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Who benefits from demand‐driven distribution of HIV/AIDS services? An analysis of the emerging CBO sector in Malawi
Author(s) -
Schou Arild
Publication year - 2009
Publication title -
public administration and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 44
eISSN - 1099-162X
pISSN - 0271-2075
DOI - 10.1002/pad.520
Subject(s) - accountability , distribution (mathematics) , elite , business , economic growth , capacity building , public administration , public relations , political science , economics , politics , mathematical analysis , mathematics , law
Community‐based organisations (CBOs) play a key role in Malawi's multi‐sector programme for responding to the HIV/AIDS pandemic. In this programme they are funded in a demand‐driven manner—which means that only those areas that apply for funds to CBO services are blessed with programme benefits. This paper argues that this funding mechanism is not conducive to either distributing CBO services to areas most in need or enhancing downward accountability. Because areas most in need of services generally also lacked the capacity to attract project funding, the programme did not reach them. Instead, it tended to reach those areas with the greatest capacity to attract funding, though not necessarily the greatest need for it. Furthermore, those CBOs that were funded were unable to facilitate collective action in their communities because of elite capture of decision making. The programme, however, was relatively responsive to the communities' thematic demands. Thus, all in all, the elites were relatively more successful in representing the communities' wishes than in caring for all geographical areas in their constituencies. Copyright © 2009 John Wiley & Sons, Ltd.