Transitioning from donor aid for health: perspectives of national stakeholders in Ghana.

Autor:	Mao W; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., McDade KK; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., Huffstetler HE; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., Dodoo J; Policy Planning Monitoring and Evaluation Directorate, Policy Coordination Unit, Ghana Ministry of Health, Accra, Greater Accra, Ghana.; School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa., Abankwah DNY; Department of Social and Behavioral Sciences, University of Ghana School of Public Health, Accra, Greater Accra, Ghana., Coleman N; University of Ghana School of Public Health, Accra, Greater Accra, Ghana., Riviere J; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., Zhang J; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., Nonvignon J; University of Ghana School of Public Health, Accra, Greater Accra, Ghana., Bharali I; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., Bandara S; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., Ogbuoji O; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA., Yamey G; Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, USA gavin.yamey@duke.edu.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2021 Jan; Vol. 6 (1).
DOI:	10.1136/bmjgh-2020-003896
Abstrakt:	Background: Ghana's shift from low-income to middle-income status will make it ineligible to receive concessional aid in the future. While transition may be a reflection of positive changes in a country, such as economic development or health progress, a loss of support from donor agencies could have negative impacts on health system performance and population health. We aimed to identify key challenges and opportunities that Ghana will face in dealing with aid transition, specifically from the point of view of country-level stakeholders. Methods: We conducted key informant interviews with 18 stakeholders from the government, civil society organisations and donor agencies in Ghana using a semistructured interview guide. We performed directed content analysis of the interview transcripts to identify key themes related to anticipated challenges and opportunities that might result from donor transitions. Results: Overall, stakeholders identified challenges more frequently than opportunities. All stakeholders interviewed believe that Ghana will face substantial challenges due to donor transitions. Challenges include difficulty filling financial gaps left by donors, the shifting of national priorities away from the health sector, lack of human resources for health, interrupted care for beneficiaries of donor-funded health programmes, neglect of vulnerable populations and loss of the accountability mechanisms that are linked with donor financing. However, stakeholders also identified key opportunities that transitions might present, including efficiency gains, increased self-determination and self-sufficiency, enhanced capacity to leverage domestic resources and improved revenue mobilisation. Conclusion: Stakeholders in Ghana believe transitioning away from aid for health presents both challenges and opportunities. The challenges could be addressed by conducting a transition readiness assessment, identifying health sector priorities, developing a transition plan with a budget to continue critical health programmes and mobilising greater political commitment to health. The loss of aid could be turned into an opportunity to integrate vertical programmes into a more comprehensive health system. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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