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Effect of Participation and Alignment on the Sustainability of Development Aid Output: Evidence from a Field Experiment in Uganda

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Abstract

Most aid project output does not last long after the departure of external donors. This inconvenient truth remains unchanged despite the introduction decades ago of participatory approaches and the alignment of aid content, on the belief that they would cure this problem via the generation of a sense of ownership and the reduction in recurrent costs. To understand this paradox, this study re-examines the impact of participation and alignment on the sustainability of aid project output through a field experiment in Uganda using an aid project that promotes household water treatment and safe storage (HWTS) as an example. The results reveal that the true impact of alignment is negative, while the impact of participation is zero. Specifically, when the aid content is changed from nonaligned to aligned while the use of a nonparticipatory approach is unchanged, the rate of HWTS retention drops by 35.4 percentage points after 2 weeks and by 43.7 percentage points after another 4 months. This finding suggests that at least the unconditional alignment of aid content should be reconsidered to prevent the further deterioration of already unsustainable aid project output.

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Notes

  1. The term sustainability has various connotations when it is used in the context of development aid (Bossert 1990; Kremer and Miguel 2007; Shediac-Rizkallah and Bone 1998; Vallejo and When 2016). However, in this study, I use the term to mean simply the continuation of the project’s output after its completion. This differs from adoption, which refers to the acceptance of activities by recipients during the project period. Adoption is one of the outputs that project inputs are expected to produce automatically. However, adoption means neither consistent implementation (e.g., the exclusive use of equipment) nor sustained implementation thereafter.

  2. The term alignment is used to mean that donors base their overall support on recipients’ own resources, such as development strategies, institutions, and procedures. At the macro level, this implies the use of the recipient country’s financial management and procurement systems by donors without setting up parallel implementation units dedicated to each project. At the micro level, this principle suggests the utilization of local resources and the indigenization of aid content to fit the recipients’ usual way of living. Since this study focuses on sustainability at the micro level, I use the term alignment to refer to the indigenization of aid content. If aid does not contain the use of any unfamiliar, redundant processes in order to achieve its project goals, it is aligned/indigenized. If the goal of the aid can be fulfilled only when recipients follow certain redundant, unfamiliar steps, it is referred to as “nonaligned/nonindigenized.”.

  3. Studies in the field (e.g., in Bolivia, India, Vietnam, Cambodia, Kenya, Zambia, Rwanda, the Democratic Republic of Congo, and Sudan) have confirmed that boiling (Clasen et al. 2008a, b; Psutka et al. 2011), chlorination (Boisson et al. 2013), ceramic filters (Brown et al. 2008; Oyanedel-Craverand and Smith 2008), fiber filters (Boisson et al. 2010; Elsanousi et al. 2009; Lindquist et al. 2014; Rosa et al. 2014), and solar power disinfection (du Preez et al. 2011), if practiced consistently, effectively reduce fecal contamination in drinking water and the prevalence of diarrhea among children under 5 years old.

  4. It is important to distinguish between “active” and “passive” forms of participation based on their substance (de Beer 1996; Lyons et al. 2001; Mansuri and Rao 2004). However, the distinction is hard to apply to actual cases because the answer to substantial questions such as “Who took the initiative?” depends on perspectives and, if not totally subjective, on time variation even within the same project. The difficulty in providing a “substantial definition” of participation has led to a “procedural definition” of participation, on which this study relies.

  5. Study subjects (households) were required to satisfy the following conditions: (a) not have access to a piped water system, (b) not have been practicing point-of-use water purification treatments of any kind, (c) have access to market chlorine tablets, (d) have at least one child under ten, and (e) have no plan to move before the end of the survey.

  6. Randomization was carried out before obtaining informed consent from the potential recipients to preempt the possibility that the households that were aware of all treatments and were supposed to be exposed to a nonparticipatory treatment based on randomization could virtually choose their aid content by withdrawing from the study. In that case, the two nonparticipatory groups would consist of those who remained in the study because they preferred their assigned method to the others.

  7. Charcoal rather than firewood was chosen because charcoal emits less smoke, can be easily distributed, and is received better in suburban areas than firewood. The charcoal and chlorination tablets were purchased locally. This is because the availability of water purification resources is essential for the practice to be continued after the departure of the donor. For the water purification tablets, this study used Aquasafe, manufactured by Hydrachem Limited in the UK and marketed by the Ugandan Health Marketing Group in Uganda. Aquasafe is endorsed by the WHO and the Ministry of Health of the Government of Uganda. One tablet contains 67 mg of sodium dichloroisocyanurate (NaDCC) and can disinfect 20 L of water. Durable items (e.g., a clay stove for boiling and a 20-L jerrycan for chlorination) were added to improve the take-up of chlorination in particular.

  8. Ethical approval for this study was obtained from the Institutional Review Board at Ehime University School of Medicine (1901002), Makerere School of Social Sciences Research Ethics Committee (MAKSS REC 12.18.241), and the Uganda National Council of Science and Technology (SS285ES).

  9. The online appendix includes a detailed comparison with the nationally representative sample from the Uganda National Panel Survey 2015/2016 (n = 3305) regarding the covariates measured in the baseline survey. Uganda Bureau of Statistics. Uganda National Panel Survey (UNPS) 2015–2016, Ref. UGA_2015_UNPS_v01_M. Dataset downloaded from https://microdata.worldbank.org/index.php/catalog/3460/get-microdata on September 26, 2019.

  10. The online appendix includes (1) the results of the block randomization at each water supply point, (2) the sample balance regarding each of the 34 control variables measured during the baseline survey, and (3) the results of the permutation test of the multinomial logit model to predict the three randomly assigned treatment statuses (participatory, nonparticipatory and nonaligned, and nonparticipatory and aligned) with all of the covariates for validation of the randomization (p = .383).

  11. The results do not change even if the event is more strictly defined as the discontinuation of HWTS through the recommended/imposed method, which includes cases in which recipients continue HWTS through other methods. See the online appendix.

  12. These results are reported in the online appendix.

  13. The “neighbor” was defined in various ways by changing the radius from 50 to 300 m at 10-m intervals. The weight given to the neighbors was calculated in three ways: equal weight, the inverse of distance, and the square of the inverse of distance. Plots of the locations of the 192 households, indicating the varying lengths of continued practice of HWTS with different colors, which are reported in the online appendix, show no apparent spatial autocorrelation.

  14. Using mosquito net in fisheries (MNF) is the classic case (Berthe et al. 2019). Another example of the repurposing of donated goods includes the use of chlorine for house cleaning (Ashraf et al. 2010).

  15. One example is an “improved” cooking stove developed in Guatemala, Lorena, which was widely applauded for its simple structure and its use of locally available material (mud and sand). However, lack of reliability quickly led to user dissatisfaction (World Bank 2011).

  16. See the online appendix.

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Acknowledgements

I thank two anonymous referees for their constructive comments. I also thank Constant Okello-Obura for helpful comments on earlier drafts of this article. I am grateful to Nekesa Winny Akullo, Wabuna Harry Okello, Joyce Alice Tabingwa, Mugisha Michael Jude, Eric Melson Haumba, Mariam Akandru, John Alfred Olot Agwanta, Jua Cicily Opious, Ooko Vincent Akumu, and Mubiru Godfray for their assistance in developing and administering the field surveys.

Funding

This research was funded by the Japan Society for the Promotion of Science (KAKENHI Grant No. JP18K11815) and the Murata Science Foundation.

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Mikami, S. Effect of Participation and Alignment on the Sustainability of Development Aid Output: Evidence from a Field Experiment in Uganda. St Comp Int Dev 57, 475–496 (2022). https://doi.org/10.1007/s12116-022-09374-9

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