Health Policy Project

The Health Policy Project has ended, but work continues under a new USAID five-year project, Health Policy Plus (HP+).

Country Ownership

Health and Education Policy Project/Guatemala 



“Country ownership” broadly refers to the end-point in a transition from a donor-led development process to one that is managed entirely by in-country stakeholders. During this transition, key stakeholders—primarily the government, nongovernmental organizations (NGOs), the private sector, and civil society—begin to take the lead in drafting and monitoring development plans and priorities, coordinating aid, and using country health systems for aid delivery.

Donors and governments support the concept of country ownership, but their policies and actions often limit full participation by civil society organizations (CSOs). Ideally, CSOs should be involved at every level of the development process (planning, finance allocation, implementation, and monitoring of both program outcomes and finances). Many CSOs make valuable contributions by tracking funding allocations, monitoring the quality of care in service delivery systems, and advocating for policies that expand access to services for marginalized or vulnerable populations. However, many CSOs are shut out of the consultation process, and some even struggle to be permitted to operate. The intensity of civil society participation remains largely context-specific and a function of how receptive governments are to civil society.

What We Do

The Health Policy Project (HPP) advances country ownership of investments in health programs and systems. We help country governments to

  • Provide the open communication and political freedom necessary for CSOs to operate effectively in their implementation and advocacy roles
  • Ensure adequate financial allocations for health services—both from domestic and external sources
  • Effectively monitor program outcomes and expenditures
  • Use monitoring data to provide feedback to health system stakeholders to inform strategic planning
  • Remain responsive to the needs of societies, including the most vulnerable populations
  • Respect commitments made in international agreements
  • Eliminate corruption

We work with development partners to

  • Align programs and funding with country-defined plans and priorities
  • Transparently provide long-term financing, including funds for country-driven technical support for government and civil society
  • Use country systems to the extent possible, and strengthen them when it is not (including health systems as well as consultations, monitoring, and reporting structures)

HPP builds the capacity of civil society organizations, a key ownership strategy, to

  • Increase their effectiveness
  • Represent the needs of communities, including people living in poverty, people living with HIV, women, children, and other vulnerable populations
  • Work in partnership with donors and governments to identify and address gaps in capacity
  • Hold governments and donors accountable, while also being accountable for their own contributions to health and development

We also work with the international community to

  • Continue developing ways to measure country ownership, particularly its participatory nature
  • Develop and share best practices of country ownership at the national and health sector and sub-sector levels

Publications and Resources

Costed Implementation Plans for Family Planning
The Health Policy Project, with various partners, has developed a collaborative, 10-step approach to creating a CIP that aligns with ongoing government planning and coordination efforts. This brief outlines these 10 steps, which when implemented, should result in a consensus-driven strategy, roadmap, and budget for achieving family planning targets under the Ouagadougou Partnership, FP2020, and/or other national programs

HIV/AIDS and Sexual Reproductive Health Among University Students in Ethiopia: A Policy Intervention Framework
In Ethiopia, the Health Policy Project (HPP) is supporting the Federal HIV/AIDS Prevention and Control Office and higher education institutions (HEIs) to prioritize and target HIV interventions in HEI settings.

Advancing Country Ownership: Civil Society's Role in Sustaining Public Health
This report examines civil society’s role in sustaining public health and transitioning to the country ownership model, and offers recommendations for civil society, governments, donors, and international development partners.

Brief: Accountability and Transparency for Public Health Policy: Advancing Country Ownership
HPP prepared this brief to provide leaders of civil society organizations working in family planning, HIV care and treatment, and maternal health with guidance on ensuring good governance, social accountability, and transparency.

Brief: Networking and Coalition Building for Health Advocacy: Advancing Country Ownership
This brief provides leaders of civil society organizations with guidance on working within networks and coalitions to advocate for improved family planning, HIV care and treatment, and maternal health policies and programs.

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The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. The project's HIV-related activities are supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group, in collaboration with Plan International USA, Avenir Health (previously Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and White Ribbon Alliance for Safe Motherhood (WRA). The information provided on this Web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.

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