Technical capacity at the country level to coordinate multiple finance flows
The large number of actors involved in aid for health, with their different delivery approaches, management systems and monitoring requirements, puts huge demands on recipient countries to monitor and coordinate these aid flows. Such work is complicated further by frequent changes to donor policies, systems and staff. For instance, between 2003/04 and 2006/07, Uganda received aid from over 40 different donors. The Ugandan government dealt with 684 different aid instruments and associated agreements.
Coordinating multiple aid flows can be very expensive and detract from spending on health. In Rwanda, 27 per cent of donor and government health expenditure was spent on administration costs. This is exacerbated by the fact that much funding is short term. As a result, there is a constant need to renegotiate agreements. It is clear that financial aid also needs to be supported by technical assistance. This must focus on strengthening information systems to monitor flows, improve budgetary planning and finance systems (including accountability mechanisms), and better communicate and coordinate between different government departments and sectors.
More broadly,the whole area of technical assistance provision in the aid architecture for health requires attention. Technical assistance (in all its guises) accounts for over a quarter of development assistance. There is currently patchy evidence about the quality of technical support used in many environments, and a lack of a shared understanding about agency comparative advantage regarding the delivery of such assistance (i.e. sometimes resulting in duplication and fragmentation of such assistance).
Coordinating multiple aid flows can be very expensive and detract from spending on health. In Rwanda, 27 per cent of donor and government health expenditure was spent on administration costs. This is exacerbated by the fact that much funding is short term. As a result, there is a constant need to renegotiate agreements. It is clear that financial aid also needs to be supported by technical assistance. This must focus on strengthening information systems to monitor flows, improve budgetary planning and finance systems (including accountability mechanisms), and better communicate and coordinate between different government departments and sectors.
More broadly,the whole area of technical assistance provision in the aid architecture for health requires attention. Technical assistance (in all its guises) accounts for over a quarter of development assistance. There is currently patchy evidence about the quality of technical support used in many environments, and a lack of a shared understanding about agency comparative advantage regarding the delivery of such assistance (i.e. sometimes resulting in duplication and fragmentation of such assistance).
Recommended readings
- Learning from experience? a review of recipient-government efforts to manage donor relations and improve the quality of aid
- ( A. Menocal; S. Mulley / Overseas Development Institute, London , 2006)
- This paper reviews the efforts of five countries seen as relatively successful examples of recipient-led aid policies and donor management. These countries are Afghanistan, Mozambique, Tanzania, Ugand...
- New actors in health financing: implications for a donor darling
- ( D. Drechsler;F. Zimmermann / OECD Development Centre , 2006)
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This policy brief, by the OECD Development Centre, examines trends in development finance, focusing on the emergence of new actors such as global funds, foundations and NGOs, who provide additional...
