Donor Coordination and a Sector Wide Approach to Health (SWAP)


Sector Wide Approaches (SWAPs) were born in the early 1990s.They developed in settings where many donors were present and in response to overly complex aid architecture that in some cases was undermining the stewardship role of governments.

In contexts where external financing plays a significant role, SWAPs have to date in several countries proved to be a good way to support government leadership and implementation and to make health financing more predictable and flexible.

A sector-wide approach (SWAP) is a method of working that brings together governments, donors and other stakeholders within any sector. It is characterized by a set of operating principles rather than a specific package of policies or activities.

The approach involves movement over time under government leadership towards:

  • a sustained partnership of all main sector partners;
  • developing and implementing a single sector policy that addresses private and public sector issues and is supported by all significant sector partners;
  • a common, realistic expenditure programme which supports the sector policy;
  • broadening policy dialogue through defining clear mechanisms for policy dialogue and consensus building;
  • defining common monitoring and review arrangements;
  • greater reliance on government financial and accountability systems.

Being engaged in a SWAP implies commitment to this direction of change, rather than the comprehensive attainment of all these different elements from the start. It implies changes to the ways in which both governments and development partner agencies operate, and in their required staff skills and systems.

WHO/Europe has played a significant role in development and operation of sector-wide approaches in countries such as Kyrgyzstan and Tajikistan, and in the current biennium (2010/2011) work on this will further be expanded to the Republic of Moldova.