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This commentary explores the challenges posed by donor-driven health interventions in low- and middle-income countries.

December 23, 2025Jurnal Administrasi Kesehatan Indonesia0 citationsOpen Access

When Donors Set the Direction: Limits of Project-Based Health Interventions in Lmics – Lessons From Indonesia

Key Points

This commentary explores the challenges posed by donor-driven health interventions in low- and middle-income countries.
Analysis of project-based health interventions in LMICs
Case study of Indonesia
Review of donor funding impacts
Project funding often ends, leading to unsustainable health programs
NGOs contribute to fragmented health service delivery
Community ownership remains low due to donor dependency

Abstract

Health development in many low- and middle-income countries (LMICs) tends to be driven by donor-driven pilot projects frequently framed as innovative and scalable solutions. However, these programs typically disappear once external funding ends, resulting in the failure to achieve sustainability and long-term impact. This commentary explores the limitations of project-based development in LMICs, highlighting how shifts in the global aid architecture create complex pressures on recipient countries. Indonesia serves as a case study to illustrate how the proliferation of non-governmental organizations (NGOs) and competition for donor funding have led to fragmented implementation, donor-dependent strategies, and low levels of community ownership. Keywords: Donor-driven development, health program sovereignty, Indonesia, NGOs

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