Donor funding for health reform in Africa: is non-project assistance the right prescription?
During the past 10 years, donors have recognized the need for major reforms to achieve sustainable development. Using non-project assistance they have attempted to leverage reforms by offering financing conditioned on the enactment of reform. The experience of USAID's health reform programmes in Niger and Nigeria suggest these programmes have proved more difficult to implement than expected. When a country has in place a high level of fiscal accountability and high institutional capacity, programmes of conditioned non-project assistance may be more effective in achieving reforms than traditional project assistance. However, when these elements are lacking, as they were in Niger, non-project assistance offers nothing inherently superior than traditional project assistance. Non-project assistance may be most effective for assisting the implementation of policy reforms adopted by the host government.
School of Medicine, Yale University, New Haven, CT 06511.
A M
AM
Foltz
D003362:Cost-Benefit Analysis; D005381:Financing, Organized / Q000379:methods*; D018166:Health Care Reform / Q000191:economics*; D006289:Health Planning Support / Q000458:organization & administration*; D007390:International Agencies; D009548:Niger; D009549:Nigeria; D015397:Program Evaluation; D014481:United States