Experience with Health SWAps


What are the key determinants of success in donor/government Sector Wide Approaches (SWAps), particularly in the Health Sector? What are the institutional, political and contextual pre-requisites that make SWAps a success, particularly in the Health Sector? What are the different models of SWAps that have been used, and with what success?


Experiences with SWAps have shown that they can have a positive impact on improved national ownership and leadership; donor harmonisation and alignment; and greater coherence, transparency and accountability along the policy-result chain. This query examines the key determinants and prerequisites for success in health SWAps. It also looks at the success of different SWAp modalities used in the health sector. Based on a study of six countries (Bangladesh, Ghana, Kyrgyz Republic, Malawi, Nepal and Tanzania), the World Bank’s Independent Evaluation Group (2009) concluded that there are four key success factors which determine a SWAp’s impact on the achievement of national health objectives:

  • Specific, prioritised, phased, and ambitious-but-feasible targets and programs of work (PoW) that assess the political economy of reforms.
  • Adequate systems and capacities are already in place for strategic management, including systems for planning, resource allocation, monitoring, tracking of expenditures and results.
  • Well-defined, well-functioning, complementary and productive partnerships among the actors and stakeholders, both national and international.
  • Reliable, predictable flows of assistance that are efficiently allocated and effectively used.