The Center for Policy Impact in Global Health (CPIGH), a collaboration between DCID and the Duke Global Health Institute (DGHI), has been awarded a one-year $25,000 award from the Duke Global Health Institute Faculty Pilot grant program.
The team will be led by Osondu Ogbuoji and Gavin Yamey of DGHI, Sarah Bermeo of Sanford/DCID, and Erik Wibbels of Duke’s Department of Political Science, who is also a faculty affiliate of DCID. The Duke team will collaborate with Ravindra Rannan-Eliya of Sri Lanka’s Institute for Health Policy and Joseph O. Dodoo of Ghana’s Ministry of Health.
The study, “Transitioning from donor assistance for health: in-country perspectives, experiences, and preferences in Ghana and Sri Lanka” will be the first of its kind to examine the concerns, challenges, and opportunities facing low- and middle-income countries themselves as they relate to the withdrawal of foreign assistance for health.
As more countries graduate from low-income to middle-income status, they face imminent loss of international aid or concessions typically enjoyed by low-income countries. It is estimated that within the next five years, around two dozen countries are likely to face simultaneous donor transitions in which they lose funding from more than one major donor at the same time. In the health sector, loss of donor support from organizations such as Gavi, the Vaccine Alliance (Gavi), the World Bank, and bilateral donors can have huge negative impacts on population health and wellbeing. Yet discussions about country transitions from donor assistance for health have largely occurred at a supranational level with little input from in-country stakeholders themselves—very little is known about their concerns, challenges, and opportunities. Even less is known about the decision-making processes that underlie a country’s preparation for, or response to, donor transitions. To fill these research gaps, we propose a sequential mixed-methods study in two lower-middle-income countries, Ghana and Sri Lanka, to: (a) explore the perspectives and experiences of in-country stakeholders with donor transition, (b) catalog their responses/adjustments to the losses arising from transition (including loss of external financing and technical assistance), and (c) understand the “why” behind the chosen response strategies adopted by each. Findings from this study will enable the Center for Policy Impact in Global Health in the Duke Global Health Institute to apply for larger grants from agencies dealing with transition-related issues that lack the relevant in-country expertise and/or experience to address sub-national concerns. These organizations include the US Agency for International Development, the World Bank, Gavi, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), and the Fogarty International Center at the National Institutes of Health.