Stakeholder Incentives and Aid Effectiveness – A Case Study in the Health District of Kayes in Mali

Abstract: This case study analyses how far donors implement aid effectiveness principles at the health district level in Mali, and why. It shows that not all aid effectiveness principles are implemented at a similar degree. Most projects have limited impact on health services, but many programmes supported by donors offer positive opportunities for health system strengthening. The representations of different categories of stakeholders diverge – notably, regarding the role of different actors in service provision. A number of consistent strategic logics influence actors’ behaviour. We show that while many donors have committed at global level to respect aid effectiveness principles, implementation lags behind.