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Transitioning from donor aid for health: perspectives of national stakeholders in Ghana

BACKGROUND: Ghana’s shift from low-income to middle-income status will make it ineligible to receive concessional aid in the future. While transition may be a reflection of positive changes in a country, such as economic development or health progress, a loss of support from donor agencies could hav...

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Autores principales: Mao, Wenhui, McDade, Kaci Kennedy, Huffstetler, Hanna E, Dodoo, Joseph, Abankwah, Daniel Nana Yaw, Coleman, Nathaniel, Riviere, Judy, Zhang, Jiaqi, Nonvignon, Justice, Bharali, Ipchita, Bandara, Shashika, Ogbuoji, Osondu, Yamey, Gavin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812084/
https://www.ncbi.nlm.nih.gov/pubmed/33441335
http://dx.doi.org/10.1136/bmjgh-2020-003896
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author Mao, Wenhui
McDade, Kaci Kennedy
Huffstetler, Hanna E
Dodoo, Joseph
Abankwah, Daniel Nana Yaw
Coleman, Nathaniel
Riviere, Judy
Zhang, Jiaqi
Nonvignon, Justice
Bharali, Ipchita
Bandara, Shashika
Ogbuoji, Osondu
Yamey, Gavin
author_facet Mao, Wenhui
McDade, Kaci Kennedy
Huffstetler, Hanna E
Dodoo, Joseph
Abankwah, Daniel Nana Yaw
Coleman, Nathaniel
Riviere, Judy
Zhang, Jiaqi
Nonvignon, Justice
Bharali, Ipchita
Bandara, Shashika
Ogbuoji, Osondu
Yamey, Gavin
author_sort Mao, Wenhui
collection PubMed
description BACKGROUND: Ghana’s shift from low-income to middle-income status will make it ineligible to receive concessional aid in the future. While transition may be a reflection of positive changes in a country, such as economic development or health progress, a loss of support from donor agencies could have negative impacts on health system performance and population health. We aimed to identify key challenges and opportunities that Ghana will face in dealing with aid transition, specifically from the point of view of country-level stakeholders. METHODS: We conducted key informant interviews with 18 stakeholders from the government, civil society organisations and donor agencies in Ghana using a semistructured interview guide. We performed directed content analysis of the interview transcripts to identify key themes related to anticipated challenges and opportunities that might result from donor transitions. RESULTS: Overall, stakeholders identified challenges more frequently than opportunities. All stakeholders interviewed believe that Ghana will face substantial challenges due to donor transitions. Challenges include difficulty filling financial gaps left by donors, the shifting of national priorities away from the health sector, lack of human resources for health, interrupted care for beneficiaries of donor-funded health programmes, neglect of vulnerable populations and loss of the accountability mechanisms that are linked with donor financing. However, stakeholders also identified key opportunities that transitions might present, including efficiency gains, increased self-determination and self-sufficiency, enhanced capacity to leverage domestic resources and improved revenue mobilisation. CONCLUSION: Stakeholders in Ghana believe transitioning away from aid for health presents both challenges and opportunities. The challenges could be addressed by conducting a transition readiness assessment, identifying health sector priorities, developing a transition plan with a budget to continue critical health programmes and mobilising greater political commitment to health. The loss of aid could be turned into an opportunity to integrate vertical programmes into a more comprehensive health system.
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spelling pubmed-78120842021-01-25 Transitioning from donor aid for health: perspectives of national stakeholders in Ghana Mao, Wenhui McDade, Kaci Kennedy Huffstetler, Hanna E Dodoo, Joseph Abankwah, Daniel Nana Yaw Coleman, Nathaniel Riviere, Judy Zhang, Jiaqi Nonvignon, Justice Bharali, Ipchita Bandara, Shashika Ogbuoji, Osondu Yamey, Gavin BMJ Glob Health Original Research BACKGROUND: Ghana’s shift from low-income to middle-income status will make it ineligible to receive concessional aid in the future. While transition may be a reflection of positive changes in a country, such as economic development or health progress, a loss of support from donor agencies could have negative impacts on health system performance and population health. We aimed to identify key challenges and opportunities that Ghana will face in dealing with aid transition, specifically from the point of view of country-level stakeholders. METHODS: We conducted key informant interviews with 18 stakeholders from the government, civil society organisations and donor agencies in Ghana using a semistructured interview guide. We performed directed content analysis of the interview transcripts to identify key themes related to anticipated challenges and opportunities that might result from donor transitions. RESULTS: Overall, stakeholders identified challenges more frequently than opportunities. All stakeholders interviewed believe that Ghana will face substantial challenges due to donor transitions. Challenges include difficulty filling financial gaps left by donors, the shifting of national priorities away from the health sector, lack of human resources for health, interrupted care for beneficiaries of donor-funded health programmes, neglect of vulnerable populations and loss of the accountability mechanisms that are linked with donor financing. However, stakeholders also identified key opportunities that transitions might present, including efficiency gains, increased self-determination and self-sufficiency, enhanced capacity to leverage domestic resources and improved revenue mobilisation. CONCLUSION: Stakeholders in Ghana believe transitioning away from aid for health presents both challenges and opportunities. The challenges could be addressed by conducting a transition readiness assessment, identifying health sector priorities, developing a transition plan with a budget to continue critical health programmes and mobilising greater political commitment to health. The loss of aid could be turned into an opportunity to integrate vertical programmes into a more comprehensive health system. BMJ Publishing Group 2021-01-13 /pmc/articles/PMC7812084/ /pubmed/33441335 http://dx.doi.org/10.1136/bmjgh-2020-003896 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Mao, Wenhui
McDade, Kaci Kennedy
Huffstetler, Hanna E
Dodoo, Joseph
Abankwah, Daniel Nana Yaw
Coleman, Nathaniel
Riviere, Judy
Zhang, Jiaqi
Nonvignon, Justice
Bharali, Ipchita
Bandara, Shashika
Ogbuoji, Osondu
Yamey, Gavin
Transitioning from donor aid for health: perspectives of national stakeholders in Ghana
title Transitioning from donor aid for health: perspectives of national stakeholders in Ghana
title_full Transitioning from donor aid for health: perspectives of national stakeholders in Ghana
title_fullStr Transitioning from donor aid for health: perspectives of national stakeholders in Ghana
title_full_unstemmed Transitioning from donor aid for health: perspectives of national stakeholders in Ghana
title_short Transitioning from donor aid for health: perspectives of national stakeholders in Ghana
title_sort transitioning from donor aid for health: perspectives of national stakeholders in ghana
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812084/
https://www.ncbi.nlm.nih.gov/pubmed/33441335
http://dx.doi.org/10.1136/bmjgh-2020-003896
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