scholarly journals Tracking Development Assistance for Health: A Comparative Study of the 29 Development Assistance Committee Countries, 2011–2019

2021 ◽  
Vol 18 (16) ◽  
pp. 8519
Author(s):  
Shuhei Nomura ◽  
Haruka Sakamoto ◽  
Aya Ishizuka ◽  
Kenji Shibuya
Keyword(s):  
Development Assistance ◽  
Health System Strengthening ◽  
Development Assistance Committee ◽  
Middle Income ◽  
Target Region ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Average Share ◽  
Sector Classification ◽  
Area Data

Development assistance for health (DAH) is an important part of financing healthcare in low- and middle-income countries. We estimated the gross disbursement of DAH of the 29 Development Assistance Committee (DAC) member countries of the Organisation for Economic Co-operation and Development (OECD) for 2011–2019; and clarified its flows, including aid type, channel, target region, and target health focus area. Data from the OECD iLibrary were used. The DAH definition was based on the OECD sector classification. For core funding to non-health-specific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for calculating imputed multilateral official development assistance (ODA). The total amount of DAH for all countries combined was 18.5 billion USD in 2019, at 17.4 USD per capita, with the 2011–2019 average of 19.7 billion USD. The average share of DAH in ODA for the 29 countries was about 7.9% in 2019. Between 2011 and 2019, most DAC countries allocated approximately 60% of their DAH to primary health care, with the remaining 40% allocated to health system strengthening. We expect that the estimates of this study will help DAC member countries strategize future DAH wisely, efficiently, and effectively while ensuring transparency.

scholarly journals Tracking Japan’s development assistance for health, 2012–2016

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Shuhei Nomura ◽  
Haruka Sakamoto ◽  
Maaya Kita Sugai ◽  
Haruyo Nakamura ◽  
Keiko Maruyama-Sakurai ◽  
...  
Keyword(s):  
Development Assistance ◽  
Foreign Affairs ◽  
Health System Strengthening ◽  
African Region ◽  
Development Assistance For Health ◽  
Health Related ◽  
Important Means ◽  
High Level ◽  
Sector Classification ◽  
Social Debate

Abstract Background Development assistance for health (DAH) is one of the most important means for Japan to promote diplomacy with developing countries and contribute to the international community. This study, for the first time, estimated the gross disbursement of Japan’s DAH from 2012 to 2016 and clarified its flows, including source, aid type, channel, target region, and target health focus area. Methods Data on Japan Tracker, the first data platform of Japan’s DAH, were used. The DAH definition was based on the Organisation for Economic Co-operation and Development’s (OECD) sector classification. Regarding core funding to non-health-specific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for calculating imputed multilateral official development assistance (ODA). Results Japan’s DAH was estimated at 853.87 (2012), 718.16 (2013), 824.95 (2014), 873.04 (2015), and 894.57 million USD (2016) in constant prices of 2016. Multilateral agencies received the largest DAH share of 44.96–57.01% in these periods, followed by bilateral grants (34.59–53.08%) and bilateral loans (1.96–15.04%). Ministry of Foreign Affairs (MOFA) was the largest contributors to the DAH (76.26–82.68%), followed by Ministry of Finance (MOF) (10.86–16.25%). Japan’s DAH was most heavily distributed in the African region with 41.64–53.48% share. The channel through which the most DAH went was Global Fund to Fight AIDS, Tuberculosis, and Malaria (20.04–34.89%). Between 2012 and 2016, approximately 70% was allocated to primary health care and the rest to health system strengthening. Conclusions With many major high-level health related meetings ahead, coming years will play a powerful opportunity to reevaluate DAH and shape the future of DAH for Japan. We hope that the results of this study will enhance the social debate for and contribute to the implementation of Japan’s DAH with a more efficient and effective strategy.

scholarly journals Distributing development assistance for health: simulating the implications of 11 criteria

2017 ◽  
Vol 12 (2) ◽  
pp. 245-263
Author(s):  
Trygve Ottersen ◽  
Suerie Moon ◽  
John-Arne Røttingen
Keyword(s):  
Low Income ◽  
Economic Transition ◽  
Development Assistance ◽  
National Income ◽  
Low Income Countries ◽  
Economic Downturn ◽  
Middle Income ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Almost All

AbstractAfter years of unprecedented growth in development assistance for health (DAH), the DAH system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases and by the economic transition and rise of the middle-income countries. Central to any potent response is a fair and effective allocation of DAH across countries. A myriad of criteria has been proposed or is currently used, but there have been no comprehensive assessment of their distributional implications. We simulated the implications of 11 quantitative allocation criteria across countries and country categories. We found that the distributions varied profoundly. The group of low-income countries received most DAH from needs-based criteria linked to domestic capacity, while the group of upper-middle-income countries was most favoured by an income-inequality criterion. Compared to a baseline distribution guided by gross national income per capita, low-income countries received less DAH by almost all criteria. The findings can inform funders when examining and revising the criteria they use, and provide input to the broader debate about what criteria should be used.

scholarly journals The challenge of middle-income countries to development assistance for health: recipients, funders, both or neither?

2017 ◽  
Vol 12 (2) ◽  
pp. 265-284 ◽  
Author(s):  
Trygve Ottersen ◽  
Suerie Moon ◽  
John-Arne Røttingen
Keyword(s):  
Development Assistance ◽  
National Income ◽  
Health Needs ◽  
Middle Income ◽  
Trade Off ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Recent Developments ◽  
Per Capita

AbstractRecent developments have transformed the role and characteristics of middle-income countries (MICs). Many stakeholders now question the appropriate role of MICs in the system of development assistance for health (DAH), and key funders have already recast their approach to these countries. The pressing question is whether MICs should be recipients, funders, both or neither. The answer has deep implications for individual countries and their citizens, and for the DAH system as a whole. We clarify the fundamental issues involved and emphasise a special feature of many MICs: mid-level gross national income per capita (GNIpc) combined with substantial health needs and large inequalities. We discuss the trade-off between concerns for capacity and need, and illustrate a capacity-based approach to setting the level of a GNIpc eligibility threshold. We also discuss how needs-based exceptions and incentive-preserving instruments can complement such a threshold. Against this background, we outline options for the future roles of MICs in various circumstances. We conclude that major players in the DAH system have reason to reconsider the criteria for allocating DAH among countries and the norms for which countries should contribute and how much.

scholarly journals Development assistance for health: what criteria do multi- and bilateral funders use?

2017 ◽  
Vol 12 (2) ◽  
pp. 223-244 ◽  
Author(s):  
Trygve Ottersen ◽  
Aparna Kamath ◽  
Suerie Moon ◽  
Lene Martinsen ◽  
John-Arne Røttingen
Keyword(s):  
Economic Transition ◽  
Development Assistance ◽  
National Income ◽  
Economic Downturn ◽  
Limited Information ◽  
Middle Income ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Allocation Criteria ◽  
Broad Overview

AbstractAfter years of unprecedented growth in development assistance for health (DAH), the system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases, and by the economic transition and rise of the middle-income countries. This raises questions about which countries should receive DAH and how much, and, fundamentally, what criteria that promote fair and effective allocation. Yet, no broad comparative assessment exists of the criteria used today. We reviewed the allocation criteria stated by five multilateral and nine bilateral funders of DAH. We found that several funders had only limited information about concrete criteria publicly available. Moreover, many funders not devoted to health lacked specific criteria for DAH or criteria directly related to health, and no funder had criteria directly related to inequality. National income per capita was emphasised by many funders, but the associated eligibility thresholds varied considerably. These findings and the broad overview of criteria can assist funders in critically examining and revising the criteria they use, and inform the wider debate about what the optimal criteria are.

scholarly journals Factors associated with the disbursements of development assistance for health in low-income and middle-income countries, 2002–2017

2021 ◽  
Vol 6 (4) ◽  
pp. e004858
Author(s):  
Modhurima Moitra ◽  
Ian Cogswell ◽  
Emilie Maddison ◽  
Kyle Simpson ◽  
Hayley Stutzman ◽  
...  
Keyword(s):  
Low Income ◽  
Development Assistance ◽  
Health Spending ◽  
Recipient Country ◽  
Health Systems Strengthening ◽  
Low Income Countries ◽  
Middle Income ◽  
Development Assistance For Health ◽  
Country Characteristics ◽  
Health Accounts

IntroductionIn 2017, development assistance for health (DAH) comprised 5.3% of total health spending in low-income countries. Despite the key role DAH plays in global health-spending, little is known about the characteristics of assistance that may be associated with committed assistance that is actually disbursed. In this analysis, we examine associations between these characteristics and disbursement of committed assistance.MethodsWe extracted data from the Creditor Reporting System of the Organization for Economic Co-operation and Development, Institute for Health Metrics and Evaluation, and the WHO National Health Accounts database. Factors examined were off-budget assistance, administrative assistance, publicly sourced assistance and assistance to health systems strengthening. Recipient-country characteristics examined were perceived level of corruption, civil fragility and gross domestic product per capita (GDPpc). We used linear regression methods for panel of data to assess the proportion of committed aid that was disbursed for a given country-year, for each data source.ResultsFactors that were associated with a higher disbursement rates include off-budget aid (p<0.001), lower administrative expenses (p<0.01), lower perceived corruption in recipient country (p<0.001), lower fragility in recipient country (p<0.05) and higher GDPpc (p<0.05).ConclusionSubstantial gaps remain between commitments and disbursements. Characteristics of assistance (administrative, publicly sourced) and indicators of government transparency and fragility are also important drivers associated with disbursement of DAH. There remains a continued need for better aid flow reporting standards and clarity around aid types for better measurement of DAH.

Understanding the challenges associated with the use of data from routine health information systems in low- and middle-income countries: A systematic review

2020 ◽  
pp. 183335832092872 ◽  
Author(s):  
Klesta Hoxha ◽  
Yuen W Hung ◽  
Bridget R Irwin ◽  
Karen A Grépin
Keyword(s):  
Information Systems ◽  
Health System ◽  
Health Information ◽  
Health Information Systems ◽  
Health System Strengthening ◽  
Middle Income ◽  
Environmental Challenges ◽  
Middle Income Countries ◽  
Data Process ◽  
Low And Middle Income

Background: Routine health information systems (RHISs) are crucial to informing decision-making at all levels of the health system. However, the use of RHIS data in low- and middle-income countries (LMICs) is limited due to concerns regarding quality, accuracy, timeliness, completeness and representativeness. Objective: This study systematically reviewed technical, behavioural and organisational/environmental challenges that hinder the use of RHIS data in LMICs and strategies implemented to overcome these challenges. Method: Four electronic databases were searched for studies describing challenges associated with the use of RHIS data and/or strategies implemented to circumvent these challenges in LMICs. Identified articles were screened against inclusion and exclusion criteria by two independent reviewers. Results: Sixty studies met the inclusion criteria and were included in this review, 55 of which described challenges in using RHIS data and 20 of which focused on strategies to address these challenges. Identified challenges and strategies were organised by their technical, behavioural and organisational/environmental determinants and by the core steps of the data process. Organisational/environmental challenges were the most commonly reported barriers to data use, while technical challenges were the most commonly addressed with strategies. Conclusion: Despite the known benefits of RHIS data for health system strengthening, numerous challenges continue to impede their use in practice. Implications: Additional research is needed to identify effective strategies for addressing the determinants of RHIS use, particularly given the disconnect identified between the type of challenge most commonly described in the literature and the type of challenge most commonly targeted for interventions.

scholarly journals Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study

2017 ◽  
Vol 27 (1) ◽  
pp. 29-39 ◽  
Author(s):  
H. Lempp ◽  
S. Abayneh ◽  
D. Gurung ◽  
L. Kola ◽  
J. Abdulmalik ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Mental Health System ◽  
Service User ◽  
Health System Strengthening ◽  
Service Users ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cross Country ◽  
Caregiver Involvement

Aims.The aims of this paper are to: (i) explore the experiences of involvement of mental health service users, their caregivers, mental health centre heads and policy makers in mental health system strengthening in three low- and middle-income countries (LMICs) (Ethiopia, Nepal and Nigeria); (ii) analyse the potential benefits and barriers of such involvement; and (iii) identify strategies required to achieve greater service user and caregiver participation.Methods.A cross-country qualitative study was conducted, interviewing 83 stakeholders of mental health services.Results.Our analysis showed that service user and caregiver involvement in the health system strengthening process was an alien concept for most participants. They reported very limited access to direct participation. Stigma and poverty were described as the main barriers for involvement. Several strategies were identified by participants to overcome existing hurdles to facilitate service user and caregiver involvement in the mental health system strengthening process, such as support to access treatment, mental health promotion and empowerment of service users. This study suggests that capacity building for service users, and strengthening of user groups would equip them to contribute meaningfully to policy development from informed perspectives.Conclusion.Involvement of service users and their caregivers in mental health decision-making is still in its infancy in LMICs. Effective strategies are required to overcome existing barriers, for example making funding more widely available for Ph.D. studies in participatory research with service users and caregivers to develop, implement and evaluate approaches to involvement that are locally and culturally acceptable in LMICs.

Global burden of non-communicable diseases will rise

2016 ◽  
Keyword(s):  
Health Workers ◽  
Communicable Diseases ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Content Type ◽  
Policy Initiatives ◽  
Development Assistance For Health ◽  
Middle Income Countries ◽  
Health Infrastructure ◽  
Global Economic Growth

Significance In the same period, the share of deaths from communicable (or infectious) diseases has fallen from 30% to 23%. Yet there has been no corresponding shift in global development assistance for health, and policy initiatives to combat NCDs are minimal. Impacts NCDs will slow global economic growth as chronic sufferers will have limited productive capacities in the workplace. Health infrastructure in low- and middle-income countries will be increasingly overwhelmed and overburdened. Their health workers will be forced to shift their focus from treating communicable to non-communicable diseases.

scholarly journals Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Maya Semrau ◽  
Atalay Alem ◽  
Jose L. Ayuso-Mateos ◽  
Dan Chisholm ◽  
Oye Gureje ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Human Resource Development ◽  
Health Systems ◽  
Building Blocks ◽  
Health System Strengthening ◽  
Mental Health Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BackgroundThere is a large treatment gap for mental, neurological or substance use (MNS) disorders. The ‘Emerging mental health systems in low- and middle-income countries (LMICs)’ (Emerald) research programme attempted to identify strategies to work towards reducing this gap through the strengthening of mental health systems.AimsTo provide a set of proposed recommendations for mental health system strengthening in LMICs.MethodThe Emerald programme was implemented in six LMICs in Africa and Asia (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda) over a 5-year period (2012–2017), and aimed to improve mental health outcomes in the six countries by building capacity and generating evidence to enhance health system strengthening.ResultsThe proposed recommendations align closely with the World Health Organization's key health system strengthening ‘building blocks’ of governance, financing, human resource development, service provision and information systems; knowledge transfer is included as an additional cross-cutting component. Specific recommendations are made in the paper for each of these building blocks based on the body of data that were collected and analysed during Emerald.ConclusionsThese recommendations are relevant not only to the six countries in which their evidential basis was generated, but to other LMICs as well; they may also be generalisable to other non-communicable diseases beyond MNS disorders.Declaration of interestNone.

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