Development Aid, Effectiveness, and Inequalities in Post-Conflict Societies

This project has studied the relationships between conflict, development, aid and inequalities. Focusing on countries in Sub-Saharan Africa, the project has addressed two key knowledge gaps through qualitative and quantitative methods. First, it examined how aid flows shape development outcomes, and how this relates to issues of equity. The research covers a broad spectrum of objectives, including how aid affects political dynamics, health service delivery and outcomes, and community coping capacity in the face of climate change. Second, given the increased focus on inequality as a development concern, and the move towards making concrete objectives related to addressing inequality in the UN's SDGs, we examine to what extent aid is responsive to inequity and marginalization, and how donors' strategic approaches to aid disbursement are shaped by the debates around equity in development. Political economy of development Aid has a clear impact on the political economy of development, but we know little about how this operates at the local level. Isaksson & Kotsadam (2018a) examined the role of aid in local-level corruption and found that the effects differed by who the donor was, suggesting that different norms surround the use and accountability of aid flows. At the local level, Chinese aid appeared to increase corruption, but not increase local economic activity. Conversely, areas with World Bank aid saw increases in economic activity with no evidence of corruption. Furthermore, results consistently indicated that Chinese development projects discourage trade union involvement in the local area (Isaksson & Kotsadam 2018b). Finally, while aid allocation within countries is sometimes thought to be used strategically by incumbents, Knutsen & Kotsadam (2020) find no evidence of aid being unduly directed to areas of incumbent support. Health Outcomes This project has looked at the effects on health outcomes particularly at the local level. Kotsadam et al. (2018) examine how aid affects infant mortality at the subnational level in Nigeria. They find that living closer to aid projects reduces infant mortality. Also, local aid projects appear to reduce systematic inter-group inequalities. Similarly, Tollefsen et al. (2019) examine the local effects of aid on under-5 mortality in post-conflict countries, finding that areas with aid see lower rates of child mortality, and that this effect is stronger in locations that have recently experienced armed conflict. Tollefsen & Østby (2019) examine aid via refugee camps on local populations' health outcomes. They find that living closer to a refugee camp increases likelihood of births at health facilities among host populations, suggesting the presence of refugee populations can improve health outcomes for local populations. Rustad et al. (2020) examine how ODA enables communities to cope with effects of drought. They find that prior aid at the local level is associated with significantly reduced weight loss among children under 5. Development Aid and inequalities One key focus is understanding how aid flows shape patterns of equity and inequality; and how issues of fairness shape donors strategic programming. Rustad et al. (2019) find that World Bank aid is allocated less often to areas with politically excluded groups, while aid from "progressive" bilateral donors is dis-proportionally allocated to the same areas. These results suggest that the geographical allocation of aid links with donor priorities, with the World Bank more sensitive to the political agendas of the countries in which it operates, while allocations made by the Nordic countries, Canada and the Netherlands are more reflective of the political agendas in their home countries. Chi et al. (2019) look at donors' considerations of equity in the allocation and distribution of aid in Northern Uganda. Findings suggest there remains groups that are underserved and untargeted by major donors due to lack of clarity over the concept of equity, local level corruption, and political interference in choice of aid location from government officials and donors. In Ethiopia, Degefe & Hoelscher (2019) examine how issues of equity are understood by donors. While donors are aware of this, , issues of financing, human and institutional capacity are undermining the equitable provision of health services, particularly in rural areas. Finally, Hoelscher (2019) reviews strategic documents from 6 bilateral and multilateral donor organizations over the past 2 decades to understand how donors conceive of inequality related to aid and development. The discussions of inequality have increased in the post-MDG era but have largely focused on gender issues. While inequality is seen as a development issue, this has not translated at scale into specific policy or programming action; nor has there been considerable reflection on how aid may shape or exacerbate patterns of inequality.

The findings of this project can promote an increased focus on how to transfer norms on inequality and equity in the development debate to strategic programming. The findings that local aid seems to have a positive effect on health outcomes, and that it is not only health but aid in general that is important. This can inform policies on where and what type of aid should be implemented. Finally, the findings that "traditional" aid seems to mitigate risks of climate change (drought) can help quid policies for climate mitigation and adaptation aid.

Despite decades of development assistance (DA), it is unclear how well DA works to improve human security and development; and whether it may even exacerbate exclusion and conflict. This project studies mechanisms linking DA and inequality, and how this affects development. We focus on the health sector in Sub-Saharan Africa in three conflict-affected countries: Ethiopia, Nigeria, and Uganda. The project adopts a mixed methods approach, combining qualitative fieldwork with quantitative analysis using unique localized aid, health, and conflict data. We conduct statistical analyses based on Demographic Health Surveys (DHS) and new geocoded aid data to assess how inequalities shape patterns of distribution; and how aid affects inequalities between individuals and groups. This is supported by qualitative interviews with key stakeholders; a health project impact assessment; and user-group surveys to understand project effectiveness and impacts on real and perceived inequalities. We collaborate with local and international stakeholders and donors on the ground. By variously focusing our unit of analysis on individuals, organizations, sub-national regions, and states, we will provide cross-cutting, actionable lessons for policy for international stakeholders. Supporting FRIPROs three primary objectives of scientific quality, innovation and career development, we extend the theoretical and empirical state-of-the-art on links between aid and inequality, and create opportunities for junior researchers. Host institution is the Peace Research Institute Oslo (PRIO), partnering with the Economic Policy Research Centre (EPRC), Makerere University, Kampala (Uganda); Center for Population Studies at the University of Addis Ababa (Ethiopia); and Port Harcourt University (Nigeria). Expected project outputs include 7 to 9 academic articles, policy briefs, a final policy report, an international policy conference, and training workshops for south partners.