The main goal of this doctoral thesis was to measure differences in speech intelligibility between older and younger hearing-impaired people and to establish the factors influencing the effectiveness of the use of hearing aids in the elderly. We focused on three related areas: 1/ To measure how the magnitude of difference of hearing and speech intelligibility in silence differs between younger and older populations, with a similar degree of hearing loss, in terms of word audiometry. 2/ To establish how speech intelligibility in competitive noise differs between younger and older populations with a similar degree of auditory defect, in terms of the Czech Test of Sentence Intelligibility in Babble Noise. 3/ To establish which factors affect the effectiveness of hearing aids for seniors, the motivation for the acquisition and regular use of hearing aids, and whether these factors correlate with age or lifestyle. Methodology 1/ A group of 143 hearing aid users was divided into young (N = 60, mean age 15,9 y.) and seniors (N = 83, mean age 83,6 y.). For these two age groups we compared the differences between SRT values (understanding in word audiometry in silence, in the free field) and PTA values (hearing threshold in pure tone audiometry). 2/ A group of 423 persons, examined using the Test of...

This study investigates the relationship between official development assistance (ODA) and human development indicators (HDIs) in 49 sub-Saharan African countries over the period of 1995 to 2017 using 3-stage least squares (3SLS). The four key sub-classes of HDIs considered for this research include education, health, government and civic society, as well as environmental indicators. Of all these HDIs, the results of the analysis show that health aid is the most effective form of aid, significantly reducing the incidence of HIV, the infant mortality rate and the maternal mortality rate, as well as leading to improved life expectancy. Education aid has a significant effect on the progression to secondary school followed by adult literacy rates. Government and civil society aid significantly affects the ability of girls to access education at primary, secondary and tertiary levels while environmental aid is found to increase the carbon efficiency of production. Hence, this study demonstrates that aid is most effective on the health, education and environmental human development indicators.

Ownership is a guiding principle in today’s development cooperation practices, aiming to foster an efficient development cooperation driven by the recipients. However, ownership is paradoxical and ambiguous. No coherent understanding of ownership exists. The multistakeholder development cooperation arena is argued to complicate the recipients’ possibilities to acquire ownership. As the literature lacks an eastern European perspective, this study addresses the above-mentioned dimensions by examining ownership in Swedish development cooperation with Ukraine. By conducting interviews, this study confirms that there is a confusion among development actors in defining what ownership is. In contrast to previous research, this study finds the multi-stakeholder approach as an advantage of ownership. Collaboration between local actors can contribute to capacity development, joint commitment and stronger responsibility, which increases the probabilities that outcomes of development projects will be governed and progressed by the local actors in the long run. Hence, this study contributes to the literature with a more clarified understanding of ownership. Ownership is perceived as a relational concept that is dynamically promoted over time. This study concludes that commitment, capacity and participation are dimensions that can promote this myriad of local actors involved in development practices to acquire a multi-actor ownership of different dimensions of the development process.

Diese kumulative Dissertation besteht aus drei Abschnitten.                                 I. Geopolitics, Aid and Growth Wir untersuchen den Effekt kurzfristiger politischer Motive auf die Effektivität von Entwicklungshilfe. Dabei testen wir, ob der Effekt der Hilfe auf Wirtschaftswachstum reduziert wird durch den Anteil der Jahre während der Hilfsvergabe, die ein Land temporäres Mitglied des Sicherheitsrates der Vereinten Nationen war. Diese Mitgliedschaft sorgt für eine quasi zufällige Variation in der Höhe der vergebenen Hilfsgelder. Unsere Ergebnisse zeigen, dass der Zusammenhang zwischen Hilfe und Wachstum schwächer und niedriger ist für Hilfe, die während der temporären Mitgliedschaft vergeben wurde. Unsere zwei Schlussfolgerungen sind: Erstens, der Einfluss politischer Motive untergräbt die Effektivität der vergebenen Hilfsgelder. Zweitens, Variablen die politisches Interesse widerspiegeln sind ungeeignet als ökonometrische Instrumente für Entwicklungshilfe. Dies weckt Zweifel an einer großen Anzahl existierender Forschungsergebnisse. II. Is there a Home Bias in Sovereign Ratings? Kreditratingagenturen werden oftmals für angeblich verzerrte Länderratings kritisiert. Dieser Abschnitt diskutiert, wie das Heimatland einer Ratingagentur deren Ratingentscheidungen aufgrund polit-ökonomischer Einflüsse und kultureller Unterschiede beeinflussen kann. Mithilfe von Daten über neun Agenturen aus sechs unterschiedlichen Ländern testen wir, ob die Agenturen bessere Ratings an ihr Heimatland oder mit ihnen ökonomisch, politisch oder kulturell verbundene Länder vergeben. Unsere Ergebnisse liefern Belege für die Existenz einer Verzerrung zugunsten des jeweiligen Heimatlandes, kulturell ähnlicher Länder, und von Ländern, in denen die Banken des Heimatlandes größeren Risiken ausgesetzt sind. Dabei scheint die linguistische Ähnlichkeit der Sprache die Haupterklärung für den gemessenen Vorteil des Heimatlandes zu sein. III. Crime, Incentives and Political Effort: A Model and Empirical Application for India Der große Anteil an Politikern, gegen welche kriminelle Vorwürfe erhoben werden, hat eine öffentliche Debatte und eine Literatur über dessen Gründe und Auswirkungen ausgelöst. Um die Auswirkungen von Kriminalität abzuschätzen, entwickeln wir ein Modell über die Anreize, welchen Abgeordnete ausgesetzt sind wenn sie entscheiden ob sie sich für ihren Wahlkreis engagieren sollen. Wir nutzen drei direkte und gut messbare Maße für das Engagement der Abgeordneten in der vierzehnten Lok Sabha während der Legislaturperiode von 2004-2009: Anwesenheitsquoten, Aktivität im Parlament und die Nutzungsrate eine Fonds für lokale Entwicklungsprojekte. Die Ergebnisse legen nahe dass kriminelle Abgeordnete im Schnitt ungefähr 5% niedrigere Anwesenheitsquoten haben, und niedrige Nutzungsraten des Fonds, aber sich nicht bezüglich der Aktivität im Parlament unterscheiden. Diese Unterschiede hängen vom ökonomischen Entwicklungsstand des Wahlkreises, einem Proxy für Möglichkeiten illegale Renten zu extrahieren und für die Intensität der Überwachung des Abgeordneten durch die Wähler, sowie von der Definition von Kriminalität ab. Wir nutzen beobachtbare Kontrollvariablen, Matchingtechniken und „Treatment Effect“ Regressionen, um zu zeigen, warum diese negativen Koeffizienten eine Obergrenze für den tatsächlich wohl noch größeren negativen Zusammenhang darstellen. Darüber hinaus analysieren wir, warum es unwahrscheinlich ist, dass Selektionsprobleme aufgrund unbeobachtbarer Einflussfaktoren unsere Ergebnisse vollständig erklären können.

La ricerca considera il problema dell'effettività dell'aiuto pubblico allo sviluppo secondo una prospettiva istituzionale. Nello specifico,la sostenibilità di accordi cooperativi tra donors and recipients viene considerata con riferimento a modelli istituzionali teorici. Il sistema di incentivi che determina la natura della relazione d'aiuto nel caso del General Budget Support è inoltre considerato con riferimento alla più recente prassi sviluppatasi in Tanzania. / The researches considers that issues that are inherently connected with the type of donor-recipient relationship affect the productivity of aid. This is mainly because incentives embodied in the relation shape party behaviours. The basic elements that characterized the aid relationship and the incentives that aid organization face, are in fact altered according to the institutional set in which money flows. Different aid modalities bear in themselves the potential of acting on the aid relationship by changing the basic rules of the game. General Budget Support (GBS), as a new aid modality represents quite an interesting institution. Getting the “incentives” right for cooperation, in such a context, would imply a rethinking of the basic theoretical model and organizational features on the ground of the evolving practices and specific technology of provision. The research aim is opening a route of possible investigation into the dynamics of incentives related to international cooperation at country level. Tanzania has been chosen among a series of possible cases study as in the Sub Saharan Africa panorama it represents one of most successful cases of GBS implementation. The analysis is grounded on a general institutional analysis that puts at the centre of observation the structure of the negotiations between the group of donors and the recipient government. The framework employed represents an adaptation of the Institutional Analysis for Development. The purpose of understanding the set of explicit and hidden motivations is functional to better delineate the contractual set in which the bulk of relations takes place.Results obtained from the empirical analysis are considered in a theoretical fashion with the purpose of generalizing on the main structural change caused by GBS on the donor-recipient relation. Concepts are taken from NIE and organizational theory to study the governance structure of aid relations.

Program utvärderingar utgör till stor del grunden till det formella lärandet inom Sida (Swedish International Development Cooperation Agency). Utvärderingars syfte är att bistå med kunskap och Utvärderingar ska garantera att insatser är baserade på god förståelse om verkligheten i mottagarländerna. Genom att gynna organisatoriskt lärande förmodas utvärderingar bidra till biståndets effektivitet (Stefan Molund, 2004).   Teorier om den lärande organisationen hävdar att organisationers fall beror på medlemmars tendens att förenkla och misstolka verkligheten. Medvetet eller omedvetet leder detta till att organisationens vision försvagas, medlemmars engagemang försvagas och den verklighet man sökt att förändra förblir den samma (Peter M. Senge, 1994).   Genom att bistå sektorer som hälsa, utbildning och demokrati mm. har det svenska biståndet präglats av en objektiv eller positivistisk syn på verkligheten i utvecklingsländer. Insatser inom hälsa leder onekligen till effektivitet i fattigdomsbekämpningen.   Min uppsats visar hur Sidas strävan efter objektivitet löper risken att försvaga organisationens vision. I de fattigaste och mest socialt komplexa utvecklingsländerna finns inte förutsättningarna[1] för objektiv utvärdering, och resultaten av en utvärdering blir ofta öppna för olika tolkningar. Trots att utvärderingarna skildrar en sann bild av verkligheten så leder detta till frustration hos handläggare. Resultatet blir att utvärderingar görs av program som handläggarna redan har god kunskap om. Mitt resultat visar att denna trend successivt försvagar Sidas vision då insatser ämnade åt att öka effektiviteten i biståndet allokeras från de ”fattigaste länderna” till länder som kommit längre i utvecklingsprocessen. [1] De “fattigaste” utvecklingsländerna saknar de institutioner för datainsamling som krävs för objektiv utvärdering. Att skapa förutsättningarna för den kostnadseffektiva objektiva utvärderingen i utvecklingsländer är ett utvecklingsmål som vilket annat som ingår i den övergripande fattigdomsbekämpningen. / Presentation har ägt rum

My dissertation is an advocacy of the idea that if aid proved to be ineffective, it is partly because of the donor and not only the recipient as it is usually argued. The thesis contributes to the theoretical and empirical literature on aid effectiveness and explores the ability of aid to achieve its goals in the presence of both incentives and informational problems. <p>The thesis consists of three essays dealing with a particular aspect of donor policies that may impact the effectiveness of aid: i) the drivers of aid allocation among recipient countries, ii) ex-post conditionality and the role of reputation in inducing compliance with aid contracts; iii) and finally, the optimal choice of aid modalities.<p>The first chapter investigates the drivers of U.S. aid policy. <p><p>I find considerable evidence that the pattern of aid is dictated as much by political and strategic considerations, as by the economic needs and merit of the recipients. Most importantly, inertia seems to impact heavily the aid allocation process. Any of these motivations, when excessive, would lead to a time inconsistency situation where the donor is not credible in his conditionality. With such an impact on aid allocation, the question arises on the effectiveness of conditioning aid provision on political, social, or economic reforms. This is precisely the scope of chapter 2.<p><p>The second chapter investigates the conditions under which reputation can serve as commitment device in order to induce donors of development aid to enforce aid contracts and recipients to comply with such contracts. The idea is that the success of conditionality rests solely on the availability of a commitment technology that ties the hands of the donor. Reputation concerns could create the required incentives and overcome the altruism effect on the donor side.<p><p>Notwithstanding that incentive creation must not be driven by the volume of aid only, but also by the way it is channelled, i.e. aid modality. This is particularly relevant for recipients with certain characteristics. Depending on the preference alignment of the donor and the recipient, the information structure in place, the optimal aid modality can change. The characteristics of the optimal aid package are investigated in chapter 3. Optimality imposes a mix of fixed project and financial transfer to recipient countries. The transfer can be negative for countries exhibiting a high willingness or ability to redistribute to the poor. This is interpreted as a contribution to the financing of the infrastructure project. The extent of the project (large or small size) is determined by the interest of government for the poor in the recipient country.<p> / Doctorat en Sciences économiques et de gestion / info:eu-repo/semantics/nonPublished

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its intended effects. The second paper examines the influence of health aid on malaria service utilization in Malawi. It tests the hypothesis that health aid boosts a facility’s readiness to provide malaria services, thereby increasing the utilization of malaria services in a facility’s service area. Findings indicate that while increased health aid is associated with increased health facility readiness to diagnose malaria, these improvements are not generally related to increased health care utilization. The final project focuses on population level health effects of health aid placement in the Democratic Republic of the Congo, specifically whether all‐cause child mortality is lower in regions receiving malarial aid interventions. Among the most promising evidence xi found on the potential benefit of health aid is that investments, such as malaria bed nets, are associated with reductions in child mortality, particularly in rural settings and among those with low malaria burden. These latter findings suggest health aid should be carefully targeted and should consider local disease risks to fully realize the benefits of population‐level improvements in child health. When taken together, my findings indicate that health aid is positively associated with limited improvements in health outcomes. Overall, these results support a need for researchers to avoid the temptation to aggregate aid flows and health outcomes at the country level, and instead examine sector‐specific aid flows at the lowest sub-national geographic unit possible in order to inform policies designed to allocate health aid.

In an attempt to improve the effectiveness of aid, many of the stakeholders in the international aid regime agreed to commit to five key principles in the Paris Declaration (PD) in 2005. These principles of ownership, alignment, harmonisation, managing for results and mutual accountability were aimed at improving the effective delivery and use of aid, although the Declaration has been followed by continuing doubts over aid effectiveness, especially in the context of deficiencies in donor cooperation and coordination and weak recipient ownership. Since the PD, donors have made varying efforts when it comes to implementing the Paris requirements towards greater aid effectiveness. However, after two OECD DAC monitoring surveys, in 2006 and in 2008, donors and recipients found out that the overall result of the progress of the implementation has been slow and that donor behavioural change towards implementing the PD has differed. In the light of this, this research aims to examine how donors have implemented the PD and why there are such differences in donor behaviour based on a comparative study of Sweden, the United Kingdom (UK), South Korea and China in Tanzania. This thesis reveals that there are key differences between advanced donors (Sweden and the UK) and emerging donors (Korea and China), particularly in terms of their levels of behavioural change in implementing the PD. While Sweden and the UK have shown greater progress in implementing many of the protocols of the PD, Korea and China have barely implemented the Paris requirements. The findings of this research highlight that the uneven responses and outcomes of the PD implementation are due to the design of the PD, which was based on the existing aid delivery mechanism of traditional donors at its top level, and the Paris requirements have not considered the bottom level reality of emerging donors who have different aid mechanisms from traditional donors. By examining seven major factors which inform the uneven donor performance (aid amount and number of staff, aid history of donors, political commitments, action plans and country specific strategies, aid management systems, aid modalities, and monitoring and evaluation), this study argues that the PD has been an 'easy option' for traditional donors such as Sweden and the UK, while it requires radical changes for emerging donors such as Korea and China. While this research relies on the public policy implementation theories to explain uneven donor behaviour in the PD implementation process, there has been less focus on the political economy and the self-interests and motivations of donors, which remains a main limitation of the study. Given this, this research has suggested conducting a further study on donor behaviour with a new methodological focus on the political economy and donor self-interests.

New Public Management has been the prevailing governance model in public sector administration since the late 1980s. In 2005, OECD-DAC member states adopted the resultsbased management model ‘Paris Agenda for Aid Effectiveness’, building on new public management theory and values. The aim was to achieve more effective aid by coordinatingand harmonising donor efforts, aligning development interventions and funding, supporting national ownership and propelling a result- and accountability culture by demonstrating achievements.Despite its worthy ambitions the Aid Effectiveness Agenda has paradoxically failed todeliver on its own outcomes. The results-based management framework underpinning theagenda has proven to be highly complex in methodology, interpretation and application. The framework is laborious and burdensome, diverting time from ‘ordinary’ work and risking a bureaucratization of the development aid sector. The ‘measurement fever’ has grippeddonors and agencies alike, and is now mainly driven by donors’ domestic accountability concerns, rather than the real needs of developing countries. More alarmingly, it has not onlyhad numerous unintended consequences but also outright adverse effects. This in turnen dangers long-term human development.This study sets out to explore to what extent the results-based management framework, based on new public management theory, has been a suitable management model to achieve aid effectiveness in the development aid sector. It departs from the governance theories of Denhardt and Denhardt (2000) and assesses whether New Public Service couldbe a fitting alternative governance model. The study utilizes the realist review methodology,specifically the CMO-configuration, in order to explore how context and mechanisms interact and how this affects the outcome. This study has through its aggregative and configurativeambition explored 26 scholarly articles in the time frame of 2011 to 2021 in order to draw conclusions.The review has found that the results-based management framework does not support the underlying theory of change that is imperative to achieve the Aid Effectiveness Agenda.Contextual factors are found to impede implementation, although due to being under research edit is difficult to determine to what extent. Further, none of the five mechanisms ofthe Paris Declaration can neither fully nor partially be said to contribute to ‘aid effectiveness’as defined in the Aid Effectiveness Agenda. Rather, the review has found that the literatureall point to numerous adverse effects of its implementation.This study concludes that the New Public Service governance model, at least intheory, could prove to be a more suitable management model for the development aidsector. Since the sector is neither linear nor predictable as the business sector for whichthe framework was developed, it is not surprising that adverse effects abound. Especiallysince the development aid sector is highly complex with a multitude of actors, politicalincentives and not least challenging implementational environments. In contrast, New Public Service places the citizen at the centre and aspire at buildingdemocratic citizenship and community through citizen participation and dialogue. Such analternative governance model built on democratic theory and participative epistemologyhas the potential to democratize governance practices by replacing the vertical top-downprincipal-agent dynamics of new public management with more horizontal forms of citizeninvolvement, co-determination and mutual accountability. New Public Service stresses the‘serving not steering’ aspect of governance, which would open up for a more authenticdiscourse of recipients owning development in their own society and setting the direction.No systematic review has previously been carried out to assess governance models inrelation to achieving the Aid Effectiveness Agenda. In fact, there is very little research onwhat has worked or not regarding the agenda. This thesis sets out to fill this gap and tocontribute to the discussion of governance models on a theoretical level. It is also anempirical contribution to applied development management regarding insights about whatcontexts and mechanisms affect aid effectiveness.