Foreign health aid and its purposes
Provide specific examples and evidence where donor aid has been positive for a given country; and where donor aid has been a burden to a country. Describe policies and approaches that may be used to address the distortionary effects of health aid. Is there evidence that such policies have been effective in improving a country’s health system outcomes related to foreign aid?
Foreign aid is where there is a transfer of resources such as goods, services, and capital from their country or international organizations so that the country that receives it and its population benefits. In short, its where rich countries, organizations or individuals give their help in form of money, goods, and services to countries that are poor and require the help to carry out their activities and benefit its citizens. It can also be referred to as economic aid, international aid or development aid but it is quite different from military aid. The foreign aid is given to serve various purposes in different sectors in the countries that receive them (Ekanayake and Chatrna 2010, pp. 1). These purposes include; access to proper healthcare and education, access to safe water, improving infrastructure, access to finance, improving agriculture and agribusiness, help in the governance and successful growth in development in the countries. When the foreign aid provided is to be specifically used for the purposes of improving the health care system in the recipient country it is referred to as health aid grants (Mavrotas 2010). When the foreign aid is utilized it can have both positive and negative effects on the countries that receive them. The donors usually give conditions and have different priorities when giving out the aid which at times do not go hand in hand with the national policies in the recipient countries and it tends to lead to the weakening of the country’s healthcare system but there are strategies which can be put in place to prevent this from happening and there exists evidence that shows this happening. The essay will cover all of these issues.
Kenya has a population of over 47 million people and it has the largest economy in the East and Central African region. It dedicates 5.7% of its budget on healthcare which is quite little in an area that requires more to serve its population. In terms of health issues, it has a variety of issues; first it suffers from quite a high mother and infant mortality rates, there is a 1 in 20% chance of an individual contracting AIDS, there is a 70% chance of individuals in the population contracting malaria with the disease remaining a major cause or mortality in Kenya and also the life expectancy is only at 64 years. In addition, every 10,000 individuals are served by only two physicians and thus they are spread quite thinly in the country, therefore, have a hard time when they want to address the HIV epidemic and also the widespread diseases across the nation. Therefore with these issues in the health sector, Kenya require foreign aid to assist in the improvement of the healthcare system. The country is a favorite to donor countries like America and organizations like AMREF, USAID, and ADS because of its record of democracy and transparency as compared to other developing nations. For instance, the US considers Kenya as an important partner in the East African region (Juma et.al 2012)
Positive examples of foreign health aid in Kenya
There exists a variety of evidence that shows how foreign health aid has been successfully utilized in Kenya. First, in 2014, the country received foreign aid and 5 million dollars was dedicated to helping the Living Goods organization do their work. They have a working model which is game-changing in that it helps Health Entrepreneurs to have the ability to deliver life-saving health products to the doorstep of the poor in Kenya by empowering these entrepreneurs. Even if the hospitals and services are improved, another issue that arises is the fact that the poor have to travel long distances to access these healthcare services which can be quite hard, therefore this organisation’s goal is to make it easy for these people and the programme was successful and it is still ongoing in the country. These entrepreneurs go house to house teaching families how what they have to do in order to improve their health as well as wealth and also they offer life-changing products and services, for example, safe delivery kits, good nutrition habits, family planning and treatments for diarrhea and malaria (Baldé 2011, pp.250). Secondly, in the fight against HIV/AIDS 70% of the funds used is attributed to foreign aid. In 2000, the number of hospitals in Kenya where one could get tested and counseling for HIV/AIDS was three but by 2010 the number stood at 4000. Also, cases of HIV/AIDS prevalence have reduced thanks to the fact that more people can now easily access ARVs at an affordable price the figure in 2010 stood at over 600,000 people being able to access the medication from just 6,000 in 2003 (Luoma et.al 2010). In the country, HIV/AIDS is a compulsory subject in school where children are given knowledge about the disease which has led to the reduction of cases of HIV/AIDS infection. In addition, the Kenyan government also sees voluntary male circumcision as a tool in the fight against HIV which has been proven to reduce chances of infection by 40% in men. All of these programmes aimed at fighting HIV in Kenya were all possible thanks to foreign health aid grants and donors which help foot the cost (Edström and MacGregor 2010). Finally, with funds from foreign aid, Kenyan schools carried out studies on the prevalence of malaria across the country and with these results they came up with impact evaluation results. The Kenyan government with funds from foreign aid through the National Malaria Strategy used these results to come up with school-based pilot interventions in the fight against malaria with the aim to control malaria through schools and this was a successful project as it now being expanded across the country (Gitonga et.al 2010, pp.306).
Negative examples of foreign health aid in Malawi
However, some countries sometimes have to bear the burden brought on foreign aid they receive which was meant to assist them in the various areas they require help to develop but because of a variety of reasons like conditions by the donors and conflicting policies, it has not been successful. A country like Malawi has sheltered the burden of receiving foreign aid, especially that is meant for the health sector. In Malawi, the leading health issues and the leading cause of death is HIV/AIDS, malaria and also acute respiratory infections. The first burden that Malawi has sheltered as a result of receiving foreign aid for the health sector is that they lack the resources required to implement the policies they agree upon with their donors. In the fight against malaria in Malawi, most of the policies that were introduced were in line with the global eradication programme called Roll Back Malaria Partnership and the World Health Organisation recommendations. They based all of these on interventions which show evidence of success in other places which have implemented the policies to fight malaria. However, Malawi is not able to put the suggestions from the results of the study into action. For instance, one suggestion is that the breeding places of mosquitoes should be destroyed at the peak of their breeding season to curb the spread of malaria but this does not happen in Malawi instead because of lack of proper resources when they are availed it is too late in the season for this to be effective. Therefore with lack of these resources, it makes it hard for these healthcare system reforms made possible by the aid to be possible (De and Becker 2015).
Secondly, most healthcare programs set up by the foreign aid have the requirement which makes it necessary to use a specific type or brand of drugs to treat the patients. These drugs are very expensive and are not easy to come by in countries like Malawi where it is required for use. Therefore because of this people will not get the drugs that they should be getting through these health programs meant to help them. Therefore these programs end up using more money in buying drugs and little is left over to implement these programs leading to failures of these projects. When projects fail, it leads to loss of faith by other donors and therefore it leads to a reduction of aid received (Selaya and Sunesen 2012, pp. 2170). Thirdly, the more aid Malawi receives the more in debt it gets in to. This foreign aid mostly have loan packages embedded into them and therefore these developing get into more debt by getting these foreign aid that they require for them to operate and some like Malawi have become dependent on it. However because of actors like corruption where individuals siphon off money meant for development this money is not made back because they are not successfully used in the projects that they are meant to fund. Therefore when they cannot pay back the loans they have to borrow more to pay back loans leading to the economy going down (Okada and Samreth 2012, pp. 242). Finally, these donors can start controlling how a recipient country is being run because these countries like Malawi are dependent on the aid too much. Therefore they spell out what they require so that they give more and the countries do it essentially losing their freedoms. This leads to overdependence on these donors (Asongu and Jellal 2013).
Strategies to address distortionary effects of health aid
Foreign aid, especially for the health sector, is quite important for the recipient countries who utilize them for a variety of projects to benefit their countries. However, the health aid can have a negative impact on these nations, therefore, policies and approaches exist to remedy these issues. The first policy is that more foreign aid donors have started to move away from the “one size fits all” approach in implementing projects in the different recipient countries. They now study conditions in the country and find a strategy which will work in that context, therefore, ensuring the success of the project. Another approach is that donors should stop the practice of giving more aid to the middle-income countries that do not really need it but should focus more o the poorer countries that are struggling with development so that the aid can help them to grow (Fowler 2013). Also, most donors should study countries that they are giving aid to ensure that they have reasonable policies and not bad unreasonable ones. There has been a new wave of approach take n by more donors who are now using the Millenium Challenge Account to base their decisions on whom to give aid (Wright and Winters 2010, pp. 70). Finally, the targets that are set by donors should be doable, measurable and achievable putting the conditions of the country receiving aid in mind. They can do this by using independent monitors who will give real figures which are achievable with the amount available (Gulrajani 2011, pp. 210).
These policies and approaches have been utilized in some counties who had previously been negatively affected by receiving foreign aid. It was successfully used in Rwanda where the government formulated the Aid policy which gives regulations which should be followed by the donors and nation in the case of accepting and utilizing the foreign, especially in the health sector. The health sector in Rwanda is what is receiving a huge chunk of funding from their donors because of previous success rates, for instance, the number of women utilizing the assisted delivery services increased to 42.7% from 12.1% among the poor percentage in the country (Farmer et.al 2013). The Rwanda policy ensures that the foreign aid that they receive does not come with unreasonable conditions and burdens like high debts after implementing projects. With this in place, it has ensured that the health services do not suffer from financial barriers when they are being implemented (Hayman 2009, pp. 170).
Evidence of the effectiveness of the strategies
All in all, foreign aid is quite useful to the recipient countries who require these funds so that they can implement the various projects that are meant to benefit their citizens. In this case, one sector that most recipient nations utilize their aid in is the health sector because it is a vital sector in most countries. The utilization of the health aid has been positive in a country like Kenya but at the same time, it had negative impacts on nations like Malawi. However, there are approaches that can be utilized so that foreign aid does no burden recipient nations and it is evidenced by a country like Rwanda which has implemented its own foreign aid policy.
References
Asongu, S.A. and Jellal, M., 2013. On the channels of foreign aid to corruption.
Baldé, Y., 2011. The impact of remittances and foreign aid on savings/investment in Sub?Saharan Africa. African Development Review, 23(2), pp.247-262.
De, R. and Becker, C., 2015. The foreign aid effectiveness debate: Evidence from Malawi. Online], vol. March, no. Working Paper, 6.
Edström, J. and MacGregor, H., 2010. The Pipers Call the Tunes in Global Aid for AIDS: The global financial architecture for HIV funding as seen by local stakeholders in Kenya, Malawi and Zambia. Global Health Governance Journal, 4.
Ekanayake, E.M. and Chatrna, D., 2010. The effect of foreign aid on economic growth in developing countries. Journal of International Business and Cultural Studies, 3, p.1.
Farmer, P.E., Nutt, C.T., Wagner, C.M., Sekabaraga, C., Nuthulaganti, T., Weigel, J.L., Farmer, D.B., Habinshuti, A., Mugeni, S.D., Karasi, J.C. and Drobac, P.C., 2013. Reduced premature mortality in Rwanda: lessons from success. Bmj, 346, p.f65.
Fowler, A. ed., 2013. Striking a balance: A guide to enhancing the effectiveness of non-governmental organisations in international development. Routledge.
Gitonga, C.W., Karanja, P.N., Kihara, J., Mwanje, M., Juma, E., Snow, R.W., Noor, A.M. and Brooker, S., 2010. Implementing school malaria surveys in Kenya: towards a national surveillance system. Malaria journal, 9(1), p.306.
Gulrajani, N., 2011. Transcending the great foreign aid debate: managerialism, radicalism and the search for aid effectiveness. Third World Quarterly, 32(2), pp.199-216.
Hayman, R., 2009. Rwanda: milking the cow. Creating policy space in spite of aid dependence. The politics of aid: African strategies for dealing with donors, pp.156-184.
Juma, K., Nahason, M., Apollo, W., Gregory, W. and Patrick, O., 2012. Current Status of E-Health in Kenya and Emerging Global Research Trends 1.
Luoma, M., Doherty, J., Muchiri, S., Barasa, T., Hofler, K., Maniscalco, L., Ouma, C., Kirika, R. and Maundu, J., 2010. Kenya health system assessment 2010. institutions.
Mavrotas, G. ed., 2010. Foreign aid for development: Issues, challenges, and the new agenda. Oxford University Press.
Okada, K. and Samreth, S., 2012. The effect of foreign aid on corruption: A quantile regression approach. Economics Letters, 115(2), pp.240-243.
Selaya, P. and Sunesen, E.R., 2012. Does foreign aid increase foreign direct investment?. World Development, 40(11), pp.2155-2176.
Wright, J. and Winters, M., 2010. The politics of effective foreign aid. Annual Review of Political Science, 13, pp.61-80.
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