DONOR POWER AND PRIORITIZATION IN DEVELOPMENT ASSISTANCE FOR HEALTH POLICIES: THE CASE OF UGANDA

Abstract

Purpose: The study sought to fill the knowledge gap by examining whether there were changes in Health Financing policies for Uganda’s health care system from 2002 to 2015 and their impact.
 Methodology: Literature on aid for health in low and middle-income countries was reviewed, while data on major donors to Uganda’s health care system obtained from their websites, as well as the Creditor Reporting System. Walt and Gilson’s health policy triangle framework was used to examine how different donors operated in Uganda’s health financing space. Vertical, horizontal, earmarked and budget support, as well as disease-specific fund allocation modes were also explored.
 Findings: Overall, donors influenced decisions on the selection of priority areas as well as fund allocation, despite efforts to involve the government in health policy formulation. The results were intended as an overarching guide for both donors and health policy-makers in future health financing decision making processes.
 Unique contribution to theory, practice and policy: Country engagement and policy ownership are critical to ensure harmonization of donor interests and country health needs. Increased aid for Health Systems Strengthening, Primary Health Care and Non-Communicable Diseases would also go a long way in improving population outcomes. Further studies on the sustainability of Development Assistance for health for middle and low-income countries are recommended.