The Role of Structural Factors in Selected Health Programs

Abstract

AbstractThis chapter explores how the structural factors relevant to aid relationships, namely, aid predictability and flexibility, stakeholders’ capacities, and their dependency on aid, unfold in selected case studies. It makes a compelling argument for the relevance of the organizational structure to the multiyear predictability of aid as well as its contingency on the availability of funds. This chapter also vividly demonstrates the implications of (de)centralized decision-making and increased control over finances on aid flexibility or responsiveness of the assistance to recipients’ changing needs. Furthermore, focusing on the capacities of the aid-recipient civil society organizations and state institutions involved in the selected health care programs, it discusses how specific gender roles, the political situation, and systemic problems affected staff recruitment and retention in these organizations. Differentiating between stakeholders’ dependency on technological and financial assets, this chapter also demonstrates considerable diversity across organizations and sectors. Overall, it provides a necessary background for analyzing aid relationships in the following chapters, along with some curious insights that are new to the studies on health care interventions and may be of interest beyond the selected health programs.