In Niger, where the healthcare sector faces chronic underfunding, the Health Common Fund was launched in 2006 through a collaborative effort between the Ministry of Public Health, the French Development Agency (AFD), and the World Bank. Today, six major donors participate in this initiative, having contributed €91 million between 2015 and 2019.

The fund’s primary objective is to enhance the health outcomes of Niger’s population, with special focus on women and children, by supporting the implementation of the country’s Health Development Plan (PDS). By pooling international resources, it aims to bolster the government’s capacity to deliver healthcare services nationwide.

Participatory evaluation approach

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

The evaluation revealed that the fund’s relevance has grown over time. It successfully adapted its management approaches to accommodate partners’ preferences for directing funds toward priority PDS activities while maintaining alignment with aid effectiveness principles. Additionally, it strengthened strategic dialogue between the Ministry and its partners, though coordination among donors still requires improvement.

Tripled budgets and operational excellence

Another key finding highlights the fund’s remarkable efficiency and robust financial management. This is evidenced by budget tripling in 2018-2019 compared to previous periods. The fund established clear, widely accepted procedures that enhanced the Ministry’s administrative capabilities. Importantly, it serves as the only reliable and predictable funding source for regional health departments to finance their annual operational plans.

However, the evaluation identified significant weaknesses in tracking financial flows, implementation progress, and outcome measurements. These gaps hinder the assessment of targeted interventions’ effectiveness. More broadly, the evaluation underscores persistent issues with the PDS’s top-down planning approach and its weak monitoring and evaluation framework.

Dr. Abaché Ranaou’s perspective

According to Dr. Abaché Ranaou, Secretary General of the Ministry of Public Health and Strategic Coordinator of the Health Common Fund:

“To ensure coordinated implementation of successive Health Development Plans aimed at promoting the social well-being of the Nigerien population, the Ministry of Public Health, in collaboration with technical and financial partners, established a donor common fund in 2005, operational since 2006. This mechanism aligns partner actions with national priorities, harmonizes interventions, and ensures predictable and stable international support.”

“The AFD-led evaluation of the fund revealed overwhelmingly positive results. These findings bolster partner confidence in the Ministry of Public Health and encourage continued adherence to the fund—a national pride benefiting our citizens.”

“While the evaluation confirms tangible results, it also highlights areas for improvement. The Health Common Fund requires targeted enhancements in communication, program design, monitoring, and evaluation. To persuade technical and financial partners and other stakeholders, we must prioritize action visibility and showcase results relative to invested resources.”

Explore the complete evaluation findings in AFD’s Africa report