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From emergency relief to system strengthening

Stakeholder perspectives on official development assistance for reproductive, maternal, neonatal and child health in Guinea-Bissau

Bibliographic Data

ID19480190
AuthorsAnaxore Casimiro (0000-0002-5351-6815, Instituto de Medicina Tropical, corresponding author), Réka Maulide Cane (0000-0001-8209-4976, Instituto de Medicina Tropical), Michel Jareski Andrade (0009-0005-7919-098X, Universidade Estadual do Centro-Oeste), Luís Varandas (0000-0002-8419-6033, Instituto de Medicina Tropical), Isabel Craveiro (0000-0003-4348-1986, Instituto de Medicina Tropical)
Year2026
Volume21
Issue1
Pages2672821-2672821
Publication date2026-12-31
Open AccessYes
TypeARTICLE
VenueGlobal Public Health (JOURNAL)
Journal identifiersISSN: 1744-1692 • E-ISSN: 1744-1706
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/17441692.2026.2672821
PMID42116235
OpenAlexW7160922345
LanguageEN
References cited25

Guinea-Bissau, a politically fragile West African nation, relies heavily on official development assistance (ODA) to sustain reproductive, maternal, neonatal and child health (RMNCH) services. This study explored how national and international stakeholders perceive the role, evolution and effectiveness of RMNCH-related ODA and how these perspectives compare with donor strategies. We conducted semi-structured interviews with 10 key informants and applied an AI-assisted, systematically validated framework to analyse 50 donor documents, integrating findings through comparative coding and convergence-divergence synthesis. Stakeholders viewed ODA as 'humanitarian' or 'emergency' aid, substituting for the state rather than catalysing durable system change. Donor documents strongly emphasised coordination, alignment and ownership but tended to underplay political risk and institutional capacity limits. Triangulated analysis identified interlinked constraints: political instability and ministerial turnover, fragmented coordination despite multiple formal mechanisms, performative alignment with national plans, limited domestic financial contribution and an evolution toward vertical funding that risks further fragmentation. Findings point to the need for hybrid coordination arrangements combining national and international leadership, depoliticised and stable technical capacity within the Ministry of Public Health, longer and more flexible programme cycles with contingency mechanisms, and greater domestic financing and use of national strategic plans as a genuine framework for system strengthening

Child protection · Christian ministry · Development aid · Emergency management · Poison control · Politics · Public health · Stakeholder · Vulnerability (computing) · Global Maternal and Child Health · Human Rights and Development · International Development and Aid

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