Ownership in Name, But not Necessarily in Action Comment on "It’s About the Idea Hitting the Bull’s Eye": How Aid Effectiveness Can Catalyse the Scale-up of Health Innovations"

Abstract

A recently-published paper by Wickremasinghe et al assesses the scalability of pilot projects in three countries using the aid effectiveness agenda as an analytical framework. The authors report uneven progress and recommend applying aid effectiveness principles to improve the scalability of projects. This commentary focuses on one key principle of aid effectiveness – country ownership; it describes difficulties in defining and achieving it, and provides practical steps donors and recipient governments can take to move forward towards country ownership.

Critical barriers to sustainable capacity strengthening in global health: a systems perspective on development assistance

“…Low-income countries (LICs) have traditionally relied on funding and technical support from bilateral donors, centrally funded mechanisms, and philanthropic foundations for implementing health programs 1,2 . This donor-recipient dichotomy has created power imbalances that favor donors and has led to many well-documented challenges, including a misalignment between donor and recipient country priorities, short-term and often complex funding structures and processes, the introduction of parallel systems, and a "fly-in fly-out" approach to technical assistance (TA) that can undermine capacity strengthening efforts and sustainability 1,3 . These factors have contributed to inefficiencies and are believed to have stifled health program co-design and capacity strengthening in ways that hamper local ownership, sustainability, and progress toward desired health outcomes 4,5 .…”

Critical barriers to sustainable capacity strengthening in global health: a systems perspective on development assistance

“…Low-income countries (LICs) have traditionally relied on funding and technical support from bilateral donors, centrally funded mechanisms, and philanthropic foundations for implementing health programs 1 , 2 . This donor-recipient dichotomy has created power imbalances that favor donors and has led to many well-documented challenges, including a misalignment between donor and recipient country priorities, short-term and often complex funding structures and processes, the introduction of parallel systems, and a “fly-in fly-out” approach to technical assistance (TA) that can undermine capacity strengthening efforts and sustainability 1 , 3 . These factors have contributed to inefficiencies and are believed to have stifled health program co-design and capacity strengthening in ways that hamper local ownership, sustainability, and progress toward desired health outcomes 4 , 5 .…”