P4H was launched as a political initiative for SHP at the G8 summit in Heiligendamm in 2007. Since then, P4H has evolved into an innovative support network for UHC/SHP, based on a model that takes global multi- and bilateral cooperation to the next level. The network combines three functions serving as:
• a platform for information exchange, dialogue and capacity development;
• a mechanism for coordination of multi-/bilateral technical support across sectors and cooperation levels;
• a marketplace for collaboration and complementary investments for scaling up support and filling any support gaps.
A unique composition: P4H comprises the World Health Organization (WHO), the World Bank, the International Labor Organization (ILO,) the African Development Bank (AfDB), the French Ministry of Foreign and European Affairs, the German Federal Ministry for Economic Cooperation and Development (BMZ), the Swiss Development Cooperation (SDC) and the Spanish Development Cooperation Agency (AECID) – a broad mix of key development partners and investors in UHC and SHP with different mandates, purposes, comparative strengths and sector affiliation. P4H combines the political commitment and financial contributions of its bilateral members with the respective normative and technical support of the multilateral members and the wealth of expertise, experience and connections of the affiliated bilateral implementing organisations, AFD, GIPSPSI, GIZ and KfW.
P4H works with a lean management structure and draws on the global, regional and country structures of its members. To facilitate collaboration and coordination between partners at global, regional and country level, P4H members have established a small coordination team – the P4H Coordination Desk – hosted by WHO in Geneva.
Many low- and middle-income countries are now striving to establish UHC/SHP, and turning to external development partners for help and advice in drawing up and implementing workable policy. Unfortunately, a lack of coherence, both at the country and DP level, often gets in the way of progress. It is not unusual, for example, for different sectors such as health, social affairs, finance, and local government to find themselves pulling in different directions as stakeholders seek to protect or further their interests. The support provided frequently fails to recognize the complexity of the issues faced or is packaged as one-size-fits-all solutions that are imposed on countries regardless of their specific needs.
The purpose and scope of P4H
The main thrust of P4H efforts is coherent, enhanced support for the creation and extension of sustainable health and social protection systems for UHC/SHP, based on the values of universality and equity.
The joint efforts of P4H members include
- the promotion of high-level political commitment to and ownership of UHC/SHP initiatives;
- a strategic approach towards UHC/SHP, e.g. by supporting the development of national UHC/SHP strategies based on the realities of what they can afford, that is in line with social and economic development objectives, and builds on a consensus about how to achieve its goals. P4H strives to offer state-of-the-art, unbiased support that encourages countries to develop and implement their own national policies and strategies according to their national priorities.
- support to Capacity Development moving away from isolated capacity building activities to a structured and systematic approach that links human resource development with institutional and organisational development.
Where and how does P4H work?
The focus of P4H is on country support. Since its launch, the number of countries working with the network has steadily increased. Please visit our country pages for details.
The main mechanism for delivering P4H support is the country network for UHC/SHP. National-level networks, comprising national stakeholders and P4H members, build on and strengthen existing coordination mechanisms, and are open to other interested parties that have a stake in UHC/SHP. Typically, P4H becomes involved at the national level, with two or more P4H partners responding to a partner country’s call for support in its efforts to develop UHC/SHP. The work of the national networks is then complemented by regional and global level support from P4H partners where requested and appropriate. Ideally, the involvement of P4H members at country, regional and global level is guided by a country-owned roadmap for UHC/SHP, which sets out the milestones, roles, and responsibilities of the various stakeholders that will ultimately bring about meaningful change. A joint support plan then allocates different support activities to specific members, and sets a timeframe for implementation. This decentralized support model forms the basis for the flexible, tailored, and integrated P4H support to countries across levels and sectors.
P4H is adding value by
- Ensuring political commitment: combining technical and political solutions.
P4H is committed to ensuring that the process of moving towards UHC/SHP is fully owned, led, and managed by individual countries. Without political commitment, the transition to UHC/SHP can easily stall or drift. So P4H also works to raise awareness about UHC/SHP beyond the technical level, to promote high-level political commitment.
- Connecting sectors.
P4H members are particularly well placed to encourage multi-sectoral collaboration fostering coherence across the areas of health, social protection, finance, poverty alleviation, and sustainable development – countering the natural tendency for stakeholders to address challenges solely from their own perspective.
- Improving the quality and dynamics of support.
The P4H network adds value across a range of support activities, reflecting the different mandates and competencies of the P4H members. Experts from a wide variety of backgrounds, including health systems, health economics, social protection, sustainable development, public policies, etc. can address a broad spectrum of key questions and challenges. Working in multi-disciplinary teams composed of experts from the country, regional, and global level of network partners, P4H promotes a balanced mix of strategic options and recommendations, while at the same avoiding duplication of effort, notably the time and resources wasted in the setting up of parallel UHC/SHP project streams. Thus, the network harmonises support within and across sectors—and increases the dynamics for accelerating the transition to UHC/SHP.
- Scaling up support.
The P4H network can also assist in scaling-up on-going support with the financial resources made available by its bilateral P4H members. These additional resources may be used to complement support activities and foster collaboration among network members at the country level. These resources thus serve as an indirect incentive for collaboration and harmonisation of support. Scaling-up support requires understanding the support need, taking into account what has already been achieved by the country network and where gaps remain. Since P4H does not work through physically pooled funding the preferred process is to develop a joint support plan at country level, which lists the various contributions of network partners and identifies the resource gaps.