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Action 3: Ensure poverty/shared prosperity lens in analytical work on HF. Indicator: % of quantitative HF AAA with decision meeting that explicitly consider the poor (defined by national or international poverty lines) and the two lowest income quintiles of household income/expenditure. FY15 (baseline): 74% FY16: 86% FY17: 93% FY18 (target): 90%]
Ensuring a poverty lens in health financing work is enabled through several key drivers: (i) the HFSA standards of practice (SOP) (ii) the Data Working Group of the HF GSG (iii) HF GSG country and regional team support for HF activities (including clinics and peer review) and (iv) the overarching monitoring mechanism of the UHC monitoring framework and Annual UHC Monitoring Report co-developed with WHO. The results of these drivers are reflected in the FY17 results for Action 3, which show that 93% of completed quantitative health financing ASAs explicitly considered the poor (defined by national or international poverty lines) or the bottom two household income/expenditure quintiles, compared with 85% in FY16.
As mentioned under reference 0308, the HFSA SOP guide the review of country health financing system capacity constraints. The core assessment, administered as part of all HFSAs, includes a comprehensive review of the countrys macro-fiscal, demographic, organizational and poverty context. This core review of country context helps identify where subsequent analytical activity supported by WBG can introduce a poverty focus where a gap exists.
The Data Working Group of the HF GSG also drives a poverty lens in analytical work through managing a global database with detailed country-level data. Every three months, the Data Working Group updates the database with breakdowns of country data by income level. This data is offered to WBG colleagues along with support for running analysis using the database, helping amplify the presence of a poverty focus in work across the HNP portfolio.
Support for country and regional teams is a core goal for the HF GSG, and these activities also contribute to furthering the poverty focus in work from across country offices. At HF GSG-organized the HF GSG offers in-depth review of preliminary products for country-level engagements. As a result, clinics help spread good practices for designing analytical work with the poverty lens in mind across the HNP GP and client serving task teams. The facilitation of the peer review of knowledge concepts and products and other deliverables by HF GSG colleagues also helps disseminate good practices, such as building a poverty focus into analytical work. Since the implementation of several such awareness-building and team support initiatives by the HF GSG, nearly all relevant ASAs have adopted the poverty lens either through explicit focus on the poor or through complementary analysis related to UHC monitoring.
In addition to the steps outlined above, the WHO/WBG UHC monitoring framework encourages the inclusion of poverty focus in analytical work from the highest level, through its monitoring of financial protection and service coverage. The framework mandates the breakdown of health financing information by income quintiles. The HNP GP also continues to inform the development of monitoring frameworks of other global health initiatives (including the SDG indicators framework), with the goal of expanding the poverty focus. The WHO and WBG publish an Annual UHC Monitoring Report, which follows the structure of the monitoring framework (more details under reference 0313). This report provides analysis on the progress toward UHC on the country level globally and includes a breakdown by distributional outcome. These results are used to create a dialogue on poverty with countries that complements the work done in analytical ASAs. As a result, the UHC global monitoring report ensures that all HF engagement in countries addresses how the task would impact people across income levels.
The change in WBG coding categorization from AAA and TA to ASAs required slight adjustment in the FY17 analysis methodology. However, as expected, this change did not significantly impact FY17 results.