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Health Sector Programme

Donors stick to preconditions for fresh funding

Reiaul Karim Byron
Donors may decide to pump approximately $600 million into the Health, Nutrition and Population Sector Programme (HNPSP), if the government agrees to their conditions that include immediate resolution of half of the 36 audit objections to its previous health programme.
If the government is willing to meet the terms and conditions, representatives of 15 donors led by the World Bank (WB) will sit with the officials concerned on January 31 to February 3 to discuss their participation in the $2.4 billion HNPSP.
"The government is agreeable to act on the audit objections," said a health ministry source, "however, there are a few conditions that it findshard to accept."
Sources at the planning ministry said in some cases the donors differ so widely in their terms and conditions that the government finds them really tough to cope with.
The previous $2.9 billion Health and Population Service Programme (HPSP) ended in 2003 amid disagreements and dissatisfaction of the donors.
The office of the Comptroller and Auditor General (Cag) made36 audit objections against corruption and anomalies in implementation of the HPSR But none of the objections were addressed and the government went ahead with the new health programme, HNPSI) last year, without getting any commitment from the donors.
Before committing any amount to the HNPSP, the donors now want the government to act on at least half of the objections, and the WB has proposed to provide technical help todcalwiththem.if necessary.
The donors' also want the government to adopt a work plan they have submitted earlier before sitting for the final negotiations.
If the government is agreeable, the WB will seek a board approval FROM PAGE 12
to grant a loan of S200 million for the HNPSP in March.
The WB laid out this schedule recently in a draft aide-memoire based on the report of an appraisal mission of the donors that had visited the country on November 21 to Decembers.
The aide-mdmoire said before the final negodations the government should develop a preliminary project pro-forma and get that cleared by the Executive Committee on National Economic Council (Ecncc).
The pro-forma has to chalk out a procurement plan and an acdon plan, both for an 18-month period, of the HNPSR The first will specify what and when the government wants to purchase for the programme and the second will lay out how the government keeps a number of commitments in the next 18 months.
The commitments include to allocate at least 25 percent of the health budget for the poorer districts, develop a regulatory frame-
work for private health practitioners and finance them to set up healthcare facilities where there is no government ones. Besides, the donors want the government to increase its per capita health budget
The planning ministry has expressed its reservadons about the preliminary project pro-forma, saying the concept does not comply with the Planning Commission's rules and regulations.
But thedonorshave categorically told the government that without the pro-forma they will not commit any finance, sources said.
The government launched the HNPSP last year with the target to continue it up to 2006 without any donor finance. But, in case the donors agree to fund, the government has prepared a strategic investment plan (SIP) for the programme for 2(103 to 2010. The SIP envisages a $2.4 billion programme budget with donors' contributions accountingforoverSl billion.
"So far the donors have indicated their willingness to finance up to 600
million dollars," said a source at the Economic Relations Division.
Canadian C1DA may contribute $70 million, the United Nations Family Planning Association over $35 million, and German donors GTZ and KfW $12 million, he said, adding others have not specified how much they want to provide.
The source said, two-thirds of the donors' funds, if received, will be spent for the core components of the HNPSP and one-third for health sectorreforms.
The HNPSP aims to ensure that at least 65 percent of the health allocations are spent for the most needed healthcare services, besides improving the service delivery. It also attaches financial and service priorities to the backward communities through decentralisation of the sector.
The programme also functions as the sole government platform for co-ordinating all development initiatives in the health sector, where donors can put in their contributions.