Global health financing and Development Assistance for Health

Abstract Background: Development assistance for health represents an important source of health financing in many low and middle-income countries. However, there are few accounts on how priorities funded through Development assistance for health are integrated with district health priorities. This study aimed at understanding the operational challenges of engaging development partners in district health planning in Tanzania Methods: This explanatory mixed methods study was conducted in Kinondoni and Bahi districts. A structured checklist to 35 participants collected quantitative data whereas a semi-structured guide collected qualitative from 20 key informants (the council health planning team members and the development partners) to obtain information related to engagement of development partners in the planning processes and subsequent implementation of the district plan. We used descriptive analysis for quantitative data and thematic analysis for qualitative data Results: Majority (86%) of the development partners delivering aid in the studied districts were Non Governmental Organizations. We found high engagement of Development partners (DPs) (87.5%) in Bahi district and very low in Kinondoni district (37.5%). Guidance on district priorities to be included in Development partner’s plans as part of the Comprehensive Council Health Plan (CCHP) was given to 36% of the Development partners. Submission of written plans to be integrated in the District plans was done by only 56% of Development partners, with majority (77.7%) from Kinondoni district not submitting their plans. Only 8% of the submitted plans appeared in the final District plan document. Qualitative findings reported operational challenges to engagements such as differences in planning cycles between the government and donors, uncertainties in funding from the prime donors, lack of transparency, limited skills of district planning teams, technical practicalities on planning tools and processes, inadequate knowledge on planning guidelines among DPs and poor donor coordination at the district level. Conclusions: We found low engagement of Development partners in planning. To be resolved are operational challenges related to differences in planning cycles, articulations and communication of local priorities, donor coordination, and technical skills on planning and stakeholder engagement.

Download Full-text

Development Assistance for Health

10.1093/oso/9780198813057.003.0006 ◽

2018 ◽

Author(s):

Jeremy Youde

Keyword(s):

Global Health ◽

International Society ◽

Development Assistance ◽

Economic Recession ◽

Foreign Assistance ◽

Development Assistance For Health ◽

Past Generation ◽

Health Funding ◽

Private Corporations ◽

Donor States

Since 1990, development assistance for health has increased approximately 500 per cent. This incredible growth is one concrete manifestation of governments’ recognition of the importance of global health within international politics. It is all the more incredible because it has continued even in times of economic recession and a generalized decrease in foreign assistance by donor states. The increase in funding for global health also demonstrates the changes in the composition of significant actors within international society. No longer solely the province of state governments, global health funding increasingly comes from non-governmental organizations, philanthropic organizations, public–private actors, and even private corporations. The funding priorities also illustrate how international society has conceptualized global health. This chapter examines the changes within global health funding over the past generation and describes the successes and shortcomings of the current funding strategies.

Download Full-text

Tracking development assistance for health from China, 2007–2017

BMJ Global Health ◽

10.1136/bmjgh-2019-001513 ◽

2019 ◽

Vol 4 (5) ◽

pp. e001513 ◽

Cited By ~ 2

Author(s):

Angela E Micah ◽

Yingxi Zhao ◽

Catherine S Chen ◽

Bianca S. Zlavog ◽

Golsum Tsakalos ◽

...

Keyword(s):

International Development ◽

Development Assistance ◽

Health Financing ◽

Health System Strengthening ◽

Government Agencies ◽

Development Assistance For Health ◽

The World Bank ◽

Level Of Economic Development ◽

Current Context ◽

International Engagement

IntroductionIn recent years, China has increased its international engagement in health. Nonetheless, the lack of data on contributions has limited efforts to examine contributions from China. Existing estimates that track development assistance for health (DAH) from China have relied primarily on one dataset. Furthermore, little is known about the disbursing agencies especially the multilaterals through which contributions are disbursed and how these are changing across time. In this study, we generated estimates of DAH from China from 2007 through 2017 and disaggregated those estimates by disbursing agency and health focus area.MethodsWe identified the major government agencies providing DAH. To estimate DAH provided by each agency, we leveraged publicly available development assistance data in government agencies’ budgets and financial accounts, as well as revenue statements from key international development agencies such as the WHO. We reported trends in DAH from China, disaggregated contributions by disbursing bilateral and multilateral agencies, and compared DAH from China with other traditional donors. We also compared these estimates with existing estimates.ResultsDAH provided by China grew dramatically, from US$323.1 million in 2007 to $652.3 million in 2017. During this period, 91.8% of DAH from China was disbursed through its bilateral agencies, including the Ministry of Commerce ($3.7 billion, 64.1%) and the National Health Commission ($917.1 million, 16.1%); the other 8.2% was disbursed through multilateral agencies including the WHO ($236.5 million, 4.1%) and the World Bank ($123.1 million, 2.2%). Relative to its level of economic development, China provided substantially more DAH than would be expected. However, relative to population size and government spending, China’s contributions are modest.ConclusionIn the current context of plateauing in the growth rate of DAH contributions, China has the potential to contribute to future global health financing, especially financing for health system strengthening.

Download Full-text

Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050

The Lancet ◽

10.1016/s0140-6736(19)30841-4 ◽

2019 ◽

Vol 393 (10187) ◽

pp. 2233-2260 ◽

Cited By ~ 73

Author(s):

Angela Y. Chang ◽

Krycia Cowling ◽

Angela E. Micah ◽

Abigail Chapin ◽

Catherine S. Chen ◽

...

Keyword(s):

Global Health ◽

Development Assistance ◽

Health Financing ◽

Private Spending

Download Full-text

How to do (or not to do) … Tracking data on development assistance for health

Health Policy and Planning ◽

10.1093/heapol/czr076 ◽

2011 ◽

Vol 27 (6) ◽

pp. 527-534 ◽

Cited By ~ 20

Author(s):

Karen A Grépin ◽

Katherine Leach-Kemon ◽

Matthew Schneider ◽

Devi Sridhar

Keyword(s):

Developing Countries ◽

Global Health ◽

Health Systems ◽

Development Assistance ◽

Tracking Data ◽

Development Assistance For Health ◽

Resource Flows ◽

Global Health Community ◽

Health Community

Abstract Development assistance for health (DAH) has increased substantially in recent years and is seen as important to the improvement of health and health systems in developing countries. As a result, there has been increasing interest in tracking and understanding these resource flows from the global health community. A number of datasets, each with its own strengths and weaknesses, are available to track DAH. In this article we review the available datasets on DAH and summarize the strengths and weaknesses of each of these datasets to help researchers make the best choice of which to use to inform their analysis. Finally, we also provide recommendations about how each of these datasets could be improved.

Download Full-text

Reinforcing locally led solutions for universal health coverage: a logic model with applications in Benin, Namibia and Uganda

BMJ Global Health ◽

10.1136/bmjgh-2020-004273 ◽

2021 ◽

Vol 6 (2) ◽

pp. e004273

Author(s):

Joël Arthur Kiendrébéogo ◽

Andrea Thoumi ◽

Keith Mangam ◽

Cheickna Touré ◽

Seyni Mbaye ◽

...

Keyword(s):

Global Health ◽

International Development ◽

Universal Health Coverage ◽

Low Income ◽

Development Assistance ◽

Health Financing ◽

Health Coverage ◽

Global Health Community ◽

Health Community ◽

Universal Health

Development assistance for health programmes is often characterised as donor-led models with minimal country ownership and limited sustainability. This article presents new ways for low-income and middle-income countries to gain more control of their development assistance programming as they move towards universal health coverage (UHC). We base our findings on the experience of the African Collaborative for Health Financing Solutions (ACS), an innovative US Agency for International Development-funded project. The ACS project stems from the premise that the global health community can more effectively support UHC processes in countries if development partners change three long-standing paradigms: (1) time-limited projects to enhancing long-lasting processes, (2) fly-in/fly-out development support to leveraging and strengthening local and regional expertise and (3) static knowledge creation to supporting practical and co-developed resources that enhance learning and capture implementation experience. We assume that development partners can facilitate progress towards UHC if interventions follow five action steps, including (1) align to country demand, (2) provide evidence-based and tailored health financing technical support, (3) respond to knowledge and learnings throughout activity design and implementation, (4) foster multi-stakeholder collaboration and ownership and (5) strengthen accountability mechanisms. Since 2017, the ACS project has applied these five action steps in its implementing countries, including Benin, Namibia and Uganda. This article shares with the global health community preliminary achievements of implementing a unique, challenging but promising experience.

Download Full-text

The relationship between development assistance for health and public health financing in 134 countries between 2000 and 2015

Health Policy and Planning ◽

10.1093/heapol/czab004 ◽

2021 ◽

Author(s):

Bryan N Patenaude

Keyword(s):

Public Health ◽

Health Outcomes ◽

Development Assistance ◽

Health Sector ◽

Health Spending ◽

Health Financing ◽

World Health ◽

Public Financing ◽

Development Assistance For Health ◽

The Relationship

Abstract This paper utilizes causal time-series and panel techniques to examine the relationship between development assistance for health (DAH) and domestic health spending, both public and private, in 134 countries between 2000 and 2015. Data on 237 656 donor transactions from the Institute for Health Metrics and Evaluation’s DAH and Health Expenditure datasets are merged with economic, demographic and health data from the World Bank Databank and World Health Organization’s Global Health Observatory. Arellano–Bond system GMM estimation is used to assess the effect of changes in DAH on domestic health spending and health outcomes. Analyses are conducted for the entire health sector and separately for HIV, TB and malaria financing. Results show that DAH had no significant impact on overall domestic public health investment. For HIV-specific investments, a $1 increase in on-budget DAH was associated with a $0.12 increase in government spending for HIV. For the private sector, $1 in DAH is associated with a $0.60 and $0.03 increase in prepaid private spending overall and for malaria, with no significant impact on HIV spending. Results demonstrate that a 1% increase in public financing reduced under-5 mortality by 0.025%, while a 1% increase in DAH had no significant effect on reducing under-5 mortality. The relationships between DAH and public health financing suggest that malaria and HIV-specific crowding-in effects are offset by crowding-out effects in other unobserved health sectors. The results also suggest policies that crowd-in public financing will likely have larger impacts on health outcomes than DAH investments that do not crowd-in public spending.

Download Full-text

China’s Development Assistance for Health on Key Tropical Diseases: A SWOT Analysis

10.1101/524678 ◽

2019 ◽

Author(s):

Hong-Mei Li ◽

Wei Ding ◽

Lu-Lu Huang ◽

Xue-Jiao Ma ◽

Ying-Jun Qian ◽

...

Keyword(s):

Global Health ◽

Soft Power ◽

Swot Analysis ◽

Development Assistance ◽

Developed Countries ◽

Tropical Diseases ◽

Internal Factors ◽

Tropical Regions ◽

Development Assistance For Health ◽

Countermeasures And Suggestions

AbstractBackgroundWHO focused and gave priority on ten serious tropical diseases, while China has made remarkable achievements on tropical diseases control. In addition, China has a history of more than 60 years in the health assistance, however, its assistance for tropical diseases started late.MethodsA qualitative questionnaire was distributed to inquiry the opinions of professionals on China’s health assistance on tropical diseases and published articles were searched to collect those data. SWOT analysis, as a tool of qualitative analysis, was used to classify and evaluate the current strengths, the weakness, the opportunities, and the threats of health assistance on tropical diseases in China.ResultsBased on SWOT analysis, the internal factors and external environments are obtained. The strengths are focused on China’s achievements on tropical diseases control, surveillance response system of tropical diseases, and human resources of public health; the weakness laid on sustainability of aid projects and funding, applicability of Chinese experience, and lack of composite talents; the opportunities are mainly in the global need of tropical diseases control, China’s health cooperation in Belt & Road and Africa, and the actively participating of international organizations in health assistance; as well as the threats are reflected in the complex international situation, domestic needs of tropical diseases control, and the significant gaps between China and developed countries.ConclusionThe internal strengths and weaknesses of development assistance for health on tropical diseases are clearly presented in the SWOT framework, as well as the external opportunities and threats and corresponding coping strategies. In the era of global health, China should strengthen and improve the health assistance for tropical diseases.Author summaryTropical diseases are serious infections in tropical and sub-tropical regions, with billions of persons infected and millions of deaths every year, especially in Africa. WHO also called for global efforts to control and eliminate tropical diseases. In the era of global health, development assistance on tropical diseases is important to demonstrate the soft power of national diplomacy, and China has started its health assistance in 1963. In this paper, a qualitative questionnaire and published articles were combined to collect data, and then SWOT analysis was used to analyze the internal factors and external environment, that is the current strengths, the weakness, the opportunities, and the threats of the China’s Health Assistance on key tropical diseases. Based on those results, we put forward the countermeasures and suggestions for the future cooperation of tropical diseases. At the end of this paper, we call on Chinese professionals should make use of their own advantages and actively improve the global tropical diseases control.

Download Full-text