title: Keeping a tight grip on the reins: donor control over aid coordination and management in Bangladesh.
abstract: A long-standing consensus that aid coordination should be owned by recipient authorities has been eclipsed by accord on the desirability of recipient management of aid along-side domestic resources. Nonetheless, in many low and lower-middle income countries, donors remain remarkably uncoordinated; where attempts at coordination are made, they are often donor-driven, and only a small proportion of aid is directly managed by recipients. This paper draws on evidence from an in-depth review of aid to the health sector in Bangladesh to analyze the systems by which external resources are managed. Based on interviews with key stakeholders, a questionnaire survey and analysis of documentary sources, the factors constraining the government from assuming a more active role in aid management are explored. The results suggest that donor perceptions of weak government capacity, inadequate accountability and compromised integrity only partially account for the propensity for donor leadership. Equally important is the consideration that aid coordination has a markedly political dimension. Stakeholders are well aware of the power, influence and leverage which aid coordination confers, an awareness which colours the desire of some stakeholders to lead aid coordination processes, and conditions the extent and manner by which others wish to be involved. It is argued that recipient management of external aid is dependent on major changes in the attitudes and behaviours of recipients and donors alike.
authors.affiliation: Health Policy Unit, London School of Hygiene and Tropical Medicine, UK.
authors.forename: K
authors.initials: K
authors.lastname: Buse
mesh_terms: D001459:Bangladesh; D003625:Data Collection; D003906:Developing Countries; D017598:Efficiency, Organizational; D005381:Financing, Organized / Q000458:organization & administration*; D006076:Government; D015276:Health Care Rationing / Q000458:organization & administration*; D019981:Health Care Sector; D005102:Health Expenditures; D006291:Health Policy; D006301:Health Services Needs and Demand; D007390:International Agencies; D012941:Social Responsibility