Do Health Sector-Wide Approaches Achieve Results? Emerging Evidence From Six Countries

Denise Vaillancourt
Independent Evaluation Group, World Bank
September 15, 2009


More than a decade ago, the World Bank and other donors proposed a new way of working with developing country governments to overcome inefficiencies, lack of government ownership, and a number of other problems that were constraining the impact of international support to developing countries. This new approach, eventually called the Sector-Wide Approach (SWAp), embraced many of the principles of harmonization and alignment that were later endorsed by the Paris Declaration on Aid Effectiveness in 2005 and subsequent international meetings.

This study distills evidence from six countries to address four questions regarding SWAps in the health sector: (1) Were the anticipated benefits of the approach realized? (2) Were the objectives of the national health strategies and programs of work achieved? (3) Did the approach facilitate the achievement of national health objectives? (4) In what ways did channeling support through a SWAp affect the World Bank’s efficacy? The pursuit of these questions aims to fill a gap in the literature, which is focused largely on definitions, advocacy, implementation issues and only the first of this study’s four questions, and largely neglectful of questions related to the development effectiveness of SWAps.

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