helping improve health outcomes over the longer term. DFAT therefore needs to continue to work with GoPNG, and the other development partners, to ensure the allocation of any resources DFAT directly provides to MDPs are addressing ‘’the right things’’. This includes health system strengthening as well as addressing the critical drivers of the preventable burden of disease in PNG. system strengthening, including public financial management and availability of essential drugs (ii) an unfinished agenda of traditional health challenges, including under-nutrition and immunisation and (iii) new health challenges including Non-communicable diseases. 8. Gender At a strategic level GoPNG and each of the multilateral agencies are committed to gender equality and empowering women and girls. This is a challenging area in PNG and will take time to improve. However, there was nevertheless limited operational level evidence that MDP efforts having made a real difference to gender equality. The Asian Development Bank’s RPHSDP is the investment with the most sophisticated approach to gender in its design, delivery and M&E. UNFPA provides estimates of the impact its family planning and other interventions on number of maternal deaths averted and other gender related data: see Table 2. The majority of project level reporting reviewed from other agencies did not contain sufficient – and in some cases any - gender disaggregated data. There was also an absence of thorough gender lens analysis in the reporting. DFAT is entitled to expect clear and more informative M & E reporting from MDPs, including evidence that the M & E is being used for overall performance management from MDPs, on such an That DFAT, GoPNG and MDPs meet to agree on a more explicit, insightful and regular means of reporting on gender disaggregated data, extracted from existing M&E systems wherever possible, as a basis for better planning and management. 49
(and PNG, as well as other governments) to have those MDPs operating effectively and efficiently in PNG. 5) Importantly, GoPNG itself states that Australia’s partnerships with MDPs is ‘’commendable and encouraged’’ (albeit possibly requiring some fine tuning in terms of how financial flows are recorded in GoPNG’s financial statements). 11. Actions that DFAT itself can take to strengthen performance management. 1. DFAT can significantly strengthen the development effectiveness of its partnership with MDPs by having a more explicit, overarching, results framework for engaging with multilaterals. Efforts to do this in the past should be renewed: current thinking and planning by Post of the future program provides an opportunity to do this. 2. Health issues in PNG are technically complex. DFAT can therefore strengthen its engagement with MDBs and health outcomes if it has the right resources, at the right time, to engage in policy dialogue and results management. 3. Australia could further strengthen its influence on the performance of MDPs by having a clearer and more direct line of communication about the successes – and weaknesses – of MDPs on the ground in PNG with the headquarters of those MDPs. 1. DFAT’s partnership with MDPs move from a collection of individual ‘’projects’’ or funding arrangements to a more coordinated overarching program with an explicit, coherent, strategy or vision. 2.If DFAT is to engage in policy dialogue in the technically demanding and complex area of health sector support and reform, that staff are appropriately resourced (and then made accountable) including with access to technical expertise, and resources to strategically examine developments at the provincial and sub-national level where service delivery occurs. 3.That clearer and simpler arrangements are made so that DFAT’s insights into the on the ground strengths - and weaknesses - of MDP operations in PNG are strategically, proactively, and consistently conveyed to the Australian representatives in the Executive Boards of those six MDPs. 59