A new report published by Aidspan suggests that countries may not be using data optimally to inform grant implementation. Implementers of Global Fund grants collect and use data for several different purposes, depending on the type of implementer. State Principal Recipients collect data to measure strategic impact, whereas non-state implementers appear to collect data mainly to meet reporting requirements.
The study, which aimed to assess flows of grant information and measurement of grant performance, also suggests that the Global Fund offers countries the flexibility to select performance indicators that are in line with the countries’ own strategic plans as well as with the Global Fund’s objectives.
Information in the report was drawn from interviews with key in-country Global Fund stakeholders – members of the Country Coordinating Mechanisms (CCMs), implementers, Local Fund Agents (LFAs) – and Global Fund Portfolio Managers (FPMs) for the five countries reviewed.
The study, which covers Cameroon, Malawi, Kenya, Rwanda and Zambia, was funded by BACKUP Health, a global program working on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ). Since 2013, the program has been co-funded by the Swiss Agency for Development and Cooperation. The five countries chosen are all high-priority countries for BACKUP Health.
Grant reporting is standard across most countries
The grant reporting cascade in four of the five countries is standard (the exception is Rwanda). In Cameroon, Malawi, Kenya, and Zambia, reporting is done from the lowest level (sub-sub-recipient; SSR) to the next-highest (sub-recipient; SR) level and from the SR to the PR, monthly. The Principal Recipient (PR) then reports to the Global Fund using the Progress Update and Disbursement Request (PU/DR) form, via the Local Fund Agent (LFA), which checks data and its quality every 6 months. The PR also reports to the CCM on a quarterly basis.
Rwanda does not report using the six-monthly PU/DR mechanism but reports annually, following its strategic plan. This is in line with the ‘differentiated risk’ approach; Global Fund support in Rwanda follows a performance-based, results model where the Global Fund pools resources with other donors and the government to fund the country’s National Strategic Framework. The indicators are part of the national disease strategic plan and have been agreed with technical partners.
Data generation and reporting face several challenges. Among them are lack of capacity by the SRs and SSRs to collect and use data, which leads to issues with compliance, inefficiency in data collection and reporting, or misunderstanding of the reporting tools. Inaccurate or untimely reporting on programs and budgets leads to grant underperformance and/or funding delays.
Multiple data collection systems also exist in most of the countries; however, these systems are often not integrated, leading to variable and sometimes duplicate data.
Grant performance indicators are objective
The study found that performance indicators that are agreed upon during the grant-making period are objective and assure some predictability in the management of grants. Under the Global Fund’s performance-based funding, grant performance is linked to funding. The Global Fund has a five-tier rating system (see Table 1, below). Ratings range from the highest, A1 (exceeds expectations, with greater than 100% achievement of targets), to the lowest, C (unacceptable performance with <30% of targets reached). An ‘A’ rating leads to disbursements ranging between 90-100% of the cumulative amount through the next reporting period.
Table 1: Performance and indicator ratings and cumulative budget amount
|Performance rating||Indicator rating||Cumulative budget amount
(including current funding request)
|A1||>100%||Exceeding expectations||Between 90-100% of cumulative budget through the next reporting period|
|B1||60-89%||Adequate||Between 60-89% of cumulative budget through the next reporting period|
|B2||30-59%||Inadequate but potential demonstrated||Between 30-59% of cumulative budget through the next reporting period|
|C||<30%||Unacceptable||To be discussed individually|
Indicators used for the grant are quantitative. Several in-country informants identified the need to capture deeper or richer information which is not possible to reflect in the current indicator framework. For instance, one indicator in Kenya is the number of persons on ART; while this indicator is useful, it fails to measure whether those who receive the medication take it and why some persons stop treatment. Capturing that kind of information could play an important role in saving the lives of people lost to treatment.
Roundtable on the use of data for decision-making in Global Fund-supported programs
Representatives from all five countries, as well as from Nigeria and Uganda, had the chance to meet and share their experiences in an Aidspan-convened round table held from 14 to 16 March 2018 in Nairobi, Kenya. Round-table discussions focused on data for: (a) appropriate decision-making in programming, (b) optimal absorption of grants, (c) efficient health product and commodity procurement, and (d) demonstrating and influencing domestic and co-financing.
In discussion, the round-table participants affirmed their commitment to test the identified best practices within their own contexts. A detailed description of the round-table presentations, discussions and recommendations can be found here.
This report is one of the outputs of the Aidspan/BACKUP Health collaboration. Other reports and related GFO articles published under this collaboration can be found on the Aidspan website here, and a multi-country study on Supreme Audit Institutions here.