Turning quicksand into bedrock : understanding the dynamic effects of disease-focused global health aid on health systems

[摘要] (cont.) Through expert interviews, this thesis identifies the most pressing system stresses in this contemporary context: the commitment to chronic care delivery which HIV/AIDS intervention creates, and the critical need for harmonization between donors which this commitment reveals. Using case examples from Kenya, these dynamics are shown to be active today, and to have instigated mitigation strategies by practitioners in the field. Finally, the systems identified above bring into focus key leverage points, including donor coordination, health worker augmentation, and engagement of local markets, which can ;;tip;; the impact of vertical programs from harming health systems to strengthening them. In doing so, this thesis provides guidance to policymakers and program implementers who seek to use their resources to strengthen systems and eventually obviate health aid entirely.

[发布机构] Massachusetts Institute of Technology