The New York Times, reporting on the devastating statistics on maternal death in Uganda, pointed to some important unintended side effects of foreign aid, namely that it decreases the spending and effectiveness of local health care:
For every dollar of foreign aid given to the governments of developing nations for health, the governments decreased their own health spending by 43 cents to $1.14, the University of Washington’s Institute for Health Metrics and Evaluation found in a 2010 study. According to the institute’s updated estimates, Uganda put 57 cents less of its own money toward health for each foreign aid dollar it collected.
The Ugandan health care system, like so many in developing countries, doesn’t have enough providers (doctors, nurses etc.), basic supplies, or functional infrastructure to serve its population. The NYT reports: “As the United States and other donors have given African nations billions of dollars to fight AIDS and other infectious diseases, helping millions of people survive, most of the African governments have reduced their own share of domestic spending devoted to health, shifting to other priorities.”
As an American concerned about these kinds of discrepancies, it can be depressing to hear this kind of analysis, but there are promising programs that empower patients directly, rather than flooding foreign governments with aid. I learned this, once again, while watching a panel on innovations in global health at this year’s Aspen Ideas Festival. I was especially impressed with the work of Priya Agrawal, a British obstetrician and gynecologist. She has just completed work with Atul Gawande as the obstetric lead on the World Health Organization’s Safe Childbirth Checklist Program. Additionally, Agrawal is a senior advisor for WHO’s Mother/Baby 7-day mCheck patient safety program and chief medical advisor to Jacaranda Health, a social enterprise dedicated to providing high-quality care and testing global innovations for safe motherhood in Kenya. Check it out: