Abstract
BackgroundOver the past decade, development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government’s own expenditures on health. Yet primary health care and other priorities identified in Uganda’s health sector strategic plan remain underfunded.MethodsUsing data available from the Creditor Reporting System (CRS), National Health Accounts (NHA), and government financial reports, we examined trends in how donors channel DAH and the extent to which DAH is aligned with sector priorities. The study follows the flow of DAH from the donor to the implementing organization, specifying the modality used for disbursing funds and categorizing funds based on program area or support function.FindingsDespite efforts to improve alignment through the formation of a sector-wide approach (SWAp) for health in 1999 and the creation of a fund to pool resources for identified priorities, increasingly DAH is provided as short-term, project-based support for disease-specific initiatives, in particular HIV/AIDS.ConclusionThese findings highlight the need to better align external resources with country priorities and refocus attention on longer-term sector-wide objectives.
Highlights
Over the past decade, development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government’s own expenditures on health
This study utilizes a health financing framework based on the approach used in National Health Accounts (NHA) in which resources are tracked from funding source to financing agent, and from financing agent to service provider or function
This has been driven in large part by the launch of several global health initiatives, such as the GFATM and in particular the President’s Emergency Plan for AIDS Relief (PEPFAR) (Figure 2)
Summary
Development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government’s own expenditures on health. The launch of the International Health Partnership (IHP+) in 2007 increased the global emphasis upon these principles, encouraging development partners to align assistance with national health plans and use country systems to disburse and manage aid. These global agreements built upon earlier efforts initiated in the mid-1990s to bring together government, donors and other key stakeholders to jointly define sector priorities and develop a common strategy to achieve those goals [2,3,4,5,6,7,8,9].
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