Division of Global Health (IHCAR), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
Health Policy. 2010 May;95(2-3):122-8. doi: 10.1016/j.healthpol.2009.11.010. Epub 2009 Dec 11.
In this study, we analysed stakeholder perceptions of the process of implementing the coordination of health-sector aid in Zambia, Africa. The aim of coordination of health aid is to increase the effectiveness of health systems and to ensure that donors comply with national priorities. With increases in the number of donors involved and resources available for health aid globally, the attention devoted to coordination worldwide has risen. While the theoretical basis of coordination has been relatively well-explored, less research has been carried out on the practicalities of how such coordination is to be implemented. In our study, we focused on potential differences between the views of the stakeholders, both government and donors, on the systems by which health aid is coordinated. A qualitative case study was conducted comprising interviews with government and donor stakeholders in the health sector, as well as document review and observations of meetings. Results suggested that stakeholders are generally satisfied with the implementation of health-sector aid coordination in Zambia. However, there were differences in perceptions of the level of coordination of plans and agreements, which can be attributed to difficulties in harmonizing and aligning organizational requirements with the Zambian health-sector plans. In order to achieve the aims of the Paris Declaration; to increase harmonization, alignment and ownership--resources from donors must be better coordinated in the health sector planning process. This requires careful consideration of contextual constraints surrounding each donor.
在这项研究中,我们分析了利益相关者对非洲赞比亚实施卫生部门援助协调过程的看法。协调卫生援助的目的是提高卫生系统的效率,并确保捐助者遵守国家优先事项。随着参与援助的捐助者数量和全球卫生援助资源的增加,全球对协调的关注也有所增加。虽然协调的理论基础已经得到了相对充分的探讨,但对于如何实施这种协调的实际问题的研究却相对较少。在我们的研究中,我们专注于政府和捐助者等利益相关者对协调卫生援助的系统的看法之间可能存在的差异。我们进行了一项定性案例研究,包括对卫生部门的政府和捐助者利益相关者进行访谈、文件审查和会议观察。研究结果表明,利益相关者对赞比亚实施卫生部门援助协调的情况普遍感到满意。然而,对计划和协议协调程度的看法存在差异,这可以归因于协调和调整组织要求与赞比亚卫生部门计划的困难。为了实现《巴黎宣言》的目标,即提高协调、一致性和自主权,必须在卫生部门规划过程中更好地协调捐助者的资源。这需要仔细考虑每个捐助者周围的环境限制。