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An unruly mélange? Coordinating external resources to the health sector: A review

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  • Buse, Kent
  • Walt, Gill

Abstract

The past two decades have witnessed an upsurge in the number of external agencies involved in the health sectors of developing countries. Concomitantly, there has been an increase in the volume of resources transferred through multilateral, bilateral and non-governmental organizations to these health systems. Notwithstanding the beneficial impact of increased resources, recipients and donors are increasingly concerned about the effects of this trend. This is particularly pertinent where the effort lacks adequate coordination. Recipients despair of an unruly mélange of external ideas and initiatives, that too often results in project proliferation and duplication, unrealistic demands, and ultimately a loss of control over the health development process. Donors on the contrary, are concerned about aid efficiency and effectiveness, two areas it is assumed will gain from increased attention to coordination. Both recipients and donors are looking for ways of better managing the aid relationship. Although there has been considerable experience with coordination strategies, most writing has considered external assistance in general, rather than the health sector in particular. The literature is striking in its bias towards the needs and perspectives of the donor community. There has been little analysis of the manner in which recipient ministries of health manage donors and the influx of resources. This review begins to fill this gap. Its focus is country-level, where most direct gains from coordination are to be reaped. The paper begins with an enumeration of the many and diverse trends which have raised the salience of aid coordination. A definition of coordination, a term used ambiguously in the existing literature, is then developed and the principles of aid coordination outlined. Finally, attention is directed to the initiatives of recipients and donors to improve the coordination of health sector aid.

Suggested Citation

  • Buse, Kent & Walt, Gill, 1997. "An unruly mélange? Coordinating external resources to the health sector: A review," Social Science & Medicine, Elsevier, vol. 45(3), pages 449-463, August.
  • Handle: RePEc:eee:socmed:v:45:y:1997:i:3:p:449-463
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    Cited by:

    1. Lettieri, Emanuele & Bartoli, Laura & Masella, Cristina, 2013. "Coordinating intra-sector services in healthcare: Requirements and elements that managers should take into account," European Management Journal, Elsevier, vol. 31(6), pages 591-601.
    2. Rohan Sweeney & Duncan Mortimer, 2016. "Has the Swap Influenced Aid Flows in the Health Sector?," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 559-577, May.
    3. Pallas, Sarah Wood & Khuat, Thi Hai Oanh & Le, Quang Duong & Ruger, Jennifer Prah, 2015. "The changing donor landscape of health sector aid to Vietnam: A qualitative case study," Social Science & Medicine, Elsevier, vol. 132(C), pages 165-172.
    4. Maame Esi Woode & Duncan Mortimer & Rohan Sweeney, 2021. "The impact of health sector‐wide approaches on aid effectiveness and infant mortality," Journal of International Development, John Wiley & Sons, Ltd., vol. 33(5), pages 826-844, July.
    5. Marten, Meredith G. & Sullivan, Noelle, 2020. "Hospital side hustles: Funding conundrums and perverse incentives in Tanzania's publicly-funded health sector," Social Science & Medicine, Elsevier, vol. 244(C).
    6. Hilsenrath Peter E & Singh Karan P, 2007. "Palestinian Health Institutions: Finding a Way Forward after the Second Intifada," Peace Economics, Peace Science, and Public Policy, De Gruyter, vol. 13(1), pages 65-77, December.
    7. Pfeiffer, James & Gimbel, Sarah & Chilundo, Baltazar & Gloyd, Stephen & Chapman, Rachel & Sherr, Kenneth, 2017. "Austerity and the “sector-wide approach” to health: The Mozambique experience," Social Science & Medicine, Elsevier, vol. 187(C), pages 208-216.
    8. Rechel, Bernd & Khodjamurodov, Ghafur, 2010. "International involvement and national health governance: The basic benefit package in Tajikistan," Social Science & Medicine, Elsevier, vol. 70(12), pages 1928-1932, June.
    9. Sundewall, Jesper & Sahlin-Andersson, Kerstin, 2006. "Translations of health sector SWAps--A comparative study of health sector development cooperation in Uganda, Zambia and Bangladesh," Health Policy, Elsevier, vol. 76(3), pages 277-287, May.
    10. Bertone, Maria Paola & Witter, Sophie, 2015. "An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone," Social Science & Medicine, Elsevier, vol. 141(C), pages 56-63.
    11. Pallas, Sarah Wood & Ruger, Jennifer Prah, 2017. "Effects of donor proliferation in development aid for health on health program performance: A conceptual framework," Social Science & Medicine, Elsevier, vol. 175(C), pages 177-186.
    12. Kenneth Sherr & Antonio Mussa & Baltazar Chilundo & Sarah Gimbel & James Pfeiffer & Amy Hagopian & Stephen Gloyd, 2012. "Brain Drain and Health Workforce Distortions in Mozambique," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-7, April.

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