The Republic of Niger faces persistent underfunding in its healthcare sector. To address this, the Ministry of Public Health launched the Health Common Fund in 2006 with initial support from AFD and the World Bank. Today, the fund involves six donors and has mobilized €91 million between 2015 and 2019.

Core objectives

The fund aims to improve population health, particularly for women and children, by supporting the implementation of Niger’s Health Development Plan (HDP). By pooling donor resources, it strengthens the government’s ability to deliver healthcare services nationwide.

Collaborative evaluation approach

AFD conducted a participatory evaluation involving central and regional health ministry officials along with all partner organizations. Findings informed the design of AFD’s fourth funding tranche for the initiative.

The evaluation confirmed the fund’s growing relevance, adapting its management to donor preferences while maintaining alignment with national priorities. It also enhanced strategic dialogue between the ministry and its partners, though coordination among donors requires further improvement.

Efficiency and growth

The fund demonstrated exceptional efficiency, with its fiscal management quality recognized by a threefold budget increase in 2018-2019 compared to prior periods. Clear, universally adopted procedures strengthened the ministry’s management capabilities. Notably, the fund serves as the only reliable source of predictable funding for regional health departments to implement their annual activity plans.

Identified improvement areas

While celebrating achievements, the evaluation identified critical weaknesses in tracking finances, project implementation, and outcomes measurement. These gaps hinder the assessment of targeted interventions’ effectiveness. Additionally, the evaluation highlighted persistent issues with top-down HDP planning and the need for a robust monitoring and evaluation framework.

Key stakeholder perspective

Dr. Abaché Ranaou, Secretary General of Niger’s Ministry of Public Health and Strategic Coordinator of the Health Common Fund, shared:

“To ensure coordinated implementation of successive Health Development Plans and promote the social well-being of Niger’s population, our ministry collaborated with technical and financial partners to establish a donor common fund in 2005, operational since 2006. This mechanism aligns partner actions with national priorities, harmonizes interventions, and ensures predictable international aid.”

The AFD-led evaluation revealed overwhelmingly positive results, reinforcing partners’ confidence in our ministry. We encourage all stakeholders to join this national pride initiative that benefits our people.

While tangible results are evident, the evaluation underscores areas for improvement, particularly in communication, program design, monitoring, and evaluation. To engage partners and stakeholders effectively, we must enhance action visibility and highlight results achieved relative to invested resources.”