Intended for healthcare professionals


Sector-wide approaches in developing countries

BMJ 2000; 321 doi: (Published 15 July 2000) Cite this as: BMJ 2000;321:129

The aid given must make the most impact

  1. Paul Garner, head,
  2. Walter Flores, lecturer in international health,
  3. Shenglan Tang, lecturer in international health
  1. International Health Division, Liverpool School of Tropical Medicine, Liverpool L3 5QA

    Sector wide approaches (SWAPs) are a new development in the organisation of aid to developing countries where donors and lenders collectively contribute to funding the entire health sector.1 They are being widely promoted as a “good way to do business.” Donors are embracing sector wide approaches enthusiastically, and they have been introduced in the health sector in several countries, including Zambia, Ghana, and Bangladesh, but the realities have been little tested.2

    In the past, donors provided support through project aid, resulting in many self contained projects which tended to fragment the health system, or through programme aid, where particular donors may provide funds through national budgets. In sector wide approaches donors agree to contribute to a single basket of funds, which in turn contributes to the country's national plan. The partner government and development agencies negotiate and agree policies and plans for development in the sector, including resource allocation, and aid is provided within this context.3 The potential benefit is that money is spent on priorities set by the country, not external agencies, and aid is more efficiently managed through the country's existing structures, with only one set …

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