External technical assistance and its contribution to donor transition and long-term sustainability

Experience from China and Georgia

Bibliographic Data

ID16763055
AuthorsAidan Huang (0000-0003-4602-3913, Tsinghua University), Chunkai Cao (Tsinghua University), Yingxi Zhao (0000-0002-4937-4703, Tsinghua University), Giorgi Soselia (Ilia State University), Maia Uchaneishvili (0000-0003-1659-6614, Ilia State University), Ivdity Chikovani (0000-0001-6925-4904, Ilia State University), George Gotsadze (0000-0002-8429-7125, Ilia State University), MoHan Lyu (Tsinghua University), Kun Tang (0000-0001-7382-9344, Tsinghua University, corresponding author)
Year2024
Volume39
IssueSupplement_1
Pagesi137-i144
Publication date2024-01-23
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czad088
PMID38253441
OpenAlexW4391116313
LanguageEN
Citations received2
References cited11

External technical assistance has played a vital role in facilitating the transitions of donor-supported health projects/programmes (or their key components) to domestic health systems in China and Georgia. Despite large differences in size and socio-political systems, these two upper-middle-income countries have both undergone similar trajectories of ‘graduating’ from external assistance for health and gradually established strong national ownership in programme financing and policymaking over the recent decades. Although there have been many documented challenges in achieving effective and sustainable technical assistance, the legacy of technical assistance practices in China and Georgia provides many important lessons for improving technical assistance outcomes and achieving more successful donor transitions with long-term sustainability. In this innovation and practice report, we have selected five projects/programmes in China and Georgia supported by the following external health partners: the World Bank and the UK Department for International Development, Gavi Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria. These five projects/programmes covered different health focus areas, ranging from rural health system strengthening to opioid substitution therapy. We discuss three innovative practices of technical assistance identified by the cross-country research teams: (1) talent cultivation for key decision-makers and other important stakeholders in the health system; (2) long-term partnerships between external and domestic experts; and (3) evidence-based policy advocacy nurtured by local experiences. However, the main challenge of implementation is insufficient domestic budgets for capacity building during and post-transition. We further identify two enablers for these practices to facilitate donor transition: (1) a project/programme governance structure integrated into the national health system and (2) a donor–recipient dynamic that enabled deep and far-reaching engagements with external and domestic stakeholders. Our findings shed light on the practices of technical assistance that strengthen long-term post-transition sustainability across multiple settings, particularly in middle-income countries

Business · China · Economic growth · Economics · Political science · Sustainability · Term (time) · Transition (genetics) · Food Security and Health in Diverse Populations