Health AID Effectiveness: Civil Societies Experience in Zambia

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Health AID EffectivenessCivil Societies
Experience in Zambia

• Christopher Chabu Kangale
• International HIV/AIDS Alliance Zambia

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Were Struggling to meet MDGs

• Life expectancy is low 40 years on average
• Limited improvements in maternal and child
  health
• Maternal mortality reduced from 729 per 100,000
  to 449.
• Under five mortality from 168 per 1000 to 119.
• Although HIV prevalence is declining from 16.5
  in 2007 to 14.3 in 2008 incidence amongst
  young people is still very high!
• We have a serious health worker crisis (28,000
  professionals short of MOH staffing targets
  operating at 47 of required staffing)
• Leading to limited health outcomes especially for
  rural communities!!!

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Mechanisms to deliver health aid in Zambia

• Budget Support e.g DFID, RNE, NORAD, Ireland
  Aid etc have decided to go for Budget Support
  through Joint Assistance Strategy to Zambia
  (JASZ)
• Bilateral Agreements e.g USAID still supporting
  government through direct support to projects
• Joint Funding Agreement e.g ZNAN, CHAZ and NAC
  (2 or more donors agree to support civil society
  jointly)

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Challenges

• This Pooling of Funding has significantly reduced
  civil societys access to HIV and AIDS funding to
  accelerate community programmes
• Limited funding for technical support,
  coordination, representation and advocacy for
  civil society.
• No mechanisms for government to fund civil
  society

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Challenges

• Bilateral agreements through project support is
  generating this unhealthy debate between vertical
  and horizontal health programming.
• Donors are focusing too much on fixing
  harmonisation principles and division of labour
  issues rather than on results to be achieved.

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For health aid to produce health

• Unpack General budget support so it can mean
• Additional funding that supports comprehensive
  primary health care by strengthening health and
  community systems
• Support national processes and not just
  government processes Civil Society is key both
  as service provider as well as voice of the
  people
• Support the democratisation of budget process
  (including budget consultations, expenditure
  tracking by citizen organisations etc).

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Thank you for Listening