National ownership of family planning: What do FP2020 commitments have to do with it?

Background: In 2020, we reached a family planning (FP) temporal milestone. This paper seeks to understand the political economy of commitments and normative best practice within FP national programs, contributing to “stock taking” of change objectives for national ownership and domestic financing of FP programs post FP2020. Stock taking is needed to understand, for example, do we expect our current approaches to deliver greater commitment or do we need to change our approach? Is time the limiting factor for FP2020 commitments or are other, contextual, mechanistic and implementation factors more critical? Methods: This paper uses mini-case studies to offer insights in response to these questions. It drew from country status updates of national FP program commitments published on the FP2020 website. These included country self-assessments, country action for acceleration plans and revitalised commitments using standard templates provided by FP2020. Results: Critical factors emerging from the case study analysis suggest the following. Context: Country programs that adapted best practices through thoughtful selection, regular monitoring, and course correction, were more responsive to context and better able to scale interventions. Mechanism: Programs that embedded commitments within national health reforms and transformative agendas were able to sustain commitment and mechanism more effectively over time. Implementation: Programs that were able to balance central coordination with devolved implementation, more effectively translated commitments to action. Monitoring: Programs that placed emphasis on monitoring progress and course correct were better able to steward national commitments and partner inputs. Conclusions: National FP programs included within the country comparative analysis benefitted from their engagement with FP2020. However, not all were able to convert FP2020 commitments into national ownership. In many FP2020 contexts, there is less need for a technical intervention and greater need for engaging politically on sensitive issues that constrain women’s and adolescent empowerment and rights and access to FP.

The role of non-governmental development organizations in the implementation of lymphatic filariasis programmes

The Lymphatic Filariasis (LF) Non-governmental Development Organization (NGDO) Network was established to engage in supporting both international and national LF elimination agendas covering areas such as assisting ministries of health as an on-the-ground link between communities and programmes, which additionally gives the Network members an important voice from the field at international meetings; playing key roles in programme evolution (especially helping to both scale up and scale down mass drug administration [MDA] as elimination thresholds are met); having a role in operational research and developing new programme delivery models that can be taken to scale (such as linkages with other disease programmes and approaches to morbidity management and disability prevention); developing advocacy and policy approaches with other partners; convening other important stakeholders (academic, technical, programmatic and funding); mobilizing financial and technical resources to support programmes; supporting national human resource capacity building to catalyse national ownership of LF programmes; providing leadership in LF governance structures and working in areas of conflict to ensure that everybody in LF-endemic areas enjoys treatment services. Three case studies will illustrate the roles identified for NGDOs in LF programmes covering development of operational research, policy and advocacy linkage between LF and malaria programmes; launching LF morbidity management projects and NGDO's ability to work and deliver LF services in areas of conflict. In addition, the case studies will show the role of NGDOs in mobilising financial and technical resources that support national human resources, leading to national ownership of programmes. Conclusions will be drawn on the role of NGDOs in the Global Alliance for LF elimination and the need for continued partnerships to reach programme goals.

Monitoring and Evaluation in South-South Cooperation: The Case of CPEC in Pakistan

Pakistan is a key country in China’s Belt and Road Initiative (BRI) where the China–Pakistan Economic Corridor (CPEC) is under implementation. An investment model of financing through loans, grants and private investments, CPEC is an example of South-South cooperation (SSC) having a number of benefits for both countries. Aimed at developing energy, industry, and communication infrastructure, the corridor initially valued at $46 billion but is now worth $62 billion. CPEC is expected to contribute significantly to socio-economic development and regional connectivity and trade. The main research question is, while implementing projects in Pakistan, to what extent China adheres to its avowed principles comprising features such as mutual respect, non-conditionality, equality, building local capacity and addressing actual needs of partner countries. Based mainly on the analysis of primary data collected during fieldwork in Pakistan, this research explores the extent to which the official narrative influences the actual practice of China’s development cooperation on the ground. To critically examine CPEC, this chapter uses a monitoring and evaluation framework developed by the Network of Southern Think Tanks (NeST), which is dedicated to generating systematic and clearly comparable knowledge on SSC (Besharati et al. 2017). The findings illustrate that, as per the five broad dimensions of the SSC framework, the China–Pakistan partnership under CPEC has performed well in the four areas of inclusive national ownership, horizontality, self-reliance and sustainability, and development effectiveness, but it has lagged in accountability and transparency.

Donor reliance and the impact on neglected tropical disease programme delivery: reflections and solutions for change from programme management perspectives

Health systems within many developing countries are reliant on donor funding and non-governmental development organisations (NGDOs); this has had positive results but also presents challenges to sustainability and national ownership, with national programmes needing to respond to changing donor priorities. Simultaneously, the WHO neglected tropical disease (NTD) roadmap 2021–2030 calls for increased country ownership and domestically financed NTD programmes. Focusing on Liberia and blending primary research from the COUNTDOWN consortium and personal programmatic experience, this commentary reflects on the sustainability and financing of NTD programme delivery within the current context. We explore the successes and challenges of current models of collaboration and opportunities to improve country ownership and sustainability.

The African Union in Peacebuilding in Africa

Since its launch in 2002 the African Union (AU) has advanced post-conflict peacebuilding frameworks and institutions as part of the broad project of deepening local solutions to African problems. This chapter argues that while the AU has made significant strides in building norms around peace, security, stability, and governance, it faces tremendous obstacles in realizing the vision and objectives articulated in the 2006 Post-Conflict Reconstruction and Development (PCRD) policy. It, therefore, urges national ownership of peacebuilding as well as a deepening and advancing of normative frameworks amongst various stakeholders. Conflict prevention is viewed as key to sustained peacebuilding in Africa. The chapter concludes that in the absence of mobilization of local resources and capacity, the AU will remain unprepared for the complex and multiple tasks entailed in peacebuilding.

Parameters of Sustainable Peace

This chapter examines normative principles for peacemakers and peacebuilding that define the parameters for just and sustainable peace in the UN system. It argues that an ‘imperfect’ peace is better than ‘just war’. It shows that UN notions of peace have been developed through practice. It explores how just peace approaches intersect with the UN peacebuilding architecture and Sustainable Development Goal 16. The author identifies core principles which shape UN post-conflict transitions, such as national ownership, inclusivity, rule of law, effective leadership, coordination, and accountability.

The political economy of universal health coverage: a systematic narrative review

The uptake and implementation of universal health coverage (UHC) is primarily a political, rather than a technical, exercise, with contested ideas and diverse stakeholders capable of facilitation or resistance—even veto—of the policy uptake. This narrative systematic review, undertaken in 2018, sought to identify all peer-reviewed publications dealing with concepts relating to UHC through a political economy framing. Of the 627 papers originally identified, 55 papers were directly relevant, with an additional eight papers added manually on referral from colleagues. The thematic analysis adapted Fox and Reich’s framework of ideas and ideologies, interests and institutions to organize the analysis. The results identified a literature strong in its exploration of the ideologies and ideas that underpin UHC, but with an apparent bias in authorship towards more rights-based, left-leaning perspectives. Despite this, political economy analyses of country case studies suggested a more diverse political framing for UHC, with the interests and institutions engaged in implementation drawing on pragmatic and market-based mechanisms to achieve outcomes. Case studies offered limited detail on the role played by specific interests, though the influence of global development trends was evident, as was the role of donor organizations. Most country case studies, however, framed the development of UHC within a narrative of national ownership, with steps in implementation often critical political milestones. The development of institutions for UHC implementation was predicated largely on available infrastructure, with elements of that infrastructure—federal systems, user fees, pre-existing insurance schemes—needing to be accommodated in the incremental progress towards UHC. The need for technical competence to deliver ideological promises was underlined. The review concludes that, despite the disparate sources for the analyses, there is an emerging shared narrative in the growing literature around the political economy of UHC that offers an increasing awareness of the political dimensions to UHC uptake and implementation.