[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-113014-en":3,"doc-seo-113014-105":29,"detail-sidebar-cat-0-en-105":90},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":13,"seo_description":14,"update_tm":27,"read_time":28},113014,7971461741311,"Ophelia","https://ap-avatar.wpscdn.com/avatar/74000253aff267980c6?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345379180704826",8,"Research & Report","Responding to Aid Volatility - Government Spending on District Health Care in Zambia 2006-2017","A corruption event in 2009 changed how donors supported the Zambian health system, including withdrawal of funding from the district basket mechanism that pooled donor and government resources for primary care. This study examines central-government budgets and actual district-level expenditures for health from 2006 to 2017, adjusting financial data for inflation and disaggregating trends by programmatic area. Funding for district-level primary care more than doubled by 2017, driven by human resources, while operational grants declined.","Public Disclosure Authorized Public Disclosure Authorized  \nAUTHOR ACCEPTED MANUSCRIPT  \nFINAL PUBLICATION INFORMATION  \nResponding to Aid Volatility  \nGovernment Spending on District Health Care in Zambia 2006-2017  \nThe definitive version of the text was subsequently published in  \nGlobal Health Action, 13(1), 2020-02  \nPublished by Taylor and Francis and found at [http://dx.doi.org/10.1080/16549716.2020.1724672](http://dx.doi.org/10.1080/16549716.2020.1724672)  \nTHE FINAL PUBLISHED VERSION OF THIS MANUSCRIPT IS AVAILABLE ON THE PUBLISHER’S PLATFORM  \nThis Author Accepted Manuscript is copyrighted by World Bank and published by Taylor and Francis. It is posted here by agreement between them. Changes resulting from the publishing process—such as editing, corrections, structural formatting, and other quality control mechanisms—may not be reflected in this version of the text.  \nYou may download, copy, and distribute this Author Accepted Manuscript for noncommercial purposes. Your license is limited by the following restrictions:  \n(1) You may use this Author Accepted Manuscript for noncommercial purposes only under a CC BY-NC-ND  \n3.0 IGO license [http://creativecommons.org/licenses/by-nc-nd/3.0/igo](http://creativecommons.org/licenses/by-nc-nd/3.0/igo).  \n(2) The integrity of the work and identification of the author, copyright owner, and publisher must be preserved in any copy.  \n(3) You must attribute this Author Accepted Manuscript in the following format: This is an Author Accepted Manuscript by Jackson, Amy; Forsberg, Birger; Chansa, Collins; Sundewall, Jesper Responding to Aid Volatility © World Bank, published in the Global Health Action13(1) 2020-02 CC BY-NC-ND 3.0 IGO [http://creativecommons.org/licenses/by-nc-nd/3.0/igo](http://creativecommons.org/licenses/by-nc-nd/3.0/igo) [http://dx.doi.org/10.1080/16549716.2020.1724672](http://dx.doi.org/10.1080/16549716.2020.1724672)  \n© 2021 World Bank  \n1 Responding to aid volatility: government spending on district health care in  \n2 Zambia 2006-2017  \n3  \n4 Short running title: Responding to aid volatility in Zambia  \n5  \n6 Authors:  \n7 Ms Amy Jackson Karolinska Institutet, SE-171 77 Stockholm, Sweden;  \n[8 ](8  amy.jackson92@outlook.com)[ amy.jackson92@outlook.com](8  amy.jackson92@outlook.com)  \n9 Associate Professor Birger Forsberg; Karolinska Institutet, SE-171 77 Stockholm, Sweden;  \n10 [birger.forsberg@ki.se](birger.forsberg@ki.se)  \n11 Mr Collins Chansa; World Bank Zambia, Lusaka, Zambia; [cchansa@worldbank.org](cchansa@worldbank.org)  \n12 Associate Professor Jesper Sundewall (Corresponding Author); HEARD, University of  \n13 KwaZulu-Natal, South Africa, and Lund University, [Sweden j](Sweden jsundewall@gmail.com)[sundewall@gmail.com](Sweden jsundewall@gmail.com).  \n14  \n15 Postal Address for corresponding author: Rudbecksgatan 24B, 21617, Limhamn, Sweden  \n16  \n17 Word count abstract: 278  \n18 Word count: 4,222  \n19 Abstract  \n20 Background A corruption event in 2009 led to changes in how donors supported the  \n21 Zambian health system. Donor funding was withdrawn from the district basket mechanism, 22 originally designed to pool donor and government financing for primary care. The withdrawal  \n23 of these funds from the pooled financing mechanism raised questions from Government and  \n24 donors regarding the impact on primary care financing during this period of aid volatility.  \n25  \n26 Objectives  \n27 To examine the budgets and actual expenditure allocated from central Government to the  \n28 district level, for health, in Zambia from 2006 to 2017 and determine trends in funding for  \n29 primary care.  \n30  \n31 Methods Financial data were extracted from Government documents and adjusted for  \n32 inflation. Budget and expenditure for the district level over the period 2006 to 2017 were  \n33 disaggregated by programmatic area for analysis.  \n34  \n35 Results Despite the withdrawal of donor funding from the district basked after 2009, funding  \n36 for primary care alloc","cbCaidQzmCki43Qw","https://ap.wps.com/l/cbCaidQzmCki43Qw","pdf",499439,1,27,"English","en",105,"# Abstract\n## Background\n## Objectives\n## Methods\n## Results\n## Conclusion\n# Background\n## Primary health care and aid effectiveness context","[{\"question\":\"What event triggered changes in donor support for Zambia’s health system?\",\"answer\":\"A corruption event in 2009 led to changes in how donors supported the Zambian health system, including withdrawal from the district basket mechanism.\"},{\"question\":\"What does the study aim to determine from 2006 to 2017?\",\"answer\":\"It examines central-government budgets and actual expenditures allocated to district levels for health and identifies trends in funding for primary care.\"},{\"question\":\"What key findings emerged about primary care funding after the 2009 donor withdrawal?\",\"answer\":\"Primary care funding allocated to the district level more than doubled from 2006 to 2017, primarily due to human resources, while operational grants declined.\"}]",1784498953,68,{"code":4,"msg":30,"data":31},"ok",{"site_id":24,"language":23,"slug":32,"title":13,"keywords":33,"description":14,"schema_data":34,"social_meta":85,"head_meta":87,"extra_data":89,"updated_unix":27},"responding-to-aid-volatility-government-spending-on-district-health-care-in-zambia-2006-2017","",{"@graph":35,"@context":84},[36,53,67],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,47,50],{"item":40,"name":41,"@type":42,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":46},"https://docshare.wps.com/document/","Document",2,{"item":48,"name":12,"@type":42,"position":49},"https://docshare.wps.com/document/research-report/",3,{"item":51,"name":13,"@type":42,"position":52},"https://docshare.wps.com/document/responding-to-aid-volatility-government-spending-on-district-health-care-in-zambia-2006-2017/113014/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":23,"description":14,"dateModified":61,"datePublished":61,"encodingFormat":60,"isAccessibleForFree":62,"interactionStatistic":63},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":40,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-19",true,{"@type":64,"interactionType":65,"userInteractionCount":4},"InteractionCounter",{"@type":66},"ViewAction",{"@type":68,"mainEntity":69},"FAQPage",[70,76,80],{"name":71,"@type":72,"acceptedAnswer":73},"What 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