Development assistance for health: past trends, associations, and the future of international financial flows for health

Dieleman, Joseph L; Schneider, Matthew; Haakenstad, Annie; Singh, Lavanya; Sadat, Nafis; Birger, Maxwell; Reynolds, Alex; Templin, Tara; Hamavid, Hannah; Chapin, Abigail; Murray, Christopher J L

doi:10.1016/s0140-6736(16)30168-4

Cited by 178 publications

(169 citation statements)

References 12 publications

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“…During the MDG era, a tremendous number of children’s lives were saved, and this has been partially credited to the global efforts following the MDGs, the ensuing increase in official development assistance [19], and the consequential scaling up of many life-saving interventions [21]. This study suggests that the progress has been uneven across diseases within countries, even in countries known as the best performers, such as Botswana or Burkina Faso, which have made successful progress in overall child mortality reduction.…”

Section: Discussionmentioning

confidence: 99%

“…When estimating child deaths, they updated the database to include new VR data up to July 2015 and new VA data up to February 2015. The details of the estimation approaches developed by Liu and colleagues have been described elsewhere [1,4,9,19]. …”

Section: Methodsmentioning

confidence: 99%

“…A detailed explanation of the equation has been presented elsewhere [10,22]. We restricted the data analysis to 2000–2015 because the progress in child survival has been in part credited to the MDG campaign, which has led to the scaling-up of many life-saving interventions and increases in official development assistance [19,23–27]. …”

Section: Methodsmentioning

confidence: 99%

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Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

Jin

Mankadi

Rigotti

et al. 2018

Global Health Action

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Background: During the Millennium Development Goal (MDG) era, impressive reductions in the under-5 mortality rate (U5MR) have been observed, although the MDG 4 target was not met. So far, cause-specific progress in child mortality has been analyzed and discussed mainly at the global and regional levels. Objectives: We aimed to explore annual changes in cause-specific mortality at the country level, assess which causes contributed the most to child mortality reduction in 2000–2015, and estimate how many child lives were saved. Methods: We used the cause-specific child mortality estimates published by Liu and colleagues. We derived average annual changes in cause-specific child mortality rates and cause-specific contribution to overall child mortality in 2000–2015. We estimated the number of cause-specific child deaths averted during the MDG era, assuming that cause-specific child mortality remained the same as in 2000. We targeted the 75 Countdown countries where 95% of maternal and child deaths occurred during the MDG era. Results: Wide disparities existed across causes within countries, both in neonatal and post-neonatal mortality reduction, except for a few countries such as China, Rwanda, and Cambodia. In 20 of the 45 sub-Saharan African countries, malaria was the main contributor to post-neonatal mortality reduction, and pneumonia was the main contributor in only six countries. A single disease often contributed to a substantial proportion of the child mortality reduction, particularly in west and central African countries. Diarrhea-specific post-neonatal child mortality reduction accounted for 7.1 million averted child deaths (24.5%), while pneumonia accounted for another 6.7 million averted child deaths (23%). Conclusions: This study demonstrates country-specific characteristics with regards to cause-wise child mortality that could not be identified by global or regional analyses. These findings provide the global community with evidence for formulating national policies and strategies to achieve the Sustainable Development Goals in child mortality reduction.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

Jin

Mankadi

Rigotti

et al. 2018

Global Health Action

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“…No major new financing commitments were made at the 2015 Financing for Development summit in Addis Ababa. Though difficult to predict, major increases in the amount of DAH seem unlikely (Dieleman et al, 2016). Emerging powers are often mentioned as potential new sources of DAH.…”

Section: Discussionmentioning

confidence: 99%

“…Neither has innovative financing been adopted on a large scale, beyond the initial major experiment with UNITAID. Nor is health spending in most LICs and many MICs projected to increase to cover basic needs before 2040 (Dieleman et al, 2016). Thus, without significant changes in mindset, significant increases in the levels of DAH seem unlikely, and major gaps between actual and total financing needed seem likely to persist.…”

Section: Discussionmentioning

confidence: 99%

Development assistance for health: critiques, proposals and prospects for change

Moon

Omole

2017

HEPL

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After a 'golden age' of extraordinary growth in the level of development assistance for health (DAH) since 1990, funding seems to have reached a plateau. With the launch of the Sustainable Development Goals, debate has intensified regarding what international financing for health should look like in the post-2015 era. In this review paper, we offer a systematic overview of problems and proposals for change. Major critiques of the current DAH system include: that the total volume of financing is inadequate; financial flows are volatile and uncertain; DAH may not result in additional resources for health; too small a proportion of DAH is transferred to recipient countries; inappropriate priority setting; inadequate coordination; weak mechanisms for accountability; and disagreement on the rationale for DAH. Proposals to address these critiques include: financing-oriented proposals to address insufficient levels and high volatility of DAH; governance-oriented proposals to address concerns regarding additionality, proportions reaching countries, priority setting, coordination and accountability; and proposals that reach beyond the existing DAH system. We conclude with a discussion of prospects for change.

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Global Development Assistance for Adolescent Health From 2003 to 2015

Patton

et al. 2018

JAMA Netw Open

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Importance Growth in financing has underpinned progress in most areas of health. Adolescent health has recently become a global priority, with inclusion in the Global Strategy for Women’s, Children’s and Adolescents’ Health, but little is known about patterns of financing and development assistance for adolescent health (DAAH). Objective To provide estimates of DAAH at global, regional, and country levels. Design, Setting, and Participants In this quality improvement study, data from the Creditor Reporting System were used to estimate flows of total DAAH and per-adolescent DAAH and to assess its distribution by donors, regions, and countries and the leading causes of burden of disease (ie, disability-adjusted life-years) in 132 developing countries between January 1, 2003, and December 31, 2015. Through use of a key word search and various funding allocation methods, 2 sets of estimates were produced: adolescent-targeted DAAH that included disbursements to projects with a primary adolescent health target and adolescent-inclusive DAAH that included disbursements to projects with either a primary or partial adolescent health target, as well as projects that could benefit adolescent health but did not include age-related key words. Main Outcomes and Measures Estimates of DAAH distinguishing between adolescent-targeted and adolescent-inclusive DAAH. Results There were 19 921 projects in 132 countries in the adolescent-targeted estimation between 2003 and 2015, with a total funding amount of $3634.6 million, accounting for 1.6% of total development assistance for health. The top 5 donors (Global Fund to Fight AIDS, Tuberculosis and Malaria, $806.8 million; United Nations Population Fund, $401.3 million; United States, $389.9 million; United Kingdom, $251.8 million; and International Development Association, $218.6 million) together provided 56.9% of all adolescent-targeted DAAH. Sub-Saharan Africa received the largest cumulative DAAH per adolescent ($5.37) during the period. In 2015, among the 10 leading causes of disability-adjusted life-years, HIV and AIDS received the largest DAAH, followed by interpersonal violence, tuberculosis, and diarrheal diseases. Other leading causes, including road injuries and depressive disorders, received few disbursements, especially among the low-income countries. Conclusions and Relevance Despite an increasing rate, DAAH composed a small proportion of total development assistance for health, suggesting that adolescent health has gained little donor attention. Moreover, recent allocations of DAAH have not aligned well with either the burden of disease or the areas where the benefits of investment are likely to be high.

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Development assistance for health: past trends, associations, and the future of international financial flows for health

Cited by 178 publications

References 12 publications

Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis

Development assistance for health: critiques, proposals and prospects for change

Global Development Assistance for Adolescent Health From 2003 to 2015

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