As more countries graduate from low-income to middle-income status, they face imminent loss of international aid or concessions typically enjoyed by low-income countries. It is estimated that within the next five years, around two dozen countries are likely to face simultaneous donor transitions in which they lose funding from more than one major donor at the same time. In the health sector, loss of donor support from organizations such as Gavi, the Vaccine Alliance, the World Bank, and bilateral donors could potentially have negative impacts on population health and well-being. Yet discussions about country transitions from donor assistance for health have largely occurred at a supranational level with little input from in-country stakeholders themselves—very little is known about these stakeholders’ concerns, challenges, and opportunities.
Even less is known about the decision-making processes that underlie a country’s preparation for, or response to, donor transitions. To fill these research gaps, we are conducting a mixed-methods study in two lower-middle-income countries, Ghana and Sri Lanka. In this research we are partnering with the University of Ghana and the Institute of Health Policy, Sri Lanka.
The study aims to:
- Explore the perspectives and experiences of in-country stakeholders with donor transition
- Documents these stakeholders’ responses and adjustments to the losses arising from transition (including loss of external financing and technical assistance)
- Understand the “why” behind the chosen response strategies adopted.