THE INFLUENCE OF DONOR-RELATED ORGANISATIONAL, RELATIONAL, AND INDIVIDUAL-LEVEL FACTORS ON AID COORDINATION IN THE TANZANIAN HEALTH SECTOR

Abstract

Weak aid coordination is generally assumed to restrict aid effectiveness and has remained a critical issue in international development for several decades. However, few systematic attempts have been made to understand the barriers to improved coordination that are related to donor organisations and their staff. To contribute to filling this gap, this thesis examines how donor-related factors influence aid coordination and how they interact with each other. It uses the Tanzanian health sector as a case study and draws on primary data collected between 2014 and 2015 in the form of 27 semi-structured interviews with 30 representatives of donor organisations and the Government of Tanzania, as well as participant observation of 18 coordination meetings. 21 reports and strategy documents were analysed as supplementary data. The thematic analysis was facilitated by using NVivo 12.1 software for qualitative data analysis. An analytical framework based on Gulrajani’s 2013 framework for improving aid effectiveness policies was used and adapted to include complexity theory to interpret the findings. The findings show that aid coordination in the Tanzanian health sector was influenced by donor-related organisational, relational, and individual-level factors. Specifically, the aid ideologies of donor organisations had a strong and pervasive effect on coordination. Moreover, the aid dependence of the Tanzanian health sector and thematic priorities of donor organisations weakened the Tanzanian government’s ownership of their health policies. Finally, the findings illustrate that the interpersonal relationships of donor staff and their professional interests and values strongly affected coordination practice. The findings indicate that non-developmental interests of donor governments, such as increasing pressures to justify aid budgets and use them to support national interests, will likely amplify coordination challenges. Improving aid coordination would require reconciling these competing agendas, aligning to local priorities, and harnessing personal relationships and local knowledge to provide tailored and partner-oriented support.