Australian aid to health service delivery in Papua New Guinea, Solomon Islands and Vanuatu

New Guinea, Solomon Islands and Vanuatu are poor countries that represent very challenging developmental environments. This report examines the effectiveness of Australian Agency for International Development’s support to improve the delivery of essential health services in these three countries.

The report indicates that the agency’s efforts in the concerned countries have been mixed. Findings are as follows:

• the agency has made positive contributions to health policy development, where the partner government has owned and led the process
• the agency has provided assistance to maintain financing of front-line health services
• however, poverty and gender inequality received little specific attention in sector policy
• similarly, mechanisms to effect better dialogue with partner governments and civil society about health sector policy, strategies and performance have been under-developed
• this includes communicating future funding intentions to partner governments and ensuring continuity in support
• furthermore, Australian assistance has on occasion missed opportunities to lock in earlier achievements when developing new activities

 Recommendations are that:

• support to build health systems capacity should be fully integrated, as part of a broader strategy and plan that addresses other factors critical for improving performance
• the agency’s strategy should recognise that government is the key to building sustainable health services in the three countries studied
• changing circumstances in each country need to be continually re-assessed to determine implications for the strategy
• the agency should continue in its efforts to build a sector partnership with government and other development partners, working towards a full sector wide approach
• the agency should progress to use government systems for financial management of aid flows
• the agency should ensure greater continuity and coherence between phases and types of support to protect the benefits achieved and avoid instability in the level of support provided