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Do Sector Wide Approaches for health aid delivery lead to ‘donor-flight’? A comparison of 46 low-income countries


  • Sweeney, Rohan
  • Mortimer, Duncan
  • Johnston, David W.


Sector Wide Approaches (SWAp) emerged during the 1990s as a new policy mechanism for aid delivery. Eschewing many features of traditional project-based aid, SWAps give greater control of aid allocation to recipient countries. Some critics have questioned whether reducing a donor's level of influence over aid allocation might lead to a decrease in donor contributions. While some qualitative evaluations have described the level of fund pooling and donor participation in SWAps, no previous study has empirically examined this potential ‘donor-flight’ response to health SWAp implementation. This paper utilises a uniquely compiled dataset of 46 low-income countries over 1990–2009 and a variety of panel data regression models to estimate the impact of health SWAp implementation on levels of health aid. Results suggest that amongst 16 especially poor low-income countries, SWAp implementation is associated with significant decreases in health aid levels compared with non-implementers. This suggests donors are not indifferent to how their contributions are allocated by recipients, and that low-income countries considering a SWAp may need to weigh the benefits of greater control of aid allocations against the possibility of reduced aid income.

Suggested Citation

  • Sweeney, Rohan & Mortimer, Duncan & Johnston, David W., 2014. "Do Sector Wide Approaches for health aid delivery lead to ‘donor-flight’? A comparison of 46 low-income countries," Social Science & Medicine, Elsevier, vol. 105(C), pages 38-46.
  • Handle: RePEc:eee:socmed:v:105:y:2014:i:c:p:38-46
    DOI: 10.1016/j.socscimed.2013.12.026

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    3. Maame Esi Woode & Duncan Mortimer & Rohan Sweeney, 2021. "The impact of health sector‐wide approaches on aid effectiveness and infant mortality," Journal of International Development, John Wiley & Sons, Ltd., vol. 33(5), pages 826-844, July.
    4. Hennessy, Jack & Mortimer, Duncan & Sweeney, Rohan & Woode, Maame Esi, 2023. "Donor versus recipient preferences for aid allocation: A systematic review of stated-preference studies," Social Science & Medicine, Elsevier, vol. 334(C).

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