Identifying the opportunities and barriers: a cross-sectional review of the health development coordination mechanisms in the World Health Organization African region. Authors

Abdulmumini Usman^1*Olushayo Oluseun Olu¹Mohamed Kakay²Ndoungou Salla Ba¹Patrick Kabore¹Hyelni Kulausa¹Emmanuel Chanda¹Alex Gasasira¹Joseph Cabore¹

• ¹World Health Organisation, Brazzaville, Republic of Congo
• ²World Health Organization Country Office, Kabul, Afghanistan

Weak health sector coordination remains a major impediment to the effective and efficient implementation of health development and humanitarian programmes in the WHO African Region. Despite numerous efforts to strengthen coordination, progress has been limited, often resulting in duplication of efforts, inefficient use of scarce resources, reduced sustainability, and continued dependence on external aid. While several studies have assessed coordination mechanisms in individual countries, a regional overview has been lacking. This study thus aimed to examine the current status and characteristics of health sector coordination mechanisms and the role of WHO in health coordination across the 47 Member States (MSs)member states of the WHO African Region. A descriptive cross-sectional study was conducted between 2017 and 2019 using a mixed-methods approach, including document reviews, key informant interviews, and focus group discussions. The findings revealed that only 9 member statesmember states (23%) had a functioning central health sector coordination platform, all of which had signed the IHP+ compact and adopted the Sector-Wide Approach. Nearly half (47%) lacked a central platform, despite 41% hosting a significant number of development partners and 36% having signed the IHP+. Sixteen member statesmember states (34%) operated multiple fragmented, programme-specific coordination mechanisms with minimal linkage to any overarching platform, despite most of the them (81%) being IHP+ signatories. In eight member statesmember states, parallel humanitarian and development coordination systems coexisted. Coordination was identified by stakeholders as one of the top five priorities for WHO support. Based on these findings, five key recommendations are proposed: strengthening national coordination capacities; streamlining multiple coordination mechanisms; addressing coordination challenges in protracted crisis settings; clearly defining WHO's coordination role in line with partner expectations; and providing context-specific support across core health system functions. Collective efforts from all stakeholders are essential to accelerate the implementation of these recommendations, thereby enhancing health governance, improving aid effectiveness, and advancing progress towards universal health coverage in the region.