Asunto(s)
Servicios de Salud Comunitaria/economía , Servicios de Planificación Familiar/economía , Servicios de Salud Materna/economía , Bienestar Social/economía , Servicios de Salud Comunitaria/organización & administración , Países en Desarrollo , Servicios de Planificación Familiar/organización & administración , Femenino , Educación en Salud , Accesibilidad a los Servicios de Salud/economía , Humanos , Masculino , Servicios de Salud Materna/organización & administración , Pobreza , Salud Reproductiva/economía , Bienestar Social/estadística & datos numéricosRESUMEN
As low income countries experience economic transition, characterized by rapid economic growth and increased government spending potential in health, they have increased fiscal space to support and sustain more of their own health programmes, decreasing need for donor development assistance. Phase out of external funds should be systematic and efforts towards this end should concentrate on government commitments towards country ownership and self-sustainability. The 2006 US Agency for International Development (USAID) family planning (FP) graduation strategy is one such example of a systematic phase-out approach. Triggers for graduation were based on pre-determined criteria and programme indicators. In 2011 the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) which primarily supports financing of new vaccines, established a graduation policy process. Countries whose gross national income per capita exceeds $1570 incrementally increase their co-financing of new vaccines over a 5-year period until they are no longer eligible to apply for new GAVI funding, although previously awarded support will continue. This article compares and contrasts the USAID and GAVI processes to apply lessons learned from the USAID FP graduation experience to the GAVI process. The findings of the review are 3-fold: (1) FP graduation plans served an important purpose by focusing on strategic needs across six graduation plan foci, facilitating graduation with pre-determined financial and technical benchmarks, (2) USAID sought to assure contraceptive security prior to graduation, phasing out of contraceptive donations first before phasing out from technical assistance in other programme areas and (3) USAID sought to sustain political support to assure financing of products and programmes continue after graduation. Improving sustainability more broadly beyond vaccine financing provides a more comprehensive approach to graduation. The USAID FP experience provides a window into understanding one approach to graduation from donor assistance. The process itself-involving transparent country-level partners well in advance of graduation-appears a valuable lesson towards success.
Asunto(s)
Países en Desarrollo/economía , Apoyo Financiero , Inmunización , Cooperación Internacional , United States Agency for International Development , Vacunas , Humanos , Estados UnidosRESUMEN
Looks at reproductive health policies and programs in eight countries. In-depth interviews in 1997 with stakeholders in Bangladesh, India, Nepal, Jordan, Ghana, Senegal, Jamaica and Peru; Adoption of the 1994 International Conference on Population and Development in six of the eight countries studied; Discussion of implementation problems.(AU)