Do poor health conditions lead to higher allocation of development assistance?

This paper analyzes the targeting of development assistance for health across countries in a multivariate regression framework, based on data from 22 bilateral donors to 160 recipients between 1990 and 2007. Donor characteristics, recipient characteristics and the donor-recipient-relationship are argued to be important determinants. The results show that health indicators influence the average allocation decision, but not to the same degree. HIV prevalence significantly increases aid receipts, while under-five mortality and maternal mortality are insignificant. The quality of the institutional environment in the recipient country, programmatic preferences of the donor and the relationship between donor and recipient also affect the average allocation pattern

The determinants of selection and allocation decisions for health assistance: Which role do health indicators play?

This paper analyzes the selection and allocation decisions of major and like-minded bilateral donors as regards development assistance for health for the period of 1990 till 2007. The central question is to what extent health indicators, reflecting the health objectives stated in the Millennium Development Goals, influence such decisions. The analysis reveals that health indicators are important determinants of the selection and allocation process for health assistance but to a different degree at the two stages; HIV prevalence is the proxy with the strongest impact. The results also show that the quality of the institutional environment and the bilateral relations affect the decisions of many donors. The national health expenditures, however, have no systematic effect and the allocation pattern of possible competitors is irrelevant for almost all donors. The evidence illustrates, furthermore, the great heterogeneity among major and like-minded donors as well as the differences between selection and allocation stage

Do poor health conditions lead to higher allocation of development assistance?

This paper analyzes the targeting of development assistance for health across countries in a multivariate regression framework, based on data from 22 bilateral donors to 160 recipients between 1990 and 2007. Donor characteristics, recipient characteristics and the donor-recipient-relationship are argued to be important determinants. The results show that health indicators influence the average allocation decision, but not to the same degree. HIV prevalence significantly increases aid receipts, while under-five mortality and maternal mortality are insignificant. The quality of the institutional environment in the recipient country, programmatic preferences of the donor and the relationship between donor and recipient also affect the average allocation pattern

The determinants of selection and allocation decisions for health assistance. Which role do health indicators play?

This paper analyzes the selection and allocation decisions of major and like-minded bilateral donors as regards development assistance for health for the period of 1990 till 2007. The central question is to what extent health indicators, reflecting the health objectives stated in the Millennium Development Goals, influence such decisions. The analysis reveals that health indicators are important determinants of the selection and allocation process for health assistance but to a different degree at the two stages; HIV prevalence is the proxy with the strongest impact. The results also show that the quality of the institutional environment and the bilateral relations affect the decisions of many donors. The national health expenditures, however, have no systematic effect and the allocation pattern of possible competitors is irrelevant for almost all donors. The evidence illustrates, furthermore, the great heterogeneity among major and like-minded donors as well as the differences between selection and allocation stage

Do Donors and Aid Intermediaries Gamble with Poor People’s Health? Strategic Decision-Making by Donors and Aid Intermediaries on the Allocation of Development Assistance for Health

The distribution of development assistance for health in sub-Saharan Africa is the visible result of decisions made by donors and aid intermediaries. Aid intermediaries have become increasingly important as connecting link between donors and recipients. Their heterogeneous group comprises bilateral aid agencies, multilateral organizations, private foundations, public-private partnerships and international non-governmental organizations. Institutions, as rules of the aid game, constrain the actions of aid intermediaries and influence transaction costs and incentives for the organizations. The process of aid allocation is portrayed in two repeated sequential games with two players, the donor and the aid intermediary. Donors pursue an array of goals by donating financial resources, while aid intermediaries aim at securing funding in order to guarantee their organizational survival. Donors use indicators to assess the performance of an aid intermediary. Trustworthiness is a crucial factor prior to any experience. The strategic choice of the intermediary depends on the financial importance of the donor. A small-scale donor expects qualitative information about achievements, whereas a large-scale donor asks for quantitative results. The intermediary tries to ensure funding in the long-run without compromising its often charitable motives too much in the short-run. Although the aid intermediary decides the aid-financed health intervention, the donor has an indirect but powerful voice in the aid allocation process thanks to the importance of funding

Do Donors and Aid Intermediaries Gamble with Poor People’s Health? Strategic Decision-Making by Donors and Aid Intermediaries on the Allocation of Development Assistance for Health

The distribution of development assistance for health in sub-Saharan Africa is the visible result of decisions made by donors and aid intermediaries. Aid intermediaries have become increasingly important as connecting link between donors and recipients. Their heterogeneous group comprises bilateral aid agencies, multilateral organizations, private foundations, public-private partnerships and international non-governmental organizations. Institutions, as rules of the aid game, constrain the actions of aid intermediaries and influence transaction costs and incentives for the organizations. The process of aid allocation is portrayed in two repeated sequential games with two players, the donor and the aid intermediary. Donors pursue an array of goals by donating financial resources, while aid intermediaries aim at securing funding in order to guarantee their organizational survival. Donors use indicators to assess the performance of an aid intermediary. Trustworthiness is a crucial factor prior to any experience. The strategic choice of the intermediary depends on the financial importance of the donor. A small-scale donor expects qualitative information about achievements, whereas a large-scale donor asks for quantitative results. The intermediary tries to ensure funding in the long-run without compromising its often charitable motives too much in the short-run. Although the aid intermediary decides the aid-financed health intervention, the donor has an indirect but powerful voice in the aid allocation process thanks to the importance of funding

The Donor-Intermediary Interaction and the Decision-Making Process of Intermediaries for Development Assistance for Health

In the first part, three sequential games model the interaction between donor and intermediary, as important players in development cooperation, under different circumstances. The game structure highlights the interdependencies between asymmetric information, trust, institutions and reputation. In each situation, the reputation mechanism has a different effect. The analysis reveals that the importance of reputation as feedback mechanism for the donor about the behavior of the intermediary is subject to the institutional setting and the relative power of each player. The game modeling allows understanding of the importance of reputation, how this mechanism is related to institutions, and under which conditions it is likely to work. The games also emphasize the importance of third parties as external sources of information in order to make reputation an effective mechanism. In the second part, the decision-making process of bilateral donors as regards development assistance for health is analyzed. The Millennium Development Goals declared the reduction of child mortality, the improvement of maternal health and the fight of HIV/Aids, malaria and other diseases as major objectives on the international agenda. Against this background, the principal question is in how far the knowledge about poor health circumstances in a potential recipient country influences the decision-making. The results show that health indicators affect the selection and allocation decision, but to a different degree. The internationally established health objectives guide the aid policies of donors heterogeneously. Overall, many motives, including political and economic factors, drive the selection and allocation policies of the average donor as well as for the majority of bilateral donors. In summary, the decision-making process for health assistance of the average donor and of individual donors is multidimensional, rather than narrowly focused on recipient need as expressed by poor health indicators

Greater involvement of people living with HIV in health care

Greater Involvement of People Living with HIV/AIDS represents a mobilising and an organising principle for the involvement of people living with HIV in program and policy responses. People with HIV have been at the forefront of designing and implementing effective HIV treatment, care and prevention activities. However, governments and health systems have yet to act to fully harness the potential and resources of people living with HIV in addressing the epidemic