Niger health fund evaluation: how AFD is strengthening healthcare systems
Since its establishment in 2006, the Niger health fund has mobilized €91 million to support the country’s health policies. A recent evaluation by the French Development Agency (AFD) highlights the fund’s effectiveness and identifies key areas for improvement.
In Niger, where the health sector faces chronic underfunding, the Niger health fund was established in 2006 under the leadership of the Ministry of Public Health. Initially supported by the AFD and the World Bank, this multi-donor initiative now brings together six funding partners and has mobilized €91 million between 2015 and 2019.
The fund’s primary mission is to enhance the health of Niger’s population, particularly women and children, by supporting the implementation of the country’s National Health Development Plan (PDS). By pooling international resources, it strengthens the government’s ability to deliver healthcare services nationwide.
Participatory evaluation reveals strengths and opportunities
The AFD-led evaluation adopted a participatory approach, engaging officials from the Ministry of Health at both central and regional levels, alongside all partner organizations. The findings not only validated the fund’s relevance but also informed the design of AFD’s fourth funding tranche.
Key achievements identified:
- Adaptability: The fund evolved to align with partner preferences for targeted funding while maintaining alignment with national health priorities.
- Strategic dialogue: It fostered improved coordination between the Ministry of Health and its partners, though further collaboration enhancements are needed.
- Efficiency: The fund’s financial management is highly efficient, as evidenced by the tripling of budgets in 2018-2019 compared to previous years. Its transparent processes have also strengthened the ministry’s capacity.
The evaluation also highlighted critical challenges, particularly in tracking funding flows, project outcomes, and results. These gaps hinder the assessment of targeted interventions’ effectiveness. Additionally, the evaluation noted persistent issues with top-down planning in the PDS and weaknesses in its monitoring and evaluation framework.
Health fund leadership emphasizes visibility and results
Dr. Abaché Ranaou, Secretary-General of the Ministry of Public Health and Strategic Coordinator of the Niger health fund, shared insights on the fund’s impact:
“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 a donor 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 confirms the fund’s overall success, reinforcing partner confidence in the Ministry of Health and encouraging further engagement. While tangible results have been achieved, areas for improvement remain—particularly in communication, program design, monitoring, and evaluation. Enhancing visibility and showcasing outcomes are essential to maintaining partner support and justifying resource allocation.”