Maimuna Abdullahi works with Africa Health Budget Network (AHBN) as a Health Economist, Monitoring, and Evaluation Specialist. She is an advocate for greater investment in health; efficient utilization of health finances; and, accountability and transparency of health finances such as the Basic Healthcare Provision Fund (BHCPF), International Monetary Fund (IMF) Special Drawing Rights (SDR), COVID – 19 finances and Family Planning budgets.
1. Before the surge of the pandemic, were you already working on the WB support to improve health service delivery in Africa? If yes, how? And what is your assessment of the WB actions regarding health?
AHBN has been intervening on some WB initiatives before the COVID pandemic. We are at the forefront in Africa building the capacity of civil society organizations on global financing facility engagement, participation, and accountability. The issues around health service delivery are not new: there have been a lot of investments going into improving the health service delivery and the same key parts have been missing: accountability and transparency regarding the utilization of the investment in the health sector related to health service delivery. Our work is to ensure that there is improvement in health service delivery by working with civil society organizations (CSO) to ensure that they are well informed about these investments. In January 2020 for example, we convened a regional training in Abuja, Nigeria for CSOs from Tanzania, Ethiopia, Sierra Leone, and Liberia and piloted the use of “How to guide” to develop country spotlights on GFF accountability. The civil society engagement in Africa on GFF is good, as information is being provided on a regular basis. However, capacity building at the country level for CSOs to fully participate needs to be enhanced. By that, we mean that it can be difficult for a CSO to have the knowledge and understanding to be able to follow IFI’s financial investments and have an adequate set of tools to work appropriately.
2. What observation led you to work specifically toward the WB financing of the COVID-19 response?
We have started working specifically toward the WB financing of the COVID-19 response for the same reason we have started working on the WB support to improve health service delivery in Africa: the lack of accountability and transparency. Looking around, we see many organizations that work in the health sector but most of them are focusing on service delivery. The main concerns within the international community are about ensuring there is enough financing for health, even more since the pandemic has started. Yet, the work of the World Bank goes beyond having enough financing, it also goes around ensuring that the available funds are actually used and utilized effectively. The WB has committed a lot of resources for African countries as a response to the COVID-19 pandemic, and AHBN’s overall vision is to ensure greater investment in health in Africa and to ensure accountability and transparency in the utilization of these investments for the benefit of the population.
3. What are your first findings on the transparency & accountability work you have done regarding COVID-19 finances in Africa?
The WB has earmarked funding through IDA and other financing facilities to support Liberia, Nigeria, and Sierra Leone for COVID-19 strategic preparedness and response at USD 7.5 million, USD 114 million, and USD 7.5 million respectively. Subsequently, Nigeria and Sierra Leone have received additional funding of USD 400 million and USD 8.5 million respectively. So far in Nigeria, the first tranche of USD 70 million for 2021 has been released by the WB to the Government of Nigeria. However, we do not have any details on the level of implementation of the disbursed funds. This is an area that needs improvement from the relevant implementing agencies. On the other hand, in Sierra Leone, the WB held a consultative meeting with CSOs on the COVID response project to promote accountability and transparency. In addition, the Director of Public Finance Management in the Ministry of Finance serves as the co-chair of the COVID-19 finances accountability working group that has CSO as the chair. This demonstrates partnership, participation, and collaboration between CSOs and the government.
4. What role and added value do you see for civil society at both the national and international levels to engage in this discussion on the role of the world bank in supporting countries to better prepare and respond to health threats?
For every project that is implemented in a country, the beneficiaries are usually the citizens. CSOs have the added value of working in communities at the grassroot levels and are thus well placed to provide a better needs assessment of the target populations. As a result, CSOs should be involved in planning discussions with the WB and relevant international and national authorities. CSOs play a role in monitoring the disbursement of WB funds. By working with the media, CSOs help to enlighten the public on the available health financing from the WB to ensure that governments are held to account for the utilization of WB funds. CSOs also play monitoring and evaluation roles as projects are being implemented. They can provide real-time feedback to the WB, government, and implementing agencies for project review and to ensure alignment with project objectives.