Enhancing Support for Civil Society Organizations in National Health Policies

This presentation showcases the case development for a fund supporting Civil Society Organizations (CSOs) active in national health policies. It highlights the need for a dedicated fund to enhance the impact and effectiveness of CSOs engaged in advocating for better health policies. The content discusses the strengths and areas for improvement identified in the 2013 review, as well as insights from interviews with stakeholders involved in the health policy process.

• CSOs
• Health Policies
• Funding
• Advocacy
• Capacity Building

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1. Case development for a fund supporting CSOs active in national health policies Presentation to the IHP+ Steering Committee

2. Table of Contents Context CSO-support fund as a public good What a CSO-support fund could look like How a CSO-support fund could be structured How a CSO-support fund could be structured Next steps Annex 2

3. The 2013 HPAF review identified strengths and showed potential for greater impact by adjusting grant size & duration, and supporting capacity building Strengths of HPAF Areas for improvement Grant duration: The time frame (12- 18 months) is too short for advocacy work to cause significant change HPAF fills an important niche as other grants in this space are usually much more earmarked to e.g., a specific disease area Grant size: $30,000 grants are too small to really make a difference, particularly in networks Grantees are able to adapt to a changing policy environment due to the flexibility allowed in work plans Focus of support: Grantees often lack capabilities that would allow them to have more impact and to focus on aid effectiveness Grantees are provided with support locally 4 SOURCE: Dalberg 2013 Review of CSO engagement in national health policy processes supported through the HPAF

4. Table of Contents Context CSO-support fund as a public good What a CSO-support fund could look like How a CSO-support fund could be structured How a CSO-support fund could be structured Next steps 5

5. Our interviews with HPAF stakeholders confirmed that there is a need for a support fund for civil society organizations engaged in national health policies Most NGOs focus on one issue and cannotengage in the broader health dialogue. This is probably because internationally there were always more funds available to support NGOs focused on particular issues. Donor Building relationships with government officials takes time and money, especially given the poor infrastructure in my country. CSO-representative We would really benefit from support in the form of trainings on lobbying skills, advocacy and campaigning tactics, strategy design, proposal writing and monitoring finances. It would also be valuable to receive help in networkingwith CSOs outside of our immediate area. Grantee 7 SOURCE: Dalberg interviews with HPAF-grantees, IHP+ CSO-representatives and IHP+ Steering Committee members

6. Donors were reluctant to make contributions to a CSO-support fund, but there might be enough interest to have talks with a coalition of the willing Concerns brought up by donors Hard to measure / attribute impact 1 2 No fit with focus area Operations Not within focus area Overlap with existing support provided to CSOs engaged in health advocacy 3 4 Budget cycle inflexibility and other internal internal constraints Despite these concerns, 3 - 5 potential donors indicated that they could see the potential to contribute to a CSO-support if a more concrete proposal were presented each with their own preferences 8 SOURCE: Interviews with potential donors for a CSO-support fund focusing on strengthening health systems

7. Table of Contents Context CSO-support fund as a public good What a CSO-support fund could look like How a CSO-support fund could be structured How a CSO-support fund could be structured Next steps 9

8. Stakeholders expressed their preference for a fund that supports coalitions (where possible) by providing grants and capacity building over a longer period Continue to provide grants to CSOs focusing on national / local health systems Focus and type of support recommendations Combine funding with (local) capacity building Provide assistance during the application process Help CSOs establish linkages with media & government Make grants more predictable and reduce admin effort Fund and grant characteristic recommendations Extend grant duration beyond 2 years Focus on coalitions where possible 10 SOURCE: Interviews with HPAF stakeholders, desk research.

9. Donors and other stakeholders shared some best practices based on their experience with supporting CSOs to strengthen health systems One donor provides assistanceduring the application process for grants to CSOs: seminars, online forum for applicants, workshops for shortlisted candidates and webinars on specific topics. Donor The WHO organizes 5-day workshops in coordination with the International Budget Partnership where they bring together parliamentarians, government officials and CSOs. WHO GPSA measures impact through a results framework developed for each project based on the pillars of governance (transparency, representation and voice, accountability, learning and improved results) GPSA 11 SOURCE: Interviews with HPAF stakeholders, http://www.thegpsa.org/; http://www.who.int/pmnch/en/

10. Table of Contents Context CSO-support fund as a public good What a CSO-support fund could look like How a CSO-support fund could be structured How a CSO-support fund could be structured Next steps 12

11. The HPAF fund can either be hosted by IHP+, by another organization or it can be an independent entity Recommendation IHP+ and external manager (as is) Fully independent Other host Donor Donor Donor Donor Donor Donor Donor Donor Donor Donor Donor Donor IHP+ IHP+ PTC (Advisor) IHP+ Core Team (Coordinator) Host Structure (Supervisor and Advisor) HPAF Steering Com- mittee (Oversight) CSO rep (Advisor) Manager and advisor HPAF (Manager) External Partner (Manager) CSO CSO CSO CSO CSO CSO CSO CSO CSO CSO CSO CSO IHP+ hosts the HPAF and an external partner manages the grants HPAF is a fully independent organization (option for external manager) HPAF is hosted and managed by another organisation (option for a separate earmarked fund) Description 13 SOURCE: Interviews with potential donors for a CSO-support fund focusing on strengthening health systems

12. If HPAF were to be hosted by another organization, GPSA currently provides the best option in terms of fit and has expressed a willingness to partner Preliminary recommendation Potential host Evaluation of fit Openness to partner + + + - - - Aligned scope Potential for a new fund for health policy Knowledge sharing potential through online platform Questions raised around capacity of secretariat to accommodate Limited results so far as the program is new Word Bank procurement rules could pose a challenge (to be checked with GPSA) Willingness to explore further + + + - - - - Aligned scope Potential to be a host in principle Knowledge sharing potential in line with current network practice Limited disease focus (RMNCH) Supporting CSOS is a small part of the work WHO systems have high administrative barriers The structure may not allow for much direct support to CSOs To be followed up with + + + - Aligned scope Potential to be a host in principle: Knowledge sharing potential amongst members Approach is not grant-based but direct support provision, with focus on advocacy for government budgeting To be followed up with 14 SOURCE: Interviews with potential donors for a CSO-support fund focusing on strengthening health systems, http://www.thegpsa.org/, http://internationalbudget.org/, http://jointlearningnetwork.org/what/challenge

13. GPSA provides broad advocacy support to CSOs seeking to improve social accountability in a broad variety of sectors No specific focus on health Sectorial focus Health systems Issue specific 4 Donor 4 (e.g., HIV/AIDS or RMNCH) Specific advocacy support (e.g. shadow budget) Broad advocacy support Functional focus SOURCE: Interviews with potential donors for a CSO-support fund focusing on strengthening health systems, http://www.thegpsa.org/, http://internationalbudget.org/, http://jointlearningnetwork.org/what/challenge 15

14. Table of Contents Context CSO-support fund as a public good What a CSO-support fund could look like How a CSO-support fund could be structured How a CSO-support fund could be structured Next steps 16

15. If the IHP+ Steering Committee decides to explore these options further, the next steps are securing donor support and detailing partner/ hosting arrangement Prepare a concept note for interested donors Reach out to high- potential donors 1 Interview potentially interested donors 2 Interview PMNCH and IBP 1 Develop partnering/ hosting options Prepare a short memo for each potential partner/ host 2 Discuss and refine memo 3 17 SOURCE: Interviews with potential donors and partners/hosts for a CSO-support fund focusing on strengthening health systems