Overview – how the Trust Fund has functioned

The original idea behind the multi-donor trust fund for health results innovation (HRITF) is a concept note produced by the World Bank in 2007 and submitted for funding consideration by the Government of Norway (GoN). An administrative agreement for HRITF –the first administrative agreement- was signed between the GoN and the World Bank in 2007. In 2009 the Government of the UK, through DFID decided to join the HRITF and a new administrative agreement was signed with the World Bank by the GoN and DFID in 2009.

Chronologically the main milestones in the implementation of the HRITF are summarised in the table on the next page.

Table 3: Timeline of the HRITF implementation

2007 Proposal (concept paper) submitted by WB to GoN

Admin Agreement for HRITF signed between Norway and WB.

In December Norway commits $104m to the trust fund as the sole donor.

2008

Trust Fund established; Procedures for fund allocation developed;

In February Round 1 receives 9 proposals. Of these 5 countries (Afghanistan, DR Congo, Eritrea, Rwanda & Zambia) are approved for funding.

Interagency working group (IWG) on RBF is established. First meeting in March, Washington DC

In October proposals from HRITF Round 2 are received. Regional WB management nominates 10 potential countries (all IDA countries eligible except those from Round 1) to compete for 3 pilots grants. Each candidate country receives $50K to support RBF proposal development (linked to an IDA credit). Following Norway´s request for focus on Africa decision is made that of the three countries to be provided funding 2 should be from Africa and 1 from another region. 9 countries submit proposals: Benin, Burkina Faso, Burundi, Djibouti, Ghana, Kyrgyz Republic, Madagascar, Senegal and Vietnam. Mali was invited but did not submit on time. RECOMMENDATIONS for support by HRITF made for Ghana, Benin and Kyrgyz republic.

July and November – First and second Impact Evaluation workshops held in Washington DC

Annual report for Jan-Dec 2008 submitted.

2009

In July 2009 after a short trial period the new RBF website is launched:

www.rbfhealth.org

In February the WB Board approves Round 2

In March Amie Batson the first HRITF Project manager leaves the Bank and hands over management of HRITF to Daniel Cotlear. Towards end of 2009 Darren Dorkin takes over as new Project manager for HRITF.

April – third meeting of the IWG in Eschborn, Germany

November – UK government joins HRITF – commits £114m ($189m). Norway commits an additional $264m (to $368m). Total HRITF is now circa $558m.

November 2009, 1st Annual IE Workshop in Capetown.

23 November – Fourth Meeting of IWG in Oslo. Interesting PBF examples reported in Philippines, Bangladesh and Pakistan (Greenstar vouchers);

health systems 20/20, a USAID project, producing case studies on PBF;

WHO conducts review of PBF experience in 5 African countries.

2009-10

Annual report submitted covering June 2009-March 2010. Zimbabwe is granted a pilot in spite of not having submitted an application: a special case.

Many workshops in countries and regions to raise awareness and clarify concepts.

2010

The Bank introduces a fundamental shift in the way countries access HRITF funds. Under the new approach countries themselves do not apply for RBF grants directly: they apply for IDA credits that include an RBF component that may then also include HRITF grant support.

June 10-11: Annual donor consultation on HRITF. There is no mention in it to the new “IDA link”.

September – Following the UN General Assembly (every woman, every child) the World Bank commits an additional $600m to support PBF for MDG 1c, 4 &

5 (this is not the HRITF presumably).

September – Launch of Round 3 – a “new and improved process” is introduced using the 3 “funding streams”. 57 proposals submitted from all regions for the 3 streams. Funding stream 1 supporting the country Pilot Grants is formally linked to the country having an active health IDA in place.

October 2010, 2nd Annual IE Workshop, Tunis.

2011

Annual report April 2010-March 2011 is submitted.

Results of Round 3 are formally communicated:

Funding Stream 1: Country program Support Pilot Grants: Burkina Faso, Burundi, Ethiopia, Laos, Nigeria, Sri Lanka and Tajikistan.

Funding Stream 2: Regional RBF Knowledge and Learning Grants. Bhutan;

Cameroon; Central African Republic; Chad; Haiti; India; Kenya; Liberia;

Madagascar; Mali; Mozambique; Niger; Senegal; Sierra Leone; Togo; Multi-country Regional Grant for the African Region 1 (Cameroon, Chad, Cote d’Ivoire, Kenya, Liberia, Lesotho, Madagascar, Mali, Mozambique, Senegal, Sierra Leone and Togo); Multi-country Regional Grant for the African Region 2 (Cameroon, Chad, Cote d’Ivoire, Kenya, Liberia, Lesotho, Madagascar, Mali, Mozambique, Niger, Senegal, Sierra Leone and Togo); Multi-country Regional Grant for the East Asia and the Pacific Region (Papua New Guinea, Solomon Islands, Timor-Leste); Multi-country Regional Grant for Eastern Europe and Central Asia Region (Kosovo, Uzbekistan); Multi-country Regional Grant for South Asia Region (India, Bangladesh, Maldives, Nepal, Pakistan, Sri Lanka).

As evidenced in the past under the HRITF, this work is expected to increase IDA financing for RBF for health and concomitant demand for Country Pilot Grants.

Funding Stream 3: Country RBF Evaluation Grants. Argentina, Cameroon, India, Mexico, Turkey. Program Assessment Grants: India, Mexico, Philippines, Turkey.

October. 3rd Annual IE Workshop, Bangkok, 5 November – Meeting of the IWG in London.

November - beginning of the HRITF Evaluation.

Darren Dorkin leaves the Project manager position – Rama Lakshminarayan appointed as HRITF Interim Project Manager.

Sources: HRITF Annual Reports, interviews with HRITF partners.

From a developmental perspective the following phases of the HRITF life were usefully described to us in the following way³:

Initial phase – 2008: Very unstructured, developing the concept into a programme and putting in place the first features: 9 activities can be funded; demand driven; how the evidence will be built; how it will fit World Bank policies and instruments; focus on building the demand up, and quickly; big workshops and meetings to generate interest in the Bank and within the international community.

Consolidation phase – 2009/10: Working out operational

arrangements, reviewing experience to date, responding to increased funding and new administrative agreements, whilst still learning by doing.

Scaling up phase– 2010/11: Establishing a basket of approaches and funding modalities (funding streams), further developing the link with IDA credits, establishing regional networks of practitioners to support ongoing activities – multi-country regional grants invited during Round 3, HRITF becoming more systematic at forecasting financial needs and use of available funds.

Strategic learning 2011/12: Addressing the gaps; stronger links IE

& results chain, first and second generation questions; initial results start to emerge from pre-pilots e.g. what are the lessons from design?

What is the best model for TA (handholding/learn from mistakes?);

links between thoroughness of design, time involved, consequences for ownership; beginning to do a landscaping before the HRITF can become more strategic.

3.2 Measuring results of the HRITF