Are donor allocations for humanitarian health assistance based on needs assessment data?

Donors have agreed to fund humanitarian assistance according to needs. We studied if project applications to a major donor, and the subsequent funding decisions for humanitarian health projects contained needs assessment data. In 2003, a total of 258 million SEK (37 million USD) was allocated by Swedish International Development Cooperation Agency (Sida) to 38 humanitarian health projects. Only 14 applications (37%) had data on the size of the target population while reference to any quantified health needs was found in less than 30% of the funding decisions. In contrast to stated policy, interviews with staff at Sida revealed that needs assessment data had a limited role in the funding decisions, whereas the implementing capacity of the applying agency was of great importance. Our findings suggest that needs assessment data has a very limited role in the decision to fund while other, not clearly defined factors are more important.