Prescribing aid coordination in Uganda’s health sector
Taylor, Emma Michelle
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This thesis aims to contribute to the body of work that seeks to unpack development by asking: how does development work? Using a purposive case study of Uganda and taking a mixed methods approach, the thesis explores the reality behind the rhetoric of aid coordination in a developing health sector, questioning the premise that coordination is pursued exclusively to improve the efficacy of official development assistance (as inferred by partners‟ vocal commitments to the tenets of the Paris Declaration on Aid Effectiveness). The study focuses on the member groups currently empowered to join Uganda‟s most important multi-stakeholder forum for health - the Health Policy Advisory Committee - finding that all members are guilty of picking and choosing from a checklist of voluntary coordination commitments. This is found to be at once logical - for facilitating the semblance of partnership between a disparate grouping of stakeholders with differing modi operandi, agency objectives and tolerance for risk – and advantageous - for masking difference and allowing outwardly homogenous groupings like the Health Development Partners to speak with “one voice” when addressing the Ugandan government. Most importantly of all however, partial adherence to the aid coordination ethos is found to permit the framing that aid to Uganda is at once necessary and well targeted, as the Government of Uganda actively invites its partners to participate in the processes of government at the central level. Such tangible commitments to the tenets of partnership and transparency are integral to maintaining donor confidence in the aftermath of two financial scandals involving the Global Fund for AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccines and Immunisation in 2005. In sum, the thesis argues that while on the surface coordination appears important for its internal significance - as an organising principle to improve the effectiveness of aid - in fact, the value of coordination stems from its external significance. Coordination creates a façade of unity which permits the continuance of aid flows to Uganda, with coordination activities now playing a pivotal role in determining who gives and receives aid, and how it should be spent.