Rethinking Health Sector Wide Approaches through the lens of Aid Effectiveness
Sector Wide Approaches (SWAps) are an approach to aid management that aim to support recipient government leadership. Health aid has grown rapidly in the past 20 years and in this time SWAps have become an important health aid delivery approach. However, the empirical evidence is that the performance of health SWAps is, at best, mixed. Outcome and impact benefits of health SWAps are inconclusive, and overall process level performance is poor. The key insight offered by this paper is that a divergence has developed between the underlying theory of change of health SWAps, and their implementation. The paper argues the theory of change underlying SWAps is highly consistent with effective aid, however the practice is not. Health SWAps have been characterised by cumbersome architecture that is partially implemented and used, and which does not facilitate government ownership and commitment to indigenous institutional development. A core stream of the analysis as to why this is the case relates to technical shortcomings within the SWAp architecture itself, however this is not sufficient to understand the reasons for the limited success of SWAps. Rather it is clear there are a range of broader incentives and understandings within both donors and governments that have shaped the implementation of SWAps at a process level. The paper concludes with some suggested actions which may assist in realigning health aid with the underlying SWAp theory of change, whilst taking into account at least some of the incentives and understandings that have cut across SWAp implementation. The essence of the proposed approach is a more realistic understanding of the nature of health systems, combined with a more politically informed set of strategies to support the development of these systems.
|Date of creation:||Feb 2012|
|Date of revision:|
|Contact details of provider:|| Postal: Crawford Building, Lennox Crossing, Building #132, Canberra ACT 2601|
Phone: +61 2 6125 4705
Fax: +61 2 6125 5448
Web page: https://devpolicy.crawford.anu.edu.au/
More information through EDIRC
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Stephen Howes, 2011. "An overview of aid effectiveness, determinants and strategies," Development Policy Centre Discussion Papers 1101, Development Policy Centre, Crawford School of Public Policy, The Australian National University.
- Pritchett, Lant & Woolcock, Michael, 2004. "Solutions When the Solution is the Problem: Arraying the Disarray in Development," World Development, Elsevier, vol. 32(2), pages 191-212, February.
- Daniel Adler & Caroline Sage & Michael Woolcock, 2009. "Interim Institutions and the Development Process: Opening Spaces for Reform in Cambodia and Indonesia," Brooks World Poverty Institute Working Paper Series 8609, BWPI, The University of Manchester.
- Wilson, Sven E., 2011. "Chasing Success: Health Sector Aid and Mortality," World Development, Elsevier, vol. 39(11), pages 2032-2043.
- Howard White, 2007. "The Bangladesh Health SWAp: Experience of a New Aid Instrument in Practice," Development Policy Review, Overseas Development Institute, vol. 25(4), pages 451-472, 07.
- Mishra, Prachi & Newhouse, David, 2009. "Does health aid matter?," Journal of Health Economics, Elsevier, vol. 28(4), pages 855-872, July.
- Gre[ss], Stefan & Niebuhr, Dea & Rothgang, Heinz & Wasem, Jurgen, 2005. "Criteria and procedures for determining benefit packages in health care: A comparative perspective," Health Policy, Elsevier, vol. 73(1), pages 78-91, July.
- Stephen Howes & Sabit Otor & Cate Rogers, 2011. "Does the World Bank have a micro-macro paradox or do the data deceive?," Development Policy Centre Discussion Papers 1105, Development Policy Centre, Crawford School of Public Policy, The Australian National University.
- Easterly, William & Williamson, Claudia R., 2011.
"Rhetoric versus Reality: The Best and Worst of Aid Agency Practices,"
Elsevier, vol. 39(11), pages 1930-1949.
- Easterly, William & Williamson, Claudia R., 2011. "Rhetoric versus reality: the best and worst of aid agency practices," MPRA Paper 39139, University Library of Munich, Germany.
When requesting a correction, please mention this item's handle: RePEc:een:devpol:1214. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Macarena Rojas)
If references are entirely missing, you can add them using this form.