Sub-national assessment of aid effectiveness: A case study of post-conflict districts in Uganda
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Globalization and health
Abstract
In post-conflict settings, many state and non-state actors interact at the sub-national levels in
rebuilding health systems by providing funds, delivering vital interventions and building capacity of local
governments to shoulder their roles. Aid relationships among actors at sub-national level represent a vital lever for
health system development. This study was undertaken to assess the aid-effectiveness in post-conflict districts of
northern Uganda.
Method: This was a three district cross sectional study conducted from January to April 2013. A two stage snowball
approach used to construct a relational-network for each district. Managers of organizations (ego) involved service
delivery were interviewed and asked to list the external organizations (alters) that contribute to three key services.
For each inter-organizational relationship (tie) a custom-made tool designed to reflect the aid-effectiveness in the
Paris Declaration was used.
Results: Three hundred eighty four relational ties between the organizations were generated from a total of 85
organizations interviewed. Satisfaction with aid relationships was mostly determined by 1) the extent ego was able
to negotiate own priorities, 2) ego’s awareness of expected results, and 3) provision of feedback about ego’s
performance. Respectively, the B coefficients were 16%, 38% and 19%. Disaggregated analysis show that satisfaction
of fund-holders was also determined by addressing own priorities (30%), while provider satisfaction was mostly
determined by awareness of expected results (66%) and feedback on performance (23%). All results were significant
at p-value of 0.05. Overall, the regression models in these analyses accounted for 44% to 62% of the findings.
Conclusion: Sub-national assessment of aid effectiveness is feasible with indicators adapted from the global
parameters. These findings illustrate the focus on “results” domain and less on “ownership” and “resourcing”
domains. The capacity and space for sub-national level authorities to negotiate local priorities requires more
attention especially for health system development in post-conflict settings
Description
Keywords
Aid-effectiveness, Aid assessment tool, Sub-national level, Post-conflict, Uganda
Citation
Ssengooba, F., Namakula, J., Kawooya, V., & Fustukian, S. (2017). Sub-national assessment of aid effectiveness: A case study of post-conflict districts in Uganda. Globalization and health, 13(1), 1-12.10.1186/s12992-017-0251-7