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Want to hear about donor-government tension in global health policy? Yes, yes you do.
Join @GlobalHPR 2nd panel with presenters Abigail H. Neel @SaraE_Fischer @LigiaPaina @sumeghaasthana @profdodoo on Nov 3rd.
Join @GlobalHPR 2nd panel with presenters Abigail H. Neel @SaraE_Fischer @LigiaPaina @sumeghaasthana @profdodoo on Nov 3rd.
About to kick off this Twitter thread but first, a public service announcement. Voting - it also affects donor-govt relations!
@SaraE_Fischer Country "ownership" that focuses only on nat'l gov't is insufficient - need to capture ownership down to district, CHWs and community. Super interesting use of principal-agent theory!
#GlobalHPR2020 @GlobalHPR
#GlobalHPR2020 @GlobalHPR
@LigiaPaina Power analysis of PEPFAR GP/transition in KE&UG >> Nat'l gov't negotiated w/PEPFAR in closed spaces but implement. at sub-nat'l level by local gov'ts&PEPFAR implementers. Power imbalances b/n donor&gov't and w/in nat'l hierarchy exacerbated.
#GlobalHPR202 @GlobalHPR
#GlobalHPR202 @GlobalHPR
@sumeghaasthana Drivers of India demand for DAH: 
public $ on health, rigid bureaucracy for state spending (vs. flexible aid), perceived lack of tech skills of gov't, policymaker interest of donor projects for experimentation, support int'l relations.
#GlobalHPR2020 @GlobalHPR
public $ on health, rigid bureaucracy for state spending (vs. flexible aid), perceived lack of tech skills of gov't, policymaker interest of donor projects for experimentation, support int'l relations.#GlobalHPR2020 @GlobalHPR
#AbigailNeel: Develop-distort dilemma to assess polio erad prog >> Feedback loops: In strong health sys, GPEI had amplifying effect b/c investment went to routine imm. For weak health sys, GPEI establ. parallel sys that de-prioritized routine svcs.
#GlobalHPR2020 @GlobalHPR
#GlobalHPR2020 @GlobalHPR
@profdodoo GAVI covers 80% of vax prog>>Ghana has 10 yr period to be fully gov't funded. Concerns: Huge finan gap, HS challenges at PHC and logistics. Have broad transition plan linked to presidential vision, high-level priority on domestic res mobil.
#GlobalHPR2020 @GlobalHPR
#GlobalHPR2020 @GlobalHPR
@JudithDaire Impact of Ipas on abortion reform in MLW: Ipas worked "from behind" to support existing efforts: cap bldg of advocacy skills for local orgs, shift framing around abortion policies, support of drafting laws.
#GlobalHPR2020 @GlobalHPR
#GlobalHPR2020 @GlobalHPR
Q&A: Accountability re: aid - To whom and for what? Who is participating in decision-making spaces?
Acct is capacity that needs developing so donor-funded partners don't take over the responsibility long-term.
#GlobalHPR2020 @GlobalHPR
Acct is capacity that needs developing so donor-funded partners don't take over the responsibility long-term.
#GlobalHPR2020 @GlobalHPR
Q&A: Power structures, indicators and sustainability: When projs are not aligned with local priorities, creates perverse incentive to build sys that serve their needs. Targets set at donor HQ problematic. Need to shift focus to long-term outcomes.
#GlobalHPR2020 @GlobalHPR
#GlobalHPR2020 @GlobalHPR
Cont...
Disconnect b/n broad buy-in global targets (e.g. 90-90-90) and how they are reached locally. Districts have a lot to say about what indicators should count but little voice.
#GlobalHPR2020 @GlobalHPR
Disconnect b/n broad buy-in global targets (e.g. 90-90-90) and how they are reached locally. Districts have a lot to say about what indicators should count but little voice.
#GlobalHPR2020 @GlobalHPR
Q&A: Global ethical guidelines for DAH: Differentiate b/n principles and policies, offer country-specific guidance, address spillover effects/unintended consequences.
#GlobalHPR2020 @GlobalHPR
#GlobalHPR2020 @GlobalHPR
Cont...Hx of donor behavior guidance shows that power differentials make it possible for donors to ignore guidelines at their convenience. Where is authority to force countries to adhere to aid principles?
#GlobalHPR2020 @GlobalHPR
#GlobalHPR2020 @GlobalHPR
Great session once again! Excellent presentations from @SaraE_Fischer @LigiaPaina @sumeghaasthana @profdodoo @judithdaire and #AbigailNeel. Thanks @GlobalHPR for today's panel.
