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审视柬埔寨卫生部门援助碎片化和合作机会。

Examining aid fragmentation and collaboration opportunities in Cambodia's health sector.

机构信息

Graduate School of Public Administration, Korea University, Sejong, South Korea.

Department of Public Health, College for Community Health, Montclair State University, Montclair, NJ, 07043, USA.

出版信息

Global Health. 2024 Aug 2;20(1):62. doi: 10.1186/s12992-024-01063-7.

Abstract

BACKGROUND

Cambodia's health sector faces significant challenges exacerbated by aid fragmentation, where development aid is dispersed among numerous small, uncoordinated projects. This study examines the distribution of health sector aid among Cambodia's principal donors to identify priorities, overlaps, and potential collaboration opportunities, addressing the urgent need for aid efficiency and alignment with national health priorities.

METHODS

Utilizing OECD datasets and the Herfindahl-Hirschman Index (HHI) for the years 2010-2021, this study quantifies aid fragmentation within Cambodia's health sector. It analyzes aid allocations from the top five donors-United States, Australia, South Korea, Japan, and Germany-across various health projects and initiatives, evaluating the extent of fragmentation and identifying areas for potential donor collaboration.

RESULTS

This study's findings highlight a pervasive issue of aid fragmentation within Cambodia's health sector, evident through the sector's low HHI score. This indicates a widespread distribution of aid across numerous small-scale initiatives, rather than targeted, unified efforts. A notable example includes Japan and Korea, which exhibit lower HHI scores, indicating a more pronounced fragmentation in their aid allocation. These countries' contributions are spread across various sectors without a dominant focus, contrasting with the United States' significant dedication to infectious disease control. However, beyond this specific area, the US's aid distribution across other priority health areas shows signs of fragmentation. This scattered approach to aid allocation, even amidst instances of focused support, illustrates the overarching challenge of aligning donor contributions with the holistic needs of Cambodia's health infrastructure.

CONCLUSIONS

This investigation highlights the critical need for enhanced collaboration and strategic harmonization among international donors to mitigate aid fragmentation in Cambodia's health sector. It underscores the importance of adopting integrated and priority-aligned aid strategies to improve the efficiency and impact of health aid. By fostering synergistic partnerships and harmonizing donor efforts, there is a potential to create a more cohesive support framework that resonates with Cambodia's comprehensive health requirements and contributes to sustainable health outcomes. Such harmonization not only aligns with Sustainable Development Goal 3 by optimizing health services and outcomes but also strengthens global partnerships under Sustainable Development Goal 17, fostering a unified approach to international development.

摘要

背景

柬埔寨的卫生部门面临着重大挑战,援助分散加剧了这些挑战,发展援助分散在众多规模较小、协调不力的项目中。本研究旨在分析柬埔寨主要援助方在卫生部门的援助分布情况,确定优先事项、重叠领域和潜在的合作机会,以解决援助效率和与国家卫生重点一致性的迫切需要。

方法

本研究利用经合组织数据集和赫芬达尔-赫希曼指数(HHI),于 2010 年至 2021 年期间对柬埔寨卫生部门的援助碎片化程度进行量化分析。它分析了美国、澳大利亚、韩国、日本和德国这五个最大援助方在各种卫生项目和倡议中的援助分配情况,评估了碎片化的程度,并确定了潜在的捐助者合作领域。

结果

本研究结果突出表明,柬埔寨卫生部门存在普遍的援助碎片化问题,这一点可以从该部门较低的 HHI 得分中看出。这表明援助广泛分布在众多小规模倡议中,而不是有针对性的、统一的努力。一个值得注意的例子是日本和韩国,它们的 HHI 得分较低,表明它们的援助分配更为分散。这些国家的贡献分散在各个部门,没有一个主导重点,与美国在传染病控制方面的大力支持形成对比。然而,除了这一特定领域之外,美国在其他优先卫生领域的援助分配也显示出碎片化的迹象。这种分散的援助分配方式,即使在有重点支持的情况下,也说明了协调捐助者的贡献以满足柬埔寨卫生基础设施全面需求的总体挑战。

结论

本研究强调了加强国际捐助者之间合作和战略协调的迫切需要,以减轻柬埔寨卫生部门的援助碎片化问题。它强调了采用综合和优先协调的援助战略以提高卫生援助的效率和影响的重要性。通过建立协同伙伴关系和协调捐助者的努力,有可能建立一个更具凝聚力的支持框架,该框架与柬埔寨全面的卫生需求产生共鸣,并有助于实现可持续的卫生成果。这种协调不仅符合通过优化卫生服务和成果实现可持续发展目标 3,还有助于在可持续发展目标 17 下加强全球伙伴关系,形成对国际发展的统一方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2b7/11297730/8414fb5f6f1c/12992_2024_1063_Fig1_HTML.jpg

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