Is there a strategy in China’s health official development assistance to African countries?

Abstract

Chinese health official development assistance (ODA) to Africa has largely increased since the beginning of the 2000’s. Even if China now ranks among the top ten bilateral donors for health aid in Africa very little is known about the determinants of Chinese health ODA to African countries. Our objective is to study the factors associated with Chinese health ODA to sub-Saharan Africa in the 2000-2013 period. We investigate the role of three types of factors that might influence the allocation of Chinese health aid: the needs of recipient countries, their merits and the self-interest of China. Chinese health ODA is measured using the 1.2 version of the AidData database constructed by the William & Mary University, the Brigham Young University and the non-governmental organization Development Gateway. In total, 389 health aid projects were financed by China in Africa between 2000 and 2013, accounting for a total amount of 2011 US$789 million. On these 389 projects, 194 (59%) correspond to the dispatch of medical teams, 109 (24%) to the sending of medical equipment or drugs and 77 (16%) to health infrastructure construction or rehabilitation. The annual number of health projects financed by China in Africa has increased sharply after the 3rd Forum on China-Africa Cooperation (FOCAC) in 2006. We study the factors associated with the number of health projects and the amount of ODA received each year by African countries between 2000 and 2013. We stratify the analysis by types of projects (medical team dispatches/infrastructure and medical equipment or drugs projects) and by sub-periods (2000-2006/2007-2013). We use Poisson regressions to estimate both the number of projects and the amount of ODA received as Poisson regressions were shown to outperform OLS and Tobit models in the presence of heteroskedasticity and many zero observations. Pooled regressions, rather than fixed effect regressions, are used in order to exploit both inter and intra-coun