date of the Africa Region of the World Bank, with the assistance of Angel Mattimore.3 Con-
1 Peter Harrold wrote the definitive explanation of sector investment programs in his work “The Broad Sector Approach to
Investment Lending,” World Bank (1995).
2 See The World Bank (2000) “A Chance to Learn: Knowledge and Finance for Education in Sub-Saharan Africa,” forth-
coming.
3 The findings, interpretations and conclusions expressed in this paper are entirely those of the author and should not be
attributed in any manner to the World Bank, its affiliated organizations or to the members of the Board of Executive Directors
or the countries they represent. The World Bank does not guarantee the accuracy of the data included in this publication and
accepts no responsibility for any consequence in their use.
v
tributions to the paper and case studies were given World Bank). We would like to thank the Norwe-
by Arvil Van Adams, Anwar Bach-Baouab, Rosemary gian Government for providing financial support for
Bellew, David Berk, Nicholas Burnett, Francois the preparation of this study through the Norwe-
Decaillet, Linda Dove, Birger Fredriksen, Donald gian Education Trust Fund. For more information
Hamilton, Bruce Jones, Julie McLaughlin, Paud about this book, send an e-mail message to
Murphy, Eliezer Orbach, O.K. Pannenborg, Robert [email protected].
Prouty, Jee Peng Tan, and Steve Weissman (all of the
Birger Fredriksen
Sector Director, Human Development
Africa Region, The World Bank
vi
EDUCATION AND HEALTH IN SUB-SAHARAN AFRICA
Summary of Main Points
Project assistance in Africa has been criticized as frag- Management systems and capacity building
mented, donor-driven and lacking impact on basic < Common implementation structures
development problems. In view of the wide-spread and procedures (harmonization of do-
limitations of projects, in the early 1990s a new lend- nor procedure—including reporting,
ing approach was developed in Africa—the “Sectoral joint annual reviews of performance,
Investment Program”. The main rationale for this procurement, disbursements to the ex-
kind of sector-wide approach was to address weak- tent possible)
nesses of the project approach and achieve greater < Use and strengthening of government in-
impact with development assistance. The main char- stitutions, procedures and staff (rather
acteristics of SIPs are as follows: than external technical assistance)
Partnership Sector-wide programs emphasize a process by
< Local stakeholders in charge—program which overall policies are translated into strategies
directed by government and programs, then into expenditure plans that make
< All key donors sign on to the program sense in a long-term national context. This is fol-
< Government coordinates donors lowed by annual reviews of actual performance
< Broad consultation with stakeholders against the plans and adjustments as appropriate.
The emphasis is on process rather than products.
Comprehensive sector policy framework Sector-wide programs can be served by different
< Sector-wide scope, covering all relevant lending instruments, including specific investment
areas, policies, programs, and projects. loans (SILs), sector investment and maintenance
< Based on an (a) overall policy for the sec- loans (SIMs), adjustable program loans (APLs), and
tor (principles and objectives); (b) strat- Technical Assistance Loans (TALs).
egy of measures to achieve policy
objectives over the medium term (about Innovations in sector-wide approaches
5 years); and translated into (c) a pro- include:
gram of specific interventions in the near < Policy development as a dynamic process,
term (2-3 years). not a one-off exercise, to be updated and re-
newed as circumstances become clearer or
Expenditure framework change.
< Overall expenditure program, including < Linkages with the macroeconomic frame-
definition of feasible intersectoral allo- work. Resource allocation is derived from
cations an overall expenditure framework.
< Intrasectoral spending plan, derived from < Clear linkages established among analysis,
program priorities policy development, strategic plans, pro-
vii
SUMMARY OF MAIN POINTS
grams, budgets, and implementation evaluation, and (c) set up appropriate finan-
through annual reviews. cial mechanisms. (Chapter 5)
< The emphasis on harmonization of donor
procedures. It is still too early to tell whether sector-wide
< The emphasis on use of government struc- approaches in the social sector are making an im-
tures and procedures for such functions as pact, but some useful findings can be identified.
procurement, financial management, and Sector programs are complex. They involve
accounting. broad scope, new procedures, donor coordination,
and channeling of external assistance through gov-
ernment budgets and the implementation of major
FINDINGS FROM THE REVIEW ABOUT reforms. Each of these adds a layer of complexity.
SECTOR-WIDE APPROACHES Complexity comes at a price—in terms of time and
resources required for sector approaches. Different
In the second half of 1999 a review was conducted kinds of staff are required, particularly those adept
in the Bank’s Africa Region of sector-wide approaches in policy analysis and negotiation.
in the social sector. The intended audience of the
review was Bank operational staff in the education
sector of the Africa region. The review sought to STRENGTHS
answer the question: how should a sector program
be done? Based on staff interviews, a literature re- Sector approaches have achieved several successes.
view, and development of eight case studies the find- Comprehensive plans and strategies were developed
ings suggest that a sector program should: in all cases reviewed and in some countries capaci-
ties were built for decentralized planning. Stronger
< Be developed only in countries that meet links were forged between policies, the allocation of
the preconditions. (Chapter 1) funds and performance. Stakeholder consultations
< Establish an effective collaborative process— were strengthened and frameworks were established
which requires a) developing donor-govern- for donor coordination. Some common procedures
ment partnerships, b) following the national were adopted by donors, particularly for joint mis-
leadership, and c) forging donor coordina- sions, monitoring, and progress reporting. These
tion. (Chapter 2) steps helped reduce the administrative burden on
< Establish a proper policy framework – which governments of external assistance. Some programs
requires (a) adopting an appropriate scope, have begun to move to budget support by pooling
(b) basing it on strong analytical work, (c) external resources and channeling them through the
consulting with stakeholders about priori- government budget. Resources allocated for the sec-
ties, and (d) continuing the policy develop- tors have also increased under sector programs in
ment process during implementation. both absolute and relative terms.
(Chapter 3)
< Prepare an overall expenditure framework
that (a) defines appropriate intersectoral al- WEAKNESSES
locations, a feasible resource envelope, and
(b) ensures appropriate allocations within Weaknesses identified at the design stage include the
the sector; (Chapter 4) and lack of rigorous sector analysis in some cases; the
< Establish management arrangements that lack of systematic analysis of implementation capac-
(a) analyze and build institutional capacity, ity in most cases (such institutional analysis can be
(b) concentrate on effective monitoring and an antidote to overly ambitious programs), and in-
viii
EDUCATION AND HEALTH IN SUB-SAHARAN AFRICA
adequate design of monitoring indicators. During parties can raise and address problems
implementation, problems and changes are the rule and their concerns.
rather than the exception. This underscores the need < Follow government’s lead, but ensure
for doing better risk analysis and contingency plan- that ownership and participation is in-
ning. Other specific problems have been weak data creased progressively from a narrow
collection, and disappointment with the outcomes group of reformers and includes par-
of joint semiannual reviews. ticipation of central ministries and leg-
islatures.
< Spell out the rights and responsibilities
RECOMMENDATIONS FOR BEST PRACTICE of all parties on paper at the start in a
Statement of Intent, and later in a
The review concludes with recommendations for best Memorandum of Understanding (or
practice and a list of prerequisites for commitment Credit Agreement) and Code of Practice.
of funding to sector programs. They are reproduced < Harmonize procedures that are feasible
below from the main text: immediately, such as reporting, joint
reviews, and monitoring systems. Also
A. Meet the Preconditions for Starting start with immediate steps to strengthen
< Ensure that the prerequisites are met for and improve government systems. Get
entering into the development of a sec- central agencies to work on generic sys-
tor-wide approach. Do not undertake tems for all sectors, such as finance and
a sector-wide approach unless the cli- procurement, rather than repeating the
ent has (a) a modicum of stability, (b) work sector by sector.
strong commitment to an integrated, < Define the role of a donor lead agency
collaborative process, and (c) at least a in advance to avoid misunderstandings.
minimum level of institutional capac- Provide sufficient administrative funds
ity. In addition, ensure that the donor to pay for the high costs of coordina-
agency allocates adequate resources and tion.
the right profile of staff for developing < Establish a joint technical assistance
a sector program. fund for project preparation to start
pooling of resources on a small scale.
B. Establish a Collaborative Process
< Do not rush the process of policy de- C. Establish a Comprehensive Policy Frame-
velopment. Sector approaches are a long work
haul, not a quick fix. Time must be al- < Distinguish between sector-wide scope
lowed for reaching agreements on policy for analytical and for investment pur-
issues and interventions, appropriate poses. That is, start with a comprehen-
procedures, legislation and clear delin- sive policy framework covering the
eation of responsibilities to ensure sector as a whole even if subsequent
sustainability (Jespersen: 12) investment programs have to be lim-
< Recognize that success ultimately de- ited to particular subsectors.
pends on the level of trust among part- < Help build stronger analytical under-
ners. Trust, in turn, is based on pinnings for sector-wide programs by
openness, transparency, negotiation, improving the quality and rigor of sec-
and compromise. Appropriate mecha- tor analysis during initial program
nisms must be in place by which all design.
ix