As a core part of the research for the HIV Monitor, CGD initiated work with local research partners to conduct in-depth analyses in three recipient countries: Mozambique, Uganda and Zambia. Working with these in-country researchers, we will examine the nature and volume of aid flows, analyse how (and by whom) aid-financed programs are designed and implemented, investigate how programs are monitored and evaluated, and explore the impacts on health and financial systems. We are concerned not only with the narrow aims of the programs, but how the programs approach major challenges of implementation in the specific country contexts and the broader impacts on national development strategies.
We have developed an initial framework of seven questions which we will address through in-depth analyses by local research partners (with assistance from a field director and CGD as necessary). Some issues to be looked at are central to the global aid effectiveness agenda, and some themes are more specific to HIV/AIDS responses and considerations. Specific areas of research include:
- Tracking the funding: By documenting how money moves and where it goes, this analysis will inform an emerging discussion among key stakeholders about the transition of the HIV/AIDS programs from “emergency” responses to a more “chronic” response.
- Beneficiary Analysis on Women and OVCs: This study will analyze whether each donor’s programs are effectively and appropriately reaching these two target groups.
- Relationship between funding and performance: By documenting the way donors are operationalizing the concept of performance-based funding in specific country contexts, this study will help donors understand how the principle of PBF is working in practice.
- Relationship of HIV/AIDS and reproductive health programs: This study will take a critical look at the wider impact of these HIV/AIDS initiatives, including whether or not there is a detrimental (or positive) impact on the existing reproductive health care programs in these countries.
- Effects of donor funds on the national health system: A polarized debate exists about whether donors should use national health care systems to scale-up a response to HIV/AIDS, or develop new, parallel systems to roll-out services. This study will hope to get to the heart of this controversy by understanding what combinations of approaches to systems work most efficiently and effectively in what contexts.
- Recurrent cost burden and sustainability: This study looks to examine how the arrival and volume of donor resources for HIV/AIDS has impacted government spending, and what measures are in place among the donors to ensure long-term financing.
- Impact on labor market for health care workers and managerial talent: The lack of qualified health workers and managers is a much discussed barrier to program scale-up. This area of research will study how the donor programs have affected the labor market, and what policies and procedures the donors have in place regarding the long-term training of health care personnel.
