DONOR POWER AND PRIORITIZATION IN DEVELOPMENT ASSISTANCE FOR HEALTH POLICIES: THE CASE OF UGANDA

Authors

  • Charity Kirabo-Nagemi
  • Catherine Lutalo Mwesigwa

DOI:

https://doi.org/10.47672/jde.640

Keywords:

Development, Aid, Health, Interests, Priorities

Abstract

Purpose: The study sought to fill the knowledge gap by examining whether there were changes in Health Financing policies for Uganda's health care system from 2002 to 2015 and their impact.

Methodology: Literature on aid for health in low and middle-income countries was reviewed, while data on major donors to Uganda's health care system obtained from their websites, as well as the Creditor Reporting System. Walt and Gilson's health policy triangle framework was used to examine how different donors operated in Uganda's health financing space. Vertical, horizontal, earmarked and budget support, as well as disease-specific fund allocation modes were also explored.

Findings: Overall, donors influenced decisions on the selection of priority areas as well as fund allocation, despite efforts to involve the government in health policy formulation. The results were intended as an overarching guide for both donors and health policy-makers in future health financing decision making processes.

Unique contribution to theory, practice and policy: Country engagement and policy ownership are critical to ensure harmonization of donor interests and country health needs. Increased aid for Health Systems Strengthening, Primary Health Care and Non-Communicable Diseases would also go a long way in improving population outcomes. Further studies on the sustainability of Development Assistance for health for middle and low-income countries are recommended.

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Author Biographies

Charity Kirabo-Nagemi

Master of Health Economics: School of Economics

University of Queensland -Brisbane, Queensland - Australia.

 

Catherine Lutalo Mwesigwa

 Lecturer/ Public Health Practitioner 

Makerere University, Kampala - Uganda

References

Agaba, E. (2009). Funding the promise: Monitoring Uganda's health sector financing from an HIV/AIDS perspective. African Health Sciences. Vol. 9. Issue 2. pp 81- 85.

Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2877291/

Bank of Uganda. (2017). Exchange rates.

Retrieved from http://www.bou.or.ug/bou/rates_statistics/statistics.html

Behague, D., Taiwah, C., Rosato, M., Some, T., and Morrison, J. (2009). Evidence-based policy-making: the implications of globally-applicable research for context-specific problem-solving in developing countries. Social Science Medicine. Vol. 69. Issue 10. pp 1539-1546.

Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19781839

Bendavid, E., Holmes, C. B., Bhattacharya, J., and Miller, G. (2012). HIV Development Assistance and Adult Mortality in Africa. Journal of the American Medical Association. Vol. 307. Issue 19. pp 2060-2067

Retrieved from https://jamanetwork.com/journals/jama/fullarticle/1157487

Bill and Melinda Gates Foundation. (2016). How we work.

Retrieved from http://www.gatesfoundation.org/How-We-Work

Cardno. (2015). USAID/Uganda Private Health Support Program. Retrieved from https://www.cardno.com/projects/usaid-uganda-private-health-support-phs-program/

Clinton Health Access Inc. (2014). Annual Report. Retrieved from http://www.clintonhealthaccess.org/content/uploads/2015/08/CHAI-2014-Annual-Report.pdf

Clinton Health Access Inc. (2016). Our work. Retrieved from

https://www.clintonfoundation.org/our-work/clinton-health-access-initiative

Department for International Development. (2012). DFID Uganda. Retrieved from https://www.gov.uk/government/world/organisations/dfid-uganda

Department for International Development. 2016a. Operational Plan 2011-2015. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/67416/uganda-2011.pdf

Department for International Development. (2016b). Contributing to the control of Malaria in Uganda, Accelerating the Rise in Contraceptive Prevalence in Uganda, Increasing coverage of Long-Lasting Insecticide Nets in Uganda. Retrieved from

https://devtracker.dfid.gov.uk/projects/GB-1-204005

https://devtracker.dfid.gov.uk/projects/GB-1-202420

https://devtracker.dfid.gov.uk/projects/GB-1-203671

Dieleman, J. L., Schneider, M. T., Haakenstad, A., Singh, L., Sadat, N., Birger, M., Reynolds, A., Templin, T., Hamavid, H., Chapin, A., and Murray, C. J. (2016). Development assistance for health: past trends, associations, and the future of international financial flows for health. The Lancet. Vol. 387. Issue 10037. pp 2536-2544. Retrieved from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30168-4/fulltext

Enyaku, R. (2014). Aid effectiveness in Uganda Presentation at Fifth IHP+ Country Health Teams Meeting. Retrieved from https://www.internationalhealthpartnership.net/fileadmin/uploads/ihp/Documents/About_IHP_/mgt_arrangemts_docs/Core_Team/CHTM_2014/Day_one_presentations/EN-Paper_Aid_Effectiveness_Uganda_III_CambodiaDraft1.ppt

Health Sector Strategic and Investment Plan. (2010). Retrieved from http://www.internationalhealthpartnership.net/fileadmin/uploads/ihp/Documents/CountryPages/ Uganda/Health_Sector_Strategic_Investment_Plan_2010-2015IP%20Final.pdf

International Health Partnership plus. (2015a). About IHP. Retrieved from http://www.internationalhealthpartnership.net/en/about- ihp/history/

International Health Partnership plus. (2015b). Documents. Retrieved from

http://www.internationalhealthpartnership.net/fileadmin/uploads/ihp/Documents/CountryPages/

International Health Partnership plus. (2015c). Partners. Retrieved from http://www.internationalhealthpartnership.net/en/ihp-partners/uganda/

Michaud, C. (2003). Development assistance for health (DAH): Recent trends and resource allocation, Paper prepared for the Second Consultation Commission on Macroeconomics and Health World Health Organisation, Geneva. Retrieved from

http://www.who.int/macrohealth/events/health_for_poor/en/dah_trends_nov10.pdf

Mills, A. (1983). Vertical vs horizontal health programmes in Africa: idealism, pragmatism, resources and efficiency. Social Science and Medicine. Vol. 17. Issue 24. pp 1971-1981. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/6670002

Ministry of Health - Republic of Uganda. (2010). World Health Organisation 2010, Health financing for universal coverage, Uganda Health Financing Review. Retrieved from

http://www.who.int/health_financing/documents/cov-hsfr_e_10-uganda/en/

Ministry of Health. Knowledge management portal. (2016a). Strategic Plans. Health Financing Strategy 2015/16 - 2024/25. Retrieved from

http://www.health.go.ug/publications/strategic-plans/health-financing-strategy/

Ministry of Health. Publications. (2016b). Retrieved from

http://library.health.go.ug/publications/leadership-and-governance-governance/policy-documents/national-health-expenditure

Ministry of Finance Planning and Economic Development. (2016). Retrieved from http://www.finance.go.ug/index.php?option=com_contentandview=articleandid=34andItemid=3

Nabyonga, O. J., Sengooba, F., and Okuonzi, S. (2009). Can donor aid for health be effective in a poor country? Assessment of prerequisites for aid effectiveness in Uganda. The Pan African Medical Journal. Vol. 3. Issue 9. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984282/

National Health Accounts. (2015). Ministry of Health. Planning Secretariat. Retrieved from

http://health.go.ug/sites/default/files/NATIONAL_HEALTH_ACCOUNTS_KEY_MESSAGES_2%20SMALL%20VERSION.pdf

OECD-DAC. Bilateral ODA by sector for Uganda, 2013 - 2014. 2016. Retrieved from

https://public.tableau.com/views/OECDDACAidataglancebyrecipient_new/Recipients?%3Aembed=y&%3Adisplay_count=yes&%3AshowTabs=y&%3Atoolbar=no%3F&%3AshowVizHome= no

Okwero, P., Tandon, A., Sparkes, S., McLaughlin, J., and Hoogeveen, J. G. (2010). Fiscal space for Health In Uganda. World Bank working paper no. 186, Africa Human Development Series. Retrieved from http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/Peer-Reviewed-Publications/WP186FiscalSpaceforHealthinUgandapdf.pdf

Oleribe, O. O., and Nwanwanyu, O. (2015). Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature. The Pan African Medical Journal. Vol. 20. Issue 214. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470451/

Ooms, G., Van Damme, W., Baker, B. K., Zeitz, P., and Schrecker, T. (2008). The "˜diagonal' approach to Global financing: a cure for the broader malaise of Health Systems? Globalisation and Health. Vol. 4. Issue 8. Retrieved from https://globalisationandhealth.biomedcentral.com/articles/10.1186/1744-8603-4-6

Orne-Gliermann, J., Perez, F., Leroy, V., Newel, M. L., and Dabis, F. (2003). A decade of child health research in developing countries, Sante. Vol. 3. Issue 2. pp 69 - 75. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/14530116/

Second National Health Policy (NHP II). (2010). Ministry of Health Knowledge Management Portal. Retrieved from

http://library.health.go.ug/publications/policy-documents/second-national-health-policy-2010

Stierman, E., Sengooba, F., and Bennet, S. (2013). Aid alignment: a longer term lens on trends in development assistance for health in Uganda. Globalisation and Health Vol. 9. Issue 7. Retrieved from https://globalisationandhealth.biomedcentral.com/articles/10.1186/1744-8603-9-7#Sec13

The Global Fund. (2015a). Retrieved from

https://www.theglobalfund.org/en/government/

The Global Fund. (2015b). Uganda. Overview. Documentation. Country Results Profiles. Retrieved from https://www.theglobalfund.org/en/portfolio/country/?loc=UGAandk=9e8b8568-adaa-4b26-af09-da5b112c51e7

The Global Fund. (2016a). Find a grant. Country. Uganda. Retrieved from

https://www.theglobalfund.org/en/portfolio/find/

The Global Fund. (2016b). Funding decisions. 2016. Retrieved from http://www.theglobalfund.org/en/fundingdecisions/

The Global Fund. (2016c). Uganda. Overview. Disbursements by component. Retrieved from

https://www.theglobalfund.org/en/portfolio/country/?loc=UGAandk=9e8b8568-adaa-4b26-af09-da5b112c51e7

The Global Fund. (2016d). Uganda. Overview. Investments to date. Retrieved from

https://www.theglobalfund.org/en/portfolio/country/?loc=UGAandk=9e8b8568-adaa-4b26-af09-da5b112c51e7

The Global Fund. (2017). Where we invest. Topics. Retrieved from

Retrieved from https://www.theglobalfund.org/en/resilient-sustainable-systems-for-health/

The U.S. President's Emergency Plan for AIDS Relief. (2015). Office of the U.S. Global AIDS Coordinator, Congressional Budget Justification Supplement, Fiscal Year 2015. Retrieved from https://www.pepfar.gov/documents/organisation/236283.pdf

The U.S. President's Emergency Plan for AIDS Relief. (2016a). About us.

Retrieved from https://www.pepfar.gov

The U.S. President's Emergency Plan for AIDS Relief. (2016b). Countries. Uganda.

Retrieved from https://www.pepfar.gov

The Vaccine Alliance. (2016a). About GAVI, the Vaccine Alliance.

Retrieved from http://www.gavi.org/about/

The Vaccine Alliance. (2016b). GAVI Uganda fact sheet, 2016.

Retrieved from http://www.gavi.org/country/uganda/

The Vaccine Alliance. (2016c). Governing GAVI.

Retrieved from http://www.gavi.org/about/governance/

The Vaccine Alliance. (2016d). 2015 Full country evaluations report - Uganda. Retrieved from https://www.gavi.org/results/evaluations/hss/full-country-evaluations/ ww.gavi.org/

Uganda budget information. (2016). National Budget documents. Retrieved from http://www.budget.go.ug/index.php?p=cga-top-search-resultsandflag

Uganda Health System Strengthening Project. (2010). Ministry of Health. Retrieved from

https://www.health.go.ug/projects/completed-projects/uganda-health-system-strengthening-project-uhssp/

Unitaid. (2016a). About us. Retrieved from https://www.unitaid.org

Unitaid. (2016b). How we work. Countries. Retrieved from https://www.unitaid.org

USAID. (2015). Who we are. Retrieved from https://www.usaid.gov/who-we-are

USAID. (2016a). Dollars to Results. USAID investments and illustrative results. Country, Uganda. Spending by sector. Basic health. Population policies and reproductive health. https://results.usaid.gov/results/country/uganda?fiscalYear=2015

USAID. (2016b). Foreign Aid by country. Uganda.

Retrieved from https://explorer.usaid.gov/cd/UGA

Van de Maele, M., Evans, D. B., and Tan-Torres, T. (2013). Development assistance for health in Africa: are we telling the right story? Bulletin of the World Health Organisation. Vol. 91. pp 483-490. Retrieved from www.who.int/bulletin/volumes/91/7/12-115410/en/

World Bank. (2016a). Countries: Uganda.

Retrieved from http://www.worldbank.org/en/country/uganda

World Bank. Data Bank. (2016b). World Development Indicators. Domestic general government health expenditure. Uganda (% of general government expenditure). Retrieved from http://databank.worldbank.org/data/reports.aspx?source=2andseries=SH.XPD.GHED.GE.ZS

World Health Organisation. (2016). Health Systems Abuja Declaration ten years on.

Retrieved from http://www.who.int/healthsystems/publications/abuja_declaration/en/

World Health Organisation. (2008). Report Health Systems Financing. Retrieved from http://www.who.int/healthinfo/statistics/toolkit_hss/EN_PDF_Toolkit_HSS_Financing.pdf

World Health Organisation. (2014). WHO's work in countries. Country Cooperation Strategy at a glance. Uganda. Retrieved from http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_uga_en.pdf

Zikusooka, C. M., Kyomuhang, R., Orem, J. N., and Tumwine, M. (2009a). Is health care financing in Uganda equitable? African Health Services. Vol. 9. Issue 2. pp 52-58. Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/2877292/

Zikusooka, C. M., Tumwine, M., and Tutembe, P. (2009b). Financing for HIV/AIDS, TB and Malaria in Uganda: An equity Analysis. Retrieved from

http://reliefweb.int/report/uganda/financing-hiv-aids-tb-and-malaria-uganda-equity-analysis

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Published

2021-01-01

How to Cite

Nagemi, C. . ., & Mwesigwa, C. . (2021). DONOR POWER AND PRIORITIZATION IN DEVELOPMENT ASSISTANCE FOR HEALTH POLICIES: THE CASE OF UGANDA. Journal of Developing Economies, 2(1), 54–74. https://doi.org/10.47672/jde.640

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