Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, 120 St Stephens Green, Dublin, Ireland.
Faculty of Health Sciences, National University of Lesotho, Lesotho.
Soc Sci Med. 2012 Feb;74(3):381-389. doi: 10.1016/j.socscimed.2011.07.020. Epub 2011 Aug 25.
One of the biggest challenges in scaling up health interventions in sub-Saharan Africa for government recipients is to effectively manage the rapid influx of aid from different donors, each with its own requirements and conditions. However, there is little empirical evidence on how governments absorb knowledge from new donors in order to satisfy their requirements. This case study applies Cuellar and Gallivan's (2006) framework on knowledge absorptive capacity (AC) to illustrate how recipient government organisations in Lesotho identified, assimilated and utilised knowledge on how to meet the disbursement and reporting requirements of Lesotho's Round 5 grant from the Global Fund to Fight AIDS, TB and Malaria (Global Fund). In-depth topic guided interviews with 22 respondents and document reviews were conducted between July 2008 and February 2009. Analysis focused on six organisational determinants that affect an organisation's absorptive capacity: prior-related knowledge, combinative capabilities, motivation, organisational structure, cultural match, and communication channels. Absorptive capacity was mostly evident at the level of the Principal Recipient, the Ministry of Finance, who established a new organisational unit to meet the requirements of Global Fund Grants, while the level of AC was less advanced among the Ministry of Health (Sub-Recipient) and district level implementers. Recipient organisations can increase their absorptive capacity, not only through prior knowledge of donor requirements, but also by deliberately changing their organisational form and through combinative capabilities. The study also revealed how vulnerable African governments are to loss of staff capacity. The application of organisational theory to analyse the interactions of donor agencies with public and non-public country stakeholders illustrates the complexity of the environment that aid recipient governments have to manage.
在撒哈拉以南非洲地区，将卫生干预措施扩大到政府接受者的最大挑战之一是如何有效地管理来自不同捐助者的援助的快速涌入，每个捐助者都有自己的要求和条件。然而，关于政府如何吸收新捐助者的知识以满足其要求的经验证据很少。本案例研究应用 Cuellar 和 Gallivan（2006）的知识吸收能力（AC）框架来说明莱索托的接受政府组织如何确定、吸收和利用有关如何满足全球抗击艾滋病、结核病和疟疾基金（全球基金）第五轮莱索托赠款的支出和报告要求的知识。2008 年 7 月至 2009 年 2 月期间，对 22 名受访者进行了深入的主题引导访谈和文件审查。分析重点关注影响组织吸收能力的六个组织决定因素：与主题相关的先前知识、组合能力、动机、组织结构、文化匹配和沟通渠道。吸收能力在主要接受者，即财政部一级最为明显，财政部设立了一个新的组织单位来满足全球基金赠款的要求，而卫生部（次级接受者）和地区一级执行者的吸收能力则较低。接受组织不仅可以通过事先了解捐助者的要求来提高其吸收能力，还可以通过有意改变其组织形式和组合能力来提高其吸收能力。该研究还揭示了非洲政府在人员能力丧失方面的脆弱性。应用组织理论分析捐助机构与公共和非公共国家利益相关者的相互作用，说明了援助接受政府必须管理的环境的复杂性。
