Enhancing public health programs with performance-based memorandum of understanding

Area of Science:

• Public Health
• Health Systems Strengthening
• International Development

Background:

• Performance-based agreements are increasingly used in public health.
• Donor funding often requires enhanced accountability and measurable outcomes.
• Strengthening primary healthcare is a global health priority.

Purpose of the Study:

• To explore the effects of a performance-based Memorandum of Understanding (MoU) on public health donor programs.
• To assess the impact of the MoU on health metrics, program efficiency, and accountability.
• To evaluate the effectiveness of the MoU in strengthening primary healthcare in Kebbi State, Nigeria.

Main Methods:

• A case study approach was used to examine the MoU between Kebbi State Government and USAID.
• Health Systems Strengthening (HSS) indicators were monitored through quarterly and biannual reviews.
• A dashboard developed by the Integrated Health Program (IHP) was utilized for tracking progress.

Main Results:

• The MoU improved monitoring of primary healthcare revitalization and health sector work plan harmonization.
• Data quality and tracking of key health indicators, including financing, immunization, and skilled birth attendants, showed improvement.
• The performance-based MoU demonstrated potential for increased program efficiency and political commitment.

Conclusions:

• Performance-based Memoranda of Understanding (MoU) are valuable tools for outcome-driven public health funding.
• MoUs can enhance accountability, efficiency, and resource mobilization in donor-funded health programs.
• The case study supports the recommendation of MoUs for improving public health initiatives.