Does donor proliferation in development aid for health affect health service delivery and population health? Cross-country regression analysis from 1995 to 2010

Saúde Global

Health Policy and Planning – Sarah Wood Pallas and Jennifer Prah Ruger – Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA


Background: Previous literature suggests that increasing numbers of development aid donors can reduce aid effectiveness but this has not been tested in the health sector, which has experienced substantial recent growth in aid volume and number of donors.

Methods: Based on annual data for 1995–2010 on 139 low- and middle-income countries that received health sector aid from donors reporting to the OECD’s Creditor Reporting System, the study used two-step system generalized method of moments regression models to test whether the number of health aid donors and an index of health aid donor fragmentation affect health services (measured by DTP3 immunization rate) or health outcomes (measured by infant mortality rate) for three subsectors of health aid.

Results: For total health aid and…

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