Transitioning Away from Donor Funding for Health: A Cross Cutting Examination of Donor Approaches to Transition

The Center for Policy Impact in Global Health.

Duke Global Working Paper Series No. 21, April 2020

28 Pages Posted: 21 Apr 2020

See all articles by Kaci Kennedy McDade

Kaci Kennedy McDade

Center for Policy Impact in Global Health, Duke University

Marco Schäferhoff

Open Consultants

Osondu Ogbuoji

Duke University

Ipchita Bharali

Duke University - Duke Global Health Institute

Siddharth Dixit

Duke University - Duke Global Health Institute

Wenhui Mao

Center for Policy Impact in Global Health, Duke University

Shashika Bandara

affiliation not provided to SSRN

Gavin Yamey

Duke Global Health Institute

Abstract

Many donors are reconsidering their approach to providing health aid to countries that are viewed as becoming increasingly capable of self-financing their own development. To better understand this phenomenon, we analyzed the transition approaches adopted by six key global health donors, three multilateral and three bilateral, who provided nearly 75% of all disbursed official development assistance for health in 2016. We conducted a desk-based review and triangulated our findings with semi-structured key informant interviews.

We found: 1) there is no consensus on the terminology used to describe the transition process;
2) donors vary in terms of the formality of their policies, the indicators used to allocate resources and/or trigger transition, and the timeline/duration of transition; 3) some donors view the unit of transition at the sector or program level rather than the country level; and 4) donors provide varying degrees of support before, during, and after transition.

Our findings suggest that more explicit transition approaches and greater definitional clarity are needed. Donors should avoid a “one size fits all” approach—a lack of flexibility puts countries at risk. Evidence should be generated and shared on which transition modalities work best and under which circumstances. Donors should communicate with each other and avoid transitioning at the same time. As more low-income countries transition to middle-income status, transitions away from donor support for health will become an increasingly important phenomenon to understand.

Keywords: Transition, graduation, foreign aid, health aid, development assistance for health, aid for health, multilateral donor, bilateral donor, the World Bank, USAID, PEPFAR, DFID, JICA

Suggested Citation

McDade, Kaci Kennedy and Schäferhoff, Marco and Ogbuoji, Osondu and Bharali, Ipchita and Dixit, Siddharth and Mao, Wenhui and Bandara, Shashika and Yamey, Gavin, Transitioning Away from Donor Funding for Health: A Cross Cutting Examination of Donor Approaches to Transition. The Center for Policy Impact in Global Health.; Duke Global Working Paper Series No. 21, April 2020. Available at SSRN: https://ssrn.com/abstract=3575681 or http://dx.doi.org/10.2139/ssrn.3575681

Kaci Kennedy McDade (Contact Author)

Center for Policy Impact in Global Health, Duke University ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

Marco Schäferhoff

Open Consultants ( email )

Cantianstr. 22
Berlin, Berlin 10437
Germany

Osondu Ogbuoji

Duke University

100 Fuqua Drive
Durham, NC 27708-0204
United States

Ipchita Bharali

Duke University - Duke Global Health Institute ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

HOME PAGE: http://centerforpolicyimpact.org

Siddharth Dixit

Duke University - Duke Global Health Institute ( email )

310 Trent Drive
Box 90519
Durham, NC 27710
United States

Wenhui Mao

Center for Policy Impact in Global Health, Duke University ( email )

310 Trent Drive
Durham, NC 27710
United States

Shashika Bandara

affiliation not provided to SSRN

Gavin Yamey

Duke Global Health Institute ( email )

Trent Hall
310 Trent Drive
Durham, NC 27708
United States

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