Abstract:
Malawi is one of the countries that signed the Paris Declaration on aid effectiveness in 2005 which aimed at improving the impact of aid on poverty, inequality and economic development by changing the way aid is being managed and delivered. The Paris Declaration on aid effectiveness includes commitments around 5 principles of ownership, alignment, harmonisation, managing for results and mutual accountability that have to be undertaken by aid recipient and donor countries as well as multilateral organisations. The Paris Declaration received support from other follow up meetings on aid effectiveness such as the Accra Agenda for Action (AAA) in 2008, the Busan Partnership for effective development cooperation in 2011 and the A ddis Ababa Action Agenda in 2015.
Malawi is one of the countries that has been receiving aid from developed countries and multilateral organisation to help it achieve global goals such as the Millennium Development Goals and the Sustainable Development Goals.
There have been several studies on the implementation of the Paris Declaration in Malawi. However, no studies have looked at the health sector in Malawi which greatly relies on support from development partners who contribute over 60% of the total health expenditure. This study aimed to fill that gap in the research by looking at alignment and ownership on aid for maternal, neonatal and under 5 health in Malawi.
Maternal, neonatal and under child health are among the Sustainable Development Goals targets on health. Hence, it was important to look at how aid for maternal, neonatal and under 5 child health is delivered and managed.
A qualitative design was used and purposive sampling of key stakeholders related to the delivery of aid were selected. Semi structured interviews were conducted and coding of the data in NVIVO was done.
The results showed that there is moderate ownership and limited alignment of aid for maternal, neonatal and under 5 child health. The findings indicated that while the Ministry of Health and Distirct Health Offices involve stakeholders in the development of their plans which have issues of maternal, neonatal and under 5 health in their plans. Generally it was found that the Ministry of Health and districts do not have total control in the initiation of projects and how the aid is delivered. It was found that for both the Ministry of Health and District Health Offices aid is aligned to priorities, there is limited use of country systems, there is also existence of parallel implementation units, and little predictability of the aid . It was found that while District Health Offices are involved in the implementation of some donor funded projects, most of the projects are implemented by Non Governmental Organisations. The research established that donors perceive country systems to be weak and hence prefer to deliver their aid through off budget means.
The findings of this study are similar to findings on alignment and ownership on Malawi and also other countries such as Tanzania and Uganda.
I therefore recommend that Government of Malawi needs to improve the financial and procurement systems so that they can be reliable to donors.
There is also need for need for districts and the Ministry of Health to have more consultations with NGOs and donors respectively to discuss on the improvement of the predictability of aid.