Exploring the meaning and limits of ‘country ownership’ with externally-funded projects

1. Exploring the meaning and
limits of ‘country ownership’
with externally-funded projects
Annie Neo Parsons, Christina Zarowsky
Centre for Research in HIV and AIDS
School of Public Health
University of the Western Cape

2. Objectives
• Description of the 11 projects under the
UWC administered CDC-PEPFAR grant
• Overview of ‘Country Ownership’
• A synthesis of project experiences
• Three key areas going forward

3. Background
• CDC-PEPFAR grant administered by the UWC
Centre for Research in HIV and AIDS since 2008
• Funds 11 diverse UWC-designed projects on
developing human capacity to address HIV and AIDS
in South Africa, namely:

4. Context
• All projects sought national, provincial, and/or
district level government involvement – with
varying levels of interest/approval/involvement
• No initial funder expectation of South African
government involvement in each project
• Shift to promotion of country ownership and
integration from 2010

5. Accra Agenda
• “Country ownership is key. Developing country
governments will take stronger leadership of their
own development policies, and will engage with their
parliaments and citizens in shaping those policies.
Donors will support them by respecting countries’
priorities, investing in their human resources and
institutions, making greater use of their systems to
deliver aid, and increasing the predictability of aid
flows.”
• Accra Agenda for Action 2008, page 1

6. PEPFAR
• “PEPFAR's emphasis on country ownership will include:
– Continuing bilateral engagement through its Partnership Frameworks
and other efforts to promote and develop a more sustainable response
to the local epidemic, whether concentrated or generalized;
– Ensuring that the services PEPFAR supports are aligned with the
national plans of partner governments and integrated with existing
health care delivery systems;
– Strengthening engagement with diplomatic efforts at all levels of
government to raise the profile and dialogue around the AIDS
epidemic and its linkages with broader health and development issues;
– Expanding technical assistance and mentoring to country governments,
in order to support a capable cadre of professionals to carry out the
tasks necessary for a functioning health system; and
– Partnering with governments through bilateral, regional and
multilateral mechanisms to support and facilitate South-to-South
technical assistance.”
• http://www.pepfar.gov/about/138339.htm

7. Impact on projects
• Focus on strengthening country capacity
• Integration interpreted as incorporation
• Withdrawal of funding but projects expected
to continue
• Projects increased attempts to engage
government on future incorporation

8. A synthesis of experiences
• Questions arose as projects attempted to
incorporate with government:
– Were project aims in line with specific
government departmental priorities?
– What levels of government should projects
approach – what is a ‘locally-driven solution’?
– Were resources available? (Would projects exist
without external funding?)

9. Project aims/government priorities
• Health Promoting Schools: varying interest
and resistance from health and education at
different levels… pre 2012. Then seen as in
line with education priorities
• HIV Prevention through Sports: no interest
from (local level) sports and recreation
• Traditional Healers: upcoming regulations
from health, but by very nature not part of
any government department

10. What level of government matters
• Health Promoting Schools: agreements with
district level education superseded by
provincial decisions. Who holds operational
power?
• HIV Ed for Local Government: individual
municipalities, SALGA?... how to ensure
effective entry and ongoing participation
• Human Resources Information Systems: work
in districts; provincial authoritive body;
national overall responsibility

11. Are there resources?
• CHWs: alignment of existing policies sought
but no resources within government sector.
Latterly incorporated into SANAC.
• M&E Officers for KZN DoH: need (still) there
but posts unfilled. Department promised to
hire, but only 1 of 3 absorbed as of end 2012

12. Going forward: 3 key areas
• What relation does funding have to decision-
making power
– Projects have restricted scope in negotiating how
existing funded programmes can fit into
government need hierarchies
• What level of government holds 'ownership’
– And impacts on a project’s operations
• How can local government sustain externally
funded projects in resource-poor (or
strained) settings?