During the past 10 years, donors have recognized the need for major reforms to achieve sustainable development. Using non-project assistance they have attempted to leverage reforms by offering financing conditioned on...
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During the past 10 years, donors have recognized the need for major reforms to achieve sustainable development. Using non-project assistance they have attempted to leverage reforms by offering financing conditioned on the enactment of reform. The experience of USAID's health reform programmes in Niger and Nigeria suggest these programmes have proved more difficult to implement than expected. When a country has in place a high level of fiscal accountability and high institutional capacity, programmes of conditioned non-project assistance may be more effective in achieving reforms than traditional project assistance. However, when these elements are lacking, as they were in Niger, non-project assistance offers nothing inherently superior than traditional project assistance. Non-project assistance may be most effective for assisting the implementation of policy reforms adopted by the host government.
In 1994, the Agency for Health Care Policy and Research awarded cooperative agreements to five University-based groups to promote the establishment of managed care Institutions and development of rural health networks...
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In 1994, the Agency for Health Care Policy and Research awarded cooperative agreements to five University-based groups to promote the establishment of managed care Institutions and development of rural health networks. This paper summarizes the experiences of these rural managed care centers in the first three years of this initiative. Key ingredients for achieving the project's goals that are identified by the project directors are reported as "foundations" that must be in place from the outset, or "building blocks" that can be developed along the way. The development of information systems and efforts to foster leadership in the medical community are areas in which grant funding of this type can be most effective.
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