Development partner influence on domestic health financing contributions in Senegal: a mixed-methods case study

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http://eprints.org/relation/isVersionOf https://pure.iiasa.ac.at/id/document/109090 http://eprints.org/relation/isVolatileVersionOf https://pure.iiasa.ac.at/id/document/109090 http://eprints.org/relation/issmallThumbnailVersionOf https://pure.iiasa.ac.at/id/document/109090 archive 353 disk0/00/02/04/36 2025-03-10 08:59:01 2025-03-12 05:01:03 2025-03-10 08:59:01 article show Federspiel F. Borghi J. 9448 0000-0002-0482-5451 Mbaye E.M. Jensen H.T. Martinez Alvarez M. Development partner influence on domestic health financing contributions in Senegal: a mixed-methods case study pub ASA SYRR Senegal; development assistance; donors; equity; external development partners; health financing; interviews Sustainable and equitably contributed domestic health financing is essential for improving health and making progress towards Universal Health Coverage (UHC) in low- and middle-income countries. In this study, we explore the pathways through which development partners influence the combination of domestic health financing sources in Senegal. We performed a qualitative case study that comprised 32 key stakeholder interviews and a purposive document review, supplemented by descriptive statistical analysis of World Health Organization and Organization for Economic Cooperation and Development data on health financing sources in Senegal. We developed a novel framework to analyse the different mechanisms and directions of development partner influence on domestic health financing contributions. We identified development partner influence via four mechanisms: setting aims and standards, lobbying/negotiation, providing policy/technical advice, and providing external financing. Overall, development partners worked to increase tax-based government contributions and expand Community-Based Health Insurance (CBHI), which is seemingly equity enhancing. Fungibility and intrinsic equity issues related to CBHI may, however, limit equity gains. We encourage stakeholders in the health financing sphere to use our framework and analysis to unpack how development partners affect domestic health financing in other settings. This could help identify dynamics that do not optimally enhance equity and support progress towards UHC to help achieve more coherent policy-making across all domains of development partner activities in support of UHC. Future research should investigate the role of international creditors, lending, and loan conditionalities on domestic health financing in recipient countries, including equity implications. 2024-04 published doi:10.1093/heapol/czae110 3380 public Health Policy and Planning 40 3 300-317 TRUE 1460-2237 no info:eu-repo/semantics/article