An unruly mélange? Coordinating external resources to the health sector: A review

doi:10.1016/S0277-9536(96)00365-6

Social Science & Medicine

Volume 45, Issue 3, August 1997, Pages 449-463

https://doi.org/10.1016/S0277-9536(96)00365-6 Get rights and content

Abstract

The past two decades have witnessed an upsurge in the number of external agencies involved in the health sectors of developing countries. Concomitantly, there has been an increase in the volume of resources transferred through multilateral, bilateral and non-governmental organizations to these health systems. Notwithstanding the beneficial impact of increased resources, recipients and donors are increasingly concerned about the effects of this trend. This is particularly pertinent where the effort lacks adequate coordination.

Recipients despair of an unruly mélange of external ideas and initiatives, that too often results in project proliferation and duplication, unrealistic demands, and ultimately a loss of control over the health development process. Donors on the contrary, are concerned about aid efficiency and effectiveness, two areas it is assumed will gain from increased attention to coordination. Both recipients and donors are looking for ways of better managing the aid relationship.

Although there has been considerable experience with coordination strategies, most writing has considered external assistance in general, rather than the health sector in particular. The literature is striking in its bias towards the needs and perspectives of the donor community. There has been little analysis of the manner in which recipient ministries of health manage donors and the influx of resources. This review begins to fill this gap. Its focus is country-level, where most direct gains from coordination are to be reaped. The paper begins with an enumeration of the many and diverse trends which have raised the salience of aid coordination. A definition of coordination, a term used ambiguously in the existing literature, is then developed and the principles of aid coordination outlined. Finally, attention is directed to the initiatives of recipients and donors to improve the coordination of health sector aid.

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An unruly mélange? Coordinating external resources to the health sector: A review

Abstract

Health Policy

World Development

Health Policy

Social Science and Medicine

Social Science and Medicine

The Lancet

Health Policy

Social Science and Medicine

World Development

Social Science and Medicine

Aid Co-ordination and Aid Effectiveness: A Review of Country and Regional Experience

The direct funding of southern NGOs by donors: new agendas and old problems

Journal of International Development

Recent trends in the international relief system

Disasters

Spotlight on international organizations: the World Bank

Health Policy and Planning

In search of a holy grail? Coordinating external resources for health systems development: a policy analysis of Bangladesh

A profile of Resources available to His Majesty's Government—Ministry of Health Nepal

Aid instruments and health systems development: an analysis of current practice

Health Policy and Planning

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Journal of International Development

The systemic effects of aid and the role of coordination

Donor dependence or donor control? The case of Mozambique

Community Development Journal

Aid co-ordination: are there any lessons to be learnt from Kenya?

Development Policy Review

Emergency preparedness and response: UNOHAC

Effectiveness of Multilateral Agencies at the Country Level: UNDP in Kenya, Nepal, Sudan and Thailand

NGOs and health delivery in sub-Saharan Africa

Equity in the Finance and Delivery of Health Care

Competing for foreign aid for health development

Sectoral Consultation: A Guide to carrying Out the Process in the Health Sector

Complex emergencies and the crisis of developmentalism

IDS Bulletin

Towards better health in Africa: Africans Take Charge

Procedures for co-ordination between the Community and its Member States—council resolution

Donor funding for health reform in Africa: is non-project assistance the right prescription?

Health Policy and Planning

Viewpoint: Health-care reform: the issues and the role of donors

The Lancet

World Bank Project—Financed Research on Population, Health and Nutrition

Health in Lesotho: 1993 Profile

An Introduction to Health Planing in Developing Countries

NGOs—A policy panacea for the next millennium? Special issue on health policies in developing countries

Journal of International Development

The role of non-government organisations in the promotion of primary health care

Calamities and catastrophes: extending the UN response

Third World Quarterly

Introduction: epistemic communities and international policy coordination

International Organization

The Broad Sector Approach to Investment Lending: Sector Investment Programs

Looking a gift horse in the mouth—the shifting power balance between the Ministry of Health and donors in Ghana

Health Policy and Planning

Aid Coordination

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World Health