Bringing Donors Along on the Journey: A Preliminary Investigation of Organisational Strategies in Transitioning from Residential to Family Care for Children

Research suggests that children develop best in families. However, millions of children live in residential care centres worldwide. Many residential centres desire to transition their programs from a residential to a family-based model of care, but face barriers surrounding funding and donor support. Little research exists on how organisations address these concerns. The current article investigated the financial impact of transitioning to a family-based model of care, donor engagement practices used in this process, and changes in donor support resulting from the transition. Twenty-six organisations that had fully or partially transitioned their model completed a brief survey. Data revealed an initial increase in cost per child, but long-term the cost of services decreased. Further, findings suggested that involving donors early and using multiple methods and types of communication led to better long-term donor support. Based on these findings, five recommendations were made for organisations planning to transition their care model.

Community health workers at the dawn of a new era: 4. Programme financing

Background This is the fourth of our 11-paper supplement on “Community Health Workers at the Dawn of New Era”. Here, we first make the case for investing in health programmes, second for investing in human resources for health, third for investing in primary healthcare (PHC) workers, and finally for investing in community health workers (CHWs). Methods Searches of peer-reviewed journals and the grey literature were conducted with a focus on community health programme financing. The literature search was supplemented with a search of the grey literature for information about national health sector plans, community health strategies/policies, and costing information from databases of various countries’ ministries of health, and finally a request for information from in-country partners. Results The global shortage of human resources for health is projected to rise to 18 million health workers by 2030, with more acute shortages in Africa and South Asia. CHWs have an important role to play in mitigating this shortage because of their effectiveness (when properly trained and supported) and the feasibility of their deployment. Data are limited on the costs of current CHW programmes and how they compare to government and donor expenditures for PHC and for health services more broadly. However, available data from 10 countries in Africa indicate that the median per capita cost of CHW programmes is US$ 4.77 per year and US$ 2574 per CHW, and the median monthly salary of CHWs in these same countries is US$ 35 per month. For a subset of these countries for which spending for PHC is available, governments and donors spend 7.7 times more on PHC than on CHW programming, and 15.4 times more on all health expenditures. Even though donor funding for CHW programmes is a tiny portion of health-related donor support, most countries rely on donor support for financing their CHW programmes. Conclusion The financing of national CHW programmes has been a critical element that has not received sufficient emphasis in the academic literature on CHW programmes. Increasing domestic government funding for CHW programmes is a priority. In order to ensure growth in funding for CHW programmes, it will be important to measure CHW programme expenditures and their relationship to expenditures for PHC and for all health-related expenditures.

Lymphatic filariasis elimination in the Dominican Republic: History, progress, and remaining steps

Lymphatic filariasis (LF) is a mosquito-transmitted parasitic disease that is a leading cause of disability globally. The island of Hispaniola, which the Dominican Republic shares with Haiti, accounts for approximately 90% of LF cases in the Americas region. In 1998, the Dominican Ministry of Public Health created the Program to Eliminate Lymphatic Filariasis (PELF) with the goal of eliminating LF transmission by 2020. Baseline mapping revealed 19 (12% of total) endemic municipalities clustered into three geographic foci (Southwest, La Ciénaga and East), with a total at-risk population of 262,395 people. Beginning in 2002, PELF sequentially implemented mass drug administration (MDA) in these foci using albendazole and diethylcarbamazine (DEC). In total, 1,174,050 treatments were given over three to five annual rounds of house-to-house MDA per focus with a median coverage of 81.7% (range 67.4%–92.2%). By 2018, LF antigen prevalence was less than 2% in all foci, thus meeting criteria to stop MDA and begin post-treatment surveillance (PTS). This success has been achieved against a shifting landscape of limited domestic funding, competing domestic public health priorities, and sporadic external donor support. Remaining steps include the need to scale-up morbidity management and disability prevention services for LF and to continue PTS until LF transmission is interrupted across Hispaniola.

Setbacks to the Implementation of the Nationally Appropriate Mitigation Actions: Case Studies of the Namas of Ethiopia, Georgia and Indonesia

The lack of implementation of the Nationally Appropriate Mitigation Actions (NAMAs) of the non-Annexe I Parties registered in the NAMA Registry of the United Nations Framework Convention on Climate Change (UNFCCC) is a worrying situation in the sense that it is limiting the contributions these NAMA projects would have made towards mitigating global climate change. There is however little research on the reasons behind the lack of implementation of these NAMAs projects and this is the knowledge gap that this paper seeks to fill based on a critical overview of the NAMAs of Ethiopia, Indonesia and Georgia. The source of data for this paper is mainly from the focal persons for the NAMAs of the countries under study, which was obtained via telephone and Skype interviews with the respondents. Our findings show that lack of funding, complicated financial mechanisms, lack of technical expertise, fringe conditions to donor support and policy issues according to the findings of this study are the main hindrances to the implementation of NAMAs. International organisations, donor partners, developed countries and local governments alike are therefore encouraged to channel some of the funds meant for fighting global climate change into sponsoring the NAMAs of poorer countries, as this will see to the successful implementations of these NAMAs and their subsequent impacts on mitigating global climate change. The paper is also timely considering the scarcity of literature on NAMAs related issues.

Donor Support for the Human Rights of LGBT+

This rapid review synthesises evidence on the bilateral and multilateral donors promoting and protecting the human rights of LGBT+ people on a global scale. It focusses on those donors that have policies, implementation plans and programmes on LGBT+ rights. This review also examines the evidence on the impact of their work. The bilateral donors providing the most support for LGBT+ (Lesbian, Gay, Bisexual, Transgender, +) communities in 2017-18 are the Swedish International Development Cooperation Agency (Sida), UK Department for International Development (DFID), The Netherlands Development Cooperation, Norwegian Agency for Development Cooperation (Norad), and the European Commission (EC). Whilst the multilateral donors providing the most support for LGBT+ are the UN and World Bank. The United Nations (UN) is doing a huge amount of work on LGBT+ rights across the organisation which there was not scope to fully explore in this report. The UN Office of the High Commissioner on Human Rights (UNOCHR) in particular is doing a lot on this theme. They publish legal obligation information, call attention to rights abuses through general assembly resolutions. The dialogue with governments, monitor violations and support human rights treaties bodies. The work of the World Bank in this area focuses on inclusion rather than rights. A small number of projects were identified which receive funding from bilateral and multilateral donors. These were AMSHeR, International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), and Stonewall. This rapid review focused on identifying donor support for LGBT+ rights, therefore, searches were limited to general databases and donor websites, utilising non-academic and donor literature. Much of the information comes directly from websites and these are footnoted throughout the report. Little was identified in the way of impact evaluation within the scope of this report. The majority of projects found through searches were non-governmental and so not the focus of this report.

Interventions to Address Discrimination against LGBTQi Persons

This annotated bibliography synthesises evidence on interventions to limit discrimination and abuse against people who are LGBTQi. In general, development agencies have strong commitments to LGBTQi rights in their strategy and policy documents. However, they avoid addressing LGBTQi rights directly through programming. Historically, international donor support for LGBTQi rights has been channelled through health programmes (especially those related to sexual health or HIV/AIDS) and democracy and governance support programmes. Recently, there is a trend towards integrating LGBTQi rights across a broader set of development programmes under the auspices of “leave no one behind”. The literature notes some barriers that undermine the extent to which international development interventions or programmes can address discrimination against LGBTQi persons. One of the barriers includes LGBTQi rights are still not viewed as a development priority but as a controversy in some settings, leading embassies to be hesitant to engage with them. Limited data and understanding of the various issues that are categorised as LGBTQi curtail the extent to which these issues can be integrated with other development programmes. The literature also observes that prejudice among staff at all levels in development agencies undermines their willingness to engage with LGBTQi rights and issues.

Donor Support to Electoral Cycles

This rapid literature review explains the stages of an election cycle, and how donors provide support to electoral cycles. It draws mainly on policy guidance websites and papers due to the questions of this review and the level of analysis taken (global-level, donor-level). It focuses on publications from the last five years, and/or current/forthcoming donor strategies. The electoral cycle and its stages are well-established policy concepts for which there is widespread acceptance and use. Donor support to electoral cycles (through electoral assistance and electoral observation) is extremely widespread, and the dominant donors in this area are the multilateral organisations like the United Nations (UN) and the European Union (EU), and also the United States (US). While almost all bilateral donors also carry out some work in this area, “almost all major electoral support programmes are provided jointly with international partners” (DFID, 2014, p.5). Bilateral donors may provide broader support to democratic governance initiatives, which may not be framed as electoral assistance, but may contribute to the wider enabling environment. All of the donors reviewed in this query emphasise that their programmes are designed according to the local context and needs, and thus, beyond the big actors - EU, UN and US, there is little overarching information on what the donors do in this area. While there is a significant literature base in the broad area of electoral support, it tends to be focussed at the country, programme, or thematic, level, rather than at the global, or donor, level taken by this paper. There was a peak in global-level publications on this subject around 2006, the year the electoral cycle model was published by the European Commission, International Institute for Democracy and Electoral Assistance (International IDEA), and United Nations Development Programme (UNDP). This review concludes by providing examples of the electoral assistance work carried out by five donors (UN, EU, US, UK and Germany).

Sudan’s exchange rate reform opens path to debt relief

Significance The move opens the door to expanded international aid and debt relief under the Heavily Indebted Poor Countries (HIPC) initiative, but at the cost of increased economic pressures over the short term. Impacts Prices for imported goods will rise further, fuelling inflation over the short term and likely prompting new protests. Donor support coupled with an improved trade balance should augment foreign exchange reserves. Further reform challenges await, including improving management of state-owned enterprises and tackling corruption.