Power of partnership conference: Presentation: New norms and forms of development: Brokerage of foreign aid in maternal and child health service development and delivery in Nepal and Malawi

1. New Norms and Forms of Development
Brokerage of Foreign aid in Maternal and Child Health Service
Development and Delivery in Nepal and Malawi
A Collaborative project of University of Edinburgh (UK), Social Science Baha
(Nepal) and University of Malawi (Malawi)

2. Research aims
• to generate knowledge on the
roles and functions of
development institutions that
broker health and development
projects and programmes
• implications of changing modality
of foreign aid (i.e. shift towards
outsourcing, effectiveness,
coordination, value for money and
achievement of measurable
results) for health outcomes and
the State capacity

3. methods
• Inception workshops
• mapping institutional
terrain around external
development assistance
in Maternal and Child
Health (MCH)
• ethnographic study of
eight selected projects,
including fieldwork,
participant observation,
interviews, archival work

4. Findings
• development assistance in MCH is a messy assemblage of actors,
institutional arrangements and activities involving ‘providing’,
‘managing’ and ‘spending’ arranged through chains of
outsourcing and sub-contracting
• preoccupation with metrics and results-based frameworks has
reduced the impact to measurable results only; and marginalised
and rendered invisible politico-economic and sociocultural
dimensions
• personal relationships significantly shape the sub-contracting and
accountability systems
• impact on State capacity in terms of coordination; demoralisation
of government staff

5. Pathways to impact
• collaboration with long-
term partners
• stakeholders and partners
engagement throughout
the research process
• dissemination through
various mediums (radio,
blog, journal articles, policy
briefs, working papers,
seminars, dissemination
workshops, one-to-one
briefing/meeting with key
stakeholders)

6. Outcomes and impact
• increased research capacity (e.g. SSB emerged as
a premier social science research organisation,
RAs have authored in international journals,
established researchers, request for training in
qualitative research by NHRC and TU) and South-
South networks
• Invited to review USAID’s 25 programme in
Nepal; professionals organisations involvement in
health services delivery in Uganda
• increased debate on the unintended
consequences of sub-contracting and result-
framework on state capacity and morale of
government staff (e.g. BMJ Global, journal
articles, LSE blog, BBC World/radio, local
newspapers)
• facilitated local ethics research governance
system and process