Background

In 2011, ALMA Heads of State and Government requested a scorecard to enhance tracking and accountability for malaria. Developed primarily for Heads of State and Government, the ALMA scorecard for accountability and action is used by senior political leaders including Heads of State and Government, Ministers of Health, National Malaria Control Programmes and Development Partners to facilitate tracking of progress and strengthen accountability for malaria control and elimination across the continent.

How it works

The scorecard accountability tool is produced quarterly by the ALMA Secretariat. It has three complementary components:

• The scorecard, which displays country-level performance against key malaria, Neglected Tropical Diseases (NTDs) and Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) indicators for 46 malaria-endemic countries in Africa highlighting successes and shortfalls in performance. The Scorecard currently includes 13 malaria indicators covering financing, coverage and impact, seven RMNCAH and one NTD tracer indicator.
• An overview report summarising the status of malaria and highlighting emerging challenges and successes.
• Country quarterly reports which provide a summary of performance for each country and document and track recommended actions to address identified bottlenecks. Every quarter the countries provide feedback on due recommended actions with >80% response rate.

The ALMA Scorecard for Accountability and Action is also available on the ALMA website and is incorporated in African Union documentation for dissemination to the Heads of State and Government. Additionally, the ALMA secretariat disseminates the scorecard and quarterly reports directly to Heads of State and Government, Ministers of Health and Finance, African ambassadors to the AU Commission and UN, and key malaria partners.

Impact

The ALMA Scorecard for Accountability and Action has facilitated increased domestic resource commitments from countries, increased resources from partners, rapid policy change, accelerated commodity procurement, and action to address emergencies, amongst other actions.

A number of finance related actions have been agreed upon and realized including securing Global Fund co-financing resources with increased domestic financing for malaria in several countries and mobilization of resources from other sources to sustain availability of malaria commodities and interventions. Commitment to scale up and sustain key interventions have also received Heads of State support leading to continent-wide improvement in intervention coverage.

During the COVID-19 pandemic, the scorecard has included key indicators tracking campaigns and stock availability whilst the country reports have helped to track and address bottlenecks in the delivery of essential services for malaria, Reproductive, Maternal, Newborn, Child and Adolescent Health, and Neglected Tropical Diseases.

An independent evaluation of scorecards and data visualization tools identified the ALMA scorecard as a gold star example, noting that it has a clear and focused theory of change with defined objectives and audience, includes actionable indicators and has a clear engagement plan for its target audience. This observation was in contrast to a general conclusion that very few scorecards and data visualization tools have clear and focused theories of change about the decisions they are trying to influence.

Key success factors

• Specially developed for senior leaders to improve accountability, monitoring and response to health systems gaps
• Clear theory of change with an inbuilt accountability mechanism and two-way feedback system
• Integrated into the AU’s existing accountability mechanisms
• Populated using internationally published but up to date data