Enhancing global health accountability through results-oriented monitoring: EC/WHO collaboration

Abstract

Issue
Governments and organizations must demonstrate accountability and delivery of results. Results-Oriented Monitoring is a European Commission mechanism to enhance internal control and management. The Health System Strengthening for Universal Health Coverage program - the largest Commission grant to the World Health Organization - provides support towards achieving Universal Health Coverage through policy dialogue in 119 countries.

Description
We employ a Results-Oriented Monitoring review of the program conducted in October 2021- April 2022 as a case study to examine the question: what is the value of the Commission's Results-Oriented Monitoring system as a tool to enhance accountability of large Global Health interventions?. We conducted 87 face-to-face/remote interviews to engage stakeholders in assessing specific criteria such as relevance, efficiency, effectiveness, sustainability and human rights, in 12 purposively selected countries including Timor Leste, Colombia, the Democratic Republic of Congo, Zambia, Burkina Faso, Nigeria, Uzbekistan, the Philippines, Mongolia, Egypt, Jordan and Morocco.

Results
The Health System Strengthening for Universal Health Coverage program is a relevant intervention that responds to the needs of target groups because it is demand driven, flexible, and well-integrated within national health plans/regional frameworks. The absence of robust Monitoring and Evaluation frameworks for Universal Health Coverage at country level is a missed opportunity to pull the case for continued investment in health systems strengthening. Co-developing country level monitoring and evaluation frameworks could enhance multi-stakeholder policy dialogues anchored in the Universal Health Coverage concept.

Lessons
Our innovative adaptation of Results-Oriented Monitoring approaches to assess a large Global Health intervention (+100 countries) provided critical data to inform program implementation and fostered consensus building over subsequent steps.

Key messages
• The European commission’s results-oriented monitoring system is a valuable instrument to assess large scale global health interventions.
• Co-developing monitoring and evaluation frameworks at country level could serve as a tool to facilitate multi-stakeholder policy dialogues and to track progress towards universal health coverage.