Development assistance for health : stakeholder perspectives on emerging donors in sub-Saharan Africa

The architecture of development assistance for health (DAH) is increasingly complex with the arrival of new actors, particularly from the private sector, emerging economies, and global health initiatives. Global monitoring of financial flows for DAH as part of Official Development Assistance (ODA) fails to include these pivotal new actors, their programme activities, and their influence. Shared roles and responsibilities blur the division among traditional and emerging donor aims and responsibilities. This raises concerns about legitimacy, accountability, and international cooperation as well as concerns over potential conflicts of interest, divergence from national strategies, and lack of harmonization among donors. The influence of increasing plurality of the global health financing system on the coherence, efficiency, and effectiveness of health development programmes requires further investigation.
This thesis aims to contribute to the literature on development assistance for health and the influence of emerging donors for health, specifically the Global Fund, philanthropic foundations, corporate social responsibility, and emerging economies. It focuses on in-country perceptions of the successes and challenges of working with these partners in Chad, Ghana, Mozambique, and Tanzania – four countries that span the donor–darling / donor-orphan spectrum. In conclusion, we found that private donors and emerging economies are not often not held to the same standards as conventional donors in terms of regulation and policies. This culture of more relaxed standards begs for more stringent transparency measures. Transparency of emerging donors’ financial flows is not only important for understanding the volume of assistance these actors provide but also to mitigate potential corruption.