Transitioning from donor aid for health: perspectives of national stakeholders in Ghana
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Date
2020
Authors
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Publisher
BMJ Global Health
Abstract
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.
Description
Research Article
Keywords
national stakeholders, donor aid, perspectives, Ghana