Use of USAID's Non-Project Assistance to Achieve Health Sector Policy Reform in Africa: A Discussion Paper

摘要

This policy paper examines the experiences and effectiveness of using the U.S. Agency for International Development's (USAID) non-project assistance (NPA) to support health sector objectives in sub-Saharan Africa. Programs in Niger, Nigeria, Kenya, Togo, and Cameroon are summarized. For each country, background is provided on the health sector, and a summary and assessment of specific NPA programs are provided. Prepared for the Health and Human Resources Analysis for Africa (HHRAA) Project of USAID's Africa Bureau, the primary focus of the paper is on health finance policy reforms that were promoted through USAID-supported NPA programs. It compares and contrasts country experiences as they relate to NPA. The authors' purpose is to encourage discussion within USAID of the effectiveness of using NPA as a reform tool in policy development and the broader question of how to best support desired health outcomes in Africa. The paper provides a detailed assessment of three aspects of NPA programming: program development and design, program implementation, and program evaluation. The information sources were limited to official program documentation, and did not include field work. An extensive bibliography on the topics of non-project assistance, policy reform, and health sector policy is included.