In Niger, where the healthcare sector faces chronic underfunding, the Health Common Fund was launched in 2006 under the leadership of the Ministry of Public Health, with initial support from the French Development Agency (AFD) and the World Bank. Today, six donors contribute to the fund, which has mobilized €91 million between 2015 and 2019.

Key objectives

The fund aims to enhance the health outcomes of Niger’s population, particularly women and children, by backing the implementation of the National Health Development Plan (NHDP). By pooling resources from international partners, it seeks to bolster the government’s capacity to deliver healthcare services nationwide.

Collaborative evaluation approach

The fund’s operational model and impact were assessed through a participatory evaluation, engaging central and regional health ministry officials alongside all partner organizations. Findings from this process directly informed the design of AFD’s fourth tranche of support for the fund.

Proven relevance and efficiency

The evaluation confirmed the fund’s growing relevance, as it adapted its management practices to accommodate partners’ preferences for targeted funding of NHDP priorities while adhering to aid alignment principles. It also strengthened strategic dialogue between the Ministry and its partners, though coordination among donors still requires enhancement.

Budget growth and fiscal transparency

One of the fund’s standout achievements is its highly efficient management, recognized for its fiscal transparency. Budget allocations tripled in 2018–2019 compared to previous periods, thanks to clear, universally adopted procedures. This has empowered the Ministry with stronger financial management capabilities and provided regional health authorities with a reliable, predictable funding mechanism for annual operational plans.

Areas for improvement

Despite these successes, the evaluation identified critical gaps in tracking funding flows, project execution, and outcome measurement, limiting the ability to assess the impact of targeted interventions. Additionally, recurring concerns were raised about the top-down nature of NHDP planning and the inadequacy of its monitoring and evaluation systems.

Expert insights

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

“To ensure coordinated implementation of successive health development plans and promote the well-being of the Nigerien people, the Ministry of Public Health, in collaboration with technical and financial partners, established the donor common fund in 2005, operationalized in 2006. This mechanism fosters alignment of partner actions with national priorities, harmonizes interventions, and ensures predictability and stability in international aid.”

“The AFD-led evaluation of the fund revealed overwhelmingly positive results, reinforcing partners’ confidence in the Ministry of Public Health. These findings encourage us to advocate for broader participation in the fund, which stands as a national asset benefiting the population.”

“While the evaluation highlights tangible achievements, it also underscores areas for improvement. The fund must refine its focus on communication, programmatic aspects, monitoring, and evaluation. To further engage partners and stakeholders, it is vital to enhance the visibility of actions and highlight results in proportion to the resources mobilized.”