Niger’s health fund: evaluation highlights impact and future improvements

The health fund in Niger, a multi-donor initiative launched in 2006, has mobilized €91 million to support the country’s health policies. A recent evaluation by the French Development Agency (AFD) underscores its relevance while identifying key areas for enhancement.

a critical fund for Niger’s healthcare system

In a country where the health sector faces chronic underfunding, the Fonds commun santé was established in collaboration with Niger’s Ministry of Public Health, the AFD, and the World Bank. Today, the fund unites six major donors and has channeled €91 million between 2015 and 2019 to strengthen the nation’s health infrastructure.

The fund’s primary goal is to enhance the health of Niger’s population, with a special focus on women and children, by aligning with the country’s National Health Development Plan (PDS). By pooling international aid, it aims to bolster the government’s ability to deliver essential health services nationwide.

evaluation reveals strengths and areas for growth

The AFD-led assessment employed a participatory approach, engaging central and regional health officials, as well as all funding partners. The evaluation’s findings were instrumental in shaping the AFD’s fourth phase of support for the fund.

The review highlighted several achievements:

• Enhanced relevance over time: The fund adapted its management to prioritize specific activities within the PDS while maintaining alignment with international aid principles.
• Stronger strategic dialogue: Improved communication between the Ministry of Health and its partners, though coordination among donors still requires refinement.
• Tripled budgets: The fund’s efficient management and transparent financial processes led to a threefold increase in allocated budgets in 2018–2019.
• Empowered regional health offices: The fund provides a reliable and predictable financing mechanism for regional health departments to execute annual activity plans.

However, the evaluation also identified critical gaps, particularly in monitoring and evaluation. Weak tracking of funding, implementation, and outcomes hinders the ability to measure the impact of targeted interventions. Additionally, the top-down nature of PDS planning and its weak monitoring framework were flagged as persistent challenges.

Dr. Abaché Ranaou, Secretary-General of Niger’s Ministry of Public Health and Strategic Coordinator of the health fund, emphasized:

« The health fund was created to align partner actions with national priorities, harmonize interventions, and ensure predictable international aid. The AFD’s evaluation confirms its positive impact, reinforcing confidence among technical and financial partners. While the fund has achieved tangible results, we must prioritize improvements in communication, programmatic aspects, and monitoring to maximize its potential and demonstrate its value to all stakeholders. »

next steps for the health fund in Niger

The evaluation’s recommendations focus on strengthening the fund’s operational framework. Key priorities include:

• Enhanced visibility: Demonstrating the fund’s achievements to attract more partners and secure additional resources.
• Programmatic improvements: Refining planning and implementation processes to address identified weaknesses.
• Robust monitoring: Developing a more effective system to track funding, activities, and outcomes.

The AFD’s support and the fund’s continued evolution are poised to further advance Niger’s health sector, ensuring better access to quality care for all citizens.