Governance and Management Arrangements For Health Sector-Wide Approaches (SWAps) (WP8)

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB
WORKING PAPER SERIES NUMBER 8 | NOVEMBER 2010
Governance and management arrangements for health Sector-Wide Approaches (SWAps): Examples from Africa, Asia and the Pacific
Joel Negin
Sydney School of Public Health and Menzies Centre for Health Policy, University of Sydney
Krishna Hort
Nossal Institute for Global Health, The University of Melbourne
The Nossal Institute for Global Health
www.ni.unimelb.edu.au
KNOWLEDGE HUBS FOR HEALTH

Strengthening health systems through evidence in Asia and the Pacific
WORKING PAPER SERIES
ABOUT THIS SERIES

This Working Paper is produced by the Nossal Institute for Global Health at the University of Melbourne, Australia. The Australian Agency for International Development (AusAID) has established four Knowledge Hubs for Health, each addressing different dimensions of the health system: Health Policy and Health Finance; Health Information Systems; Human Resources for Health; and Womens and Childrens Health. Based at the Nossal Institute for Global Health, the Health Policy and Health Finance Knowledge Hub aims to support regional, national and international partners to develop effective evidence-informed policy making, particularly in the field of health finance and health systems. The Working Paper series is not a peer-reviewed journal; papers in this series are works-in-progress. The aim is to stimulate discussion and comment among policy makers and researchers. The Nossal Institute invites and encourages feedback. We would like to hear both where corrections are needed to published papers and where additional work would be useful. We also would like to hear suggestions for new papers or the investigation of any topics that health planners or policy makers would find helpful. To provide comment or obtain further information about the Working Paper series please contact; niinfo@unimelb.edu.au with Working Papers as the subject. For updated Working Papers, the title page includes the date of the latest revision. Governance and management arrangements for health Sector-Wide Approaches (SWAps): Examples from Africa, Asia and the Pacific First draft November 2010 Corresponding author: Joel Negin Address: Sydney School of Public Health and Menzies Centre for Health Policy, University of Sydney, joel.negin@sydney.edu.au Other contributors: Kris Hort, The Nossal Institute for Global Health, University of Melbourne This Working Paper represents the views of its author/s and does not represent any official position of The University of Melbourne, AusAID or the Australian Government.
ACKOWLEDGEMENTS
The author would like to thank World Bank staff in the Pacific region for their comments on an earlier draft of this paper.
Governance and management arrangements for health Sector-Wide Approaches (SWAPs): Examples from Africa, Asia and the Pacific
NUMBER 8 | NOVEMBER 2010
INTRODUCTION
This Working Paper summarises the experience of Sector-Wide Approaches (SWAps) or similar arrangements in the health sector in seven countries in Africa, Asia and the Pacific. A SWAp is characterised by an emphasis on governments and development partners working together in a whole-of-sector manner to support one agreed health plan, and a related monitoring and evaluation framework, in order to maximise the use of resources available to the sector. Some SWAps include pooled funding arrangements and aligned financial management, while non-pooled SWAps focus on harmonisation and improved aid effectiveness. According to Walt, Pavignani et al (1999), a SWAp provides a broad framework within which all resources in the health sector are coordinated in a coherent and well-managed way, in partnership and with recipients in the lead. The impetus for this Working Paper came from World Bank colleagues in the Pacific region, where the Bank works closely with governments in developing systems to support various SWAp arrangements. An earlier version of the paper was shared with partners in the Pacific to contribute to discussions about management systems for SWAps. This Working Paper follows three others on the topic of SWAps in the Pacific region by Joel Negin, with examples drawn from Samoa and the Solomon Islands. The three papers are: ector-Wide Approaches for health: an introduction to SWAps and their implementation in the Pacific region. S HPHF Knowledge Hub Working Paper No. 2, March 2010. ector-Wide Approaches for health: a comparative study of experiences in Samoa and the Solomon Islands. S HPHF Knowledge Hub Working Paper No. 3, March 2010. ector-Wide Approaches for health: lessons from Samoa and the Solomon Islands. HPHF Knowledge Hub S Working Paper No. 4, March 2010. The paper aims to provide examples of governance and management arrangements of health SWAps and similar arrangements in a number of countries. The purpose of the paper is to inform discussion of options for the Government of the Solomon Islands. It does not provide an assessment of the effectiveness or appropriateness of the arrangements, or endeavour to compare arrangements across countries. Examples of SWAps and similar arrangements were identified through a literature search. Accepted evidence included National Ministry of Health and development partner reports, SWAp reviews, conference presentations and academic literature describing and/or evaluating SWAps. The seven country examples were selected on the basis of availability of relevant information and longevity, under the assumption that SWAps that have been in existence for five or more years are more likely to have more settled and tested management structures. The exception is the Samoan health SWAp, which is included as a Pacific regional comparator to the Solomon Islands. The emphasis for inclusion of country-level SWAps was on identifying management structures and arrangements that might be relevant to the Government of the Solomon Islands. The establishment of various committees and working groups and their roles and interaction with government bodies, including during formal review processes, were extracted from relevant documents. The main findings of this review were: All SWAps are adapted to local circumstances and local needs; there is no one-size-fits-all approach. he mechanisms presented here are mostly from much larger countries than the Solomon Islands, with T many more development partners, and therefore suitability to the Solomon Islands will need to be assessed. ost SWAps have formalised governance arrangements, including annual or biannual sector reviews, more M frequent sector coordination meetings and a SWAp secretariat of some kind. Most SWAps also have a formal Memorandum of Understanding (MOU) between development partners and the government. he larger annual sector reviews generally have wide participation. They review performance, develop a T program of work for the upcoming year and provide a forum to agree on financial contributions.
ector coordination meetings generally take place approximately monthly and include at least development S partners and government and, in some cases, NGOs and private providers. All of the coordination committees are chaired by government representatives most commonly from the Ministry of Health. smaller number of SWAp countries maintain separate formal development-partner-only coordination A groups that report to the wider coordination meetings through a donor focal point. ost SWAps also have subgroups that provide forums for in-depth discussions on certain technical topics M and that report to the SWAp management. Most SWAps include subgroups on technical issues related to SWAp functioning, such as human resources, monitoring, procurement or finance. he persistence of disease-specific coordination mechanisms has been an ongoing challenge for health T sector coherence. ost countries governance and management arrangements have changed over time to respond to M emerging challenges and shortcomings.
SWAp GOVERNANCE STRUCTURES: INTERNATIONAL EXAMPLES

The following table summarises information on the management and governance arrangements of seven SWAps or similar arrangements: four in African countries (Zambia, Malawi, Uganda, Mozambique), two in Asia (Cambodia and Bangladesh) and one in a Pacific Island country (Samoa). In Cambodia the Ministry of Health has adopted sector-wide management or SWiM. Under the SWiM, some funds are pooled (especially from the World Bank through the Health Sector Support Project), and the pooled funds are used within project structures with a commitment to harmonisation and alignment of donor funding in support of the Ministrys Health Strategic Plan. Despite the somewhat different mechanism and different name, the Cambodian SWiM represents a similar arrangement to SWAps (especially that of the Solomon Islands, which is more focused on harmonisation and alignment rather than pooled funding) and is therefore included in this paper. The table provides information on key governance elements identified, such as the format of annual reviews, coordination meetings and subgroups. Following it are examples of governance mechanisms from three SWAp countries. The brief then provides more information on the various governance arrangements and other issues for consideration. The countries with health SWAps and similar arrangements described here are generally larger in terms of population and established their SWAps considerably earlier than the Solomon Islands. Additionally, some of the countries reviewed have considerably more development partners and stakeholders active in the sector than the Solomon Islands. Therefore, caution should be taken in interpreting the examples.
Category 15 million 2004 SWAp secretariat in the Planning Unit of MOH. Technical Working Group for Health secretariat has representatives of MOH and DPsformulates M&E indicators, annual work plans. 1999 SWiM adopted in 2000 2000 33 million 15 million 20 million 1998
Samoa
Zambia
Malawi
Uganda
Cambodia
Mozambique
Bangladesh 162 million
Population
200,000
13 million
Date of establishment 2007 of SWAp
Early 1990s
SWAp secretariat (composition, funding)
SWAp Coordination Unit housed and run by government. Reports to CEO of MOH. Composed of coordinator, accountant, procurement specialist and four other staff (all local). Health Sector Review Group. Members: pooled and non-pooled partners; NGOs; private sector. Function: set budget priorities and approve projects. Details: chaired by PS. Members: MOH, Finance, DPs. Sector Working Group. Technical Working Group for Health. Members: 74 (government, NGOs, DPs). Function: focus on broader strategies and health systems. MOH Task Force on Deepening Harmonisation and Alignment. SWAp Forum.
Directorate of Planning and Development within MOH; donor coordination officer within MOH. Established only in 2003.
Coordination committees
Program Steering Committee.
Policy Consultative Meeting (12 per year).
HNPSP Coordination Committee. Members: MOH and external partners. Details: Recent push to make it more inclusive and include all DPs.
Members: MOH, DPs.
Members: Ministries of Health, Finance, Social Development, DPs, private sector and NGOs. Function: review implementation progress and annual work plans. Details: chaired by MOH. Health Policy Advisory Committee: members: MOH, Finance, Education, local government, DPs, private providers. Details: meets monthly.
Function: address general health sectorrelated issues.
Members: MOH and two development partners who represent views of all development partners. Function: review implementation progress (to date has been too formal and not focused on detail). Members: MOH Department of International Cooperation.
Function: provide high-level oversight for implementation and act as forum for views and concerns of partners.
Details: presided over by the PS.
Details: Meets quarterly. Chaired by MOH or Finance.
4 Governance and management arrangements for health Sector-Wide Approaches (SWAPs): Examples from Africa, Asia and the Pacific
Category Health donor subgroup reports to Health Sector Review Group. Health Development Partners Group meets monthly to coordinate. One agency serves as chair and contact point with MOH. Joint reviews held twice each year. Progress is reviewed and plans are agreed for coming six months, including priorities and budget allocations. Eight working groups, including human resources, infrastructure, finance, monitoring. SWAp MOU. A number of programmatic and disease-specific technical working groups. Currently no SWAp MOU; the process operates as a SWiM with DP and MOH agreement. Conducted through the routine activities of the MOH; includes annual health congress and annual operational plan. Sector Coordination Committee meets twice a year, chaired by Minister of Health, includes MOH and DPs. Health Partners Group (only DPs). None.
Samoa
Zambia
Malawi
Uganda
Cambodia
Mozambique
Bangladesh Donor consortium meeting includes all DPs. Separate meeting for pooled funding partners. Annual program review includes joint field visits and review of progress.
Development partner only coordination forums
None.
None.
Annual reviews Multi-stakeholder joint reviews held twice each year with aidesmemoires arising from reviews. Coordinated by SWAp secretariat.
Health summit in March and joint review in September each year organised by government. All partners invited, including civil society and private sector. Technical working groups including procurement, human resources. Includes DPs. MOU between DPs and MOH. Refers to coordination and monitoring, financing arrangements.
Annual consultative meeting; sector advisory group meeting (2 per year).
Sectoral subgroups
None.
Yes, including financing, human resources, procurement and technical areas.
SWAp-related thematic working groupswhere more in-depth analysis is needed prior to broader forums. Code of conduct that sets the basic rules of engagement between the MOH and partners.
None.
Memorandum of Understanding
A joint partnership arrangement describes the principles of the SWAp, roles and responsibilities of DPs and government.
Health MOU and Joint Assistance Strategy both signed.
Notes:
1. SWiM: Sector-Wide Management; DP: Development Partner; MOU: Memorandum of Understanding; MOH: Ministry of Health; NGO: Non-Government Organisation; M&E: Monitoring and Evaluation; PS: Permanent Secretary; HNPSP: Health Nutrition Population Sector Program
2. The information in the table was compiled from a review of numerous documents, all listed in the Cited references and other sources section. For simplicity, the summary here does not cite these sources.
Governance and management arrangements for health Sector-Wide Approaches (SWAPs): Examples from Africa, Asia and the Pacific 5
EXAMPLES OF SWAp MANAGEMENT STRUCTURES

Examples of SWAp management structures and reporting lines in three countries are provided here in graphic form to demonstrate the variety of systems developed.
Malawi
WAp management structure is owned and centred on the Ministry of Health (MOH), with the SWAp S secretariat housed within MOH and reporting to MOH management committees. ealth Sector Review Group includes MOH and development partners as well as NGOs and private sector H and reports to MOH (and consults with SWAp secretariat). (DFID 2004)
Top Management Committee Cabinet Committee on Health Parliamentary Health Committee Chair: Health Minister, also Treasury, Local Government, Economic Planning.
Health Sector Review Groups Co-chaired Ministry/Dxxxx, NGOs, private sector providers. Senior Management Committee Chair: Principal Secretary of Health, Health Directors, Central Hospitals, Professional Councils. SWAp Secretariat
Health Sub- Groups
Technical Working Groups Financial Management and Procurement Working Group Human Resources Working Group Ad hoc groups
Departmental Meetings and Committees Zonal Offices
Uganda
ealth Policy Advisory Committee meets monthly and includes development partners, government and H private providers. ealth development partners only meet monthly and report to Health Policy Advisory Committee. H (Hutton 2004)
Office of the Minister
Top Management Committee* Permanent Secretary Senior Management Committee* Director General Health Policy Advisory Comittee*
Sector Working Group*
Partnership Fund MoH Structure Health Developement Partners* (HDP Group) Working Groups*
Inter-Agency Coordinating Committees*
Bangladesh
Ministry of Health and development partners both contribute to annual program review. eparate coordination forums exist for pool funders and for all development partners S (including non-pooled partners). ecently established Health Nutrition Population Sector Programme Coordination Committee meets R quarterly and includes two development partners who represent the wider donor consortium (Sundewall, Forsberg et al 2006)
Annual Programme Review/Policy Dialogue
HPSO Steering Committee (Pool funders)
Ministry of Health and Family Welfare
Development Partners
Donor Consortium (All development partners)
Directorate of Family Planning
Directorate of Health Services
SUMMARY OF GOVERNANCE AND MANAGEMENT ISSUES

SWAp Secretariats
Some, but not all, countries with health SWAps have formally convened SWAp secretariats. Samoa, Zambia and Malawisome of the countries with the strongest SWApshave secretariats based within the MOH and reporting to the Minister of Health. The SWAp secretariat manages the day-to-day functioning of the SWAp, including donor coordination, accounting and procurement related to SWAp funds and other management roles. Zambia explicitly places its SWAp secretariat as the go-between for development partners and the government. In other countries, management functions are retained within regular MOH functions.
Coordination Committees
Though named differently, ongoing coordination mechanisms between various health sector stakeholders exist in each SWAp country. All include development partners and government. Government representatives are generally from the central MOH but sometimes also include finance, education, social development and other relevant Ministries involved in the health sector response. Most but not all include others, such as private providers and NGOs. Both pooled and non-pooled partners are included. All of the coordination committees are chaired by government representativesmost commonly from the MOH but occasionally from other Ministries. These bodies variously review progress, develop work plans, support implementation and discuss issues as they arise. In Bangladesh, coordination meetings, which included the full suite of development partners, were deemed to be too large to permit meaningful discussion.
Development-Partner-Only Coordination Forums
Most countries do not have formal coordination forums exclusively for development partners. Malawi, Bangladesh and Uganda, however, all maintain development-partner-only forums that then report a coordinated perspective to a wider meeting including the national government. The development partner forums generally share information about program planning and program assessments and seek to reduce transaction costs for both agencies and government. Bangladeshs recently established Health Nutrition Population Sector Programme Coordination Committee meets approximately quarterly and is made up of senior MOH officers and two development partners, the latter representing the views of the wider partner community. Analysis of sector coordination in Zambia reveals that even without a formal development partner forum, informal gatherings of donors still occur. According to one report: a number of issues get discussed over a cup of coffee and in the past the Ministry has expressed opposition to such gatherings, rejecting any need to exclude policy-makers in a climate of openness and consultation. However, their continued existence demonstrates the inevitability of donor-donor communication. Furthermore, senior MOH officials welcome the opportunity for partners to present a common position (Lake and Musumali 1999). In the 1990s, Mozambique tried appointing one donor as the focal point to interface between the MOH and the donor community to relieve the MOH of part of the burden of discussing every issue with each agency. This endeavour was ultimately abandoned, however, as it was felt by both the MOH and other development partners that the focal donor had become too influential (Pavignani and Durao 1999).
Annual Reviews
All SWAp countries have annual or biannual processes to review performance, develop a program of work for the upcoming year and agree on financial contributions. Some countries go down to the level of a procurement plan for the upcoming year. Development partners generally prepare detailed reports on what they have done over the past year and specific details on what they plan to do in the coming year. In this way, the development partners work around an agreed national calendar or timetable. One document in Mozambique noted that a serious concern has been the lack of systematic follow up by the MOH and development partners of the recommendations made in the annual review. The document lamented that the reports emerging from the review were not followed by implementation plans that facilitated and directed action (Martinez 2006).
Sectoral Subgroups
Most SWAps, in addition to coordination mechanisms and reviews, have subgroups that provide forums for in-depth discussions on technical issues related to SWAp functioning such as human resources, monitoring, procurement and finance. A number of countries also maintain disease-specific technical working groups. All of these subgroups report back to the SWAp secretariat or coordination mechanism.
Memoranda of Understanding
Most countries with SWAps have some sort of agreement between development partners and the government (though most do not include private sector organisations or NGOs). Overall, MoUs set the basic rules of engagement between the government and development partners. MoUs can describe some combination of the principles of the SWAp, roles and responsibilities of the development partners and the government related to the SWAp, institutional and fiduciary arrangements, approach to capacity building, monitoring and evaluation, disbursement arrangements for contributions of the pooled partners, conflict resolution and steps for adding new partners to the pooled arrangement.
Involvement of Non-State Actors
A number of sector coordination mechanisms include only the government and development partners, to the exclusion of non-state actors such as faith-based organisations, NGOs and the private sector. Malawi and Uganda, however, in which private providers and NGOs deliver a significant percentage of health services, both include non-state actors in their ongoing coordination meetings. Most annual or biannual reviews include a wide range of the health sector, including NGOs and private/not-for-profit providers such as churches. Commentators have acknowledged that the role of NGOs in the SWAp process has all along been ambiguous (Jeppsson 2002).
Separate HIV Coordination Mechanisms
A number of countries (such as Mali, Madagascar and Mozambique) that have well-developed coordination for the health sector maintain separate mechanisms for coordination of the HIV response. This is partly due to the Global Fund requirement to have a country coordinating mechanism with specific membership requirements. Following from this, in a few countries, technical units of the MOH continue to operate in a vertical fashion, holding technical meetings with donors, arranging separate training workshops and generally not coordinating activities and plans centrally. In Mozambique, technical departments maintain close links with technical partners that hinder central coordination.
Technical Assistance to SWAp Secretariats
For SWAps in Africa, donors including the World Bank and the UK Department for International Development (DFID) have provided technical assistance in the establishment and initial staffing of SWAp secretariats. Technical assistance is thus provided explicitly with a clear mentoring and capacity-building role to strengthen the governments ability to manage the SWAp.
Governance and management arrangements for health Sector-Wide Approaches (SWAPs): Examples from Africa, Asia and the Pacific NUMBER 8 | NOVEMBER 2010
10
The Samoan SWAp secretariat has recently hired one adviser focused on procurement (of items as diverse as vehicles, civil works, pharmaceuticals and information technology equipment) and one on program management, who are both international advisers and are both donor funded. The technical assistance was in response to discussions between development partners and government on SWAp secretariat needs and skill gaps. Documents describing the Malawi SWAp went into significant detail on technical assistance. The Malawi MOH and the SWAp donor group conducted a human resources needs assessment that included effective SWAp management. The technical assistance needs identified were to be funded through the SWAp and included procurement specialists, human resources management specialists, M&E specialists and financial management specialists. The ten technical assistant (TA) posts in Malawi were recruited directly by the MOH through a competitive and open process facilitated by one of the SWAp partners, and the funds for the posts were provided by DFID. The advisers are managed and monitored by the MOHthis differed from the past, when technical assistants reported to the funding donor. A review of past technical assistance in Malawi (Malawi MOH and Health SWAp Donor Group 2007) revealed that although the assistance was effective in terms of output, the impact of capacity building and skills transfer was often very poor due to lack of government counterparts for technical advisors or insufficient focus by the adviser. Improvement in capacity building is part of the commitment for new technical assistance, and the longterm objective of SWAp partners is to phase out technical assistance over a ten to fifteen year period. The needs assessment in Malawi is to be conducted annually, with procurement of assistance to respond to needs identified. Technical assistance is funded from within the pooled funding.
CONCLUSION
The various SWAps and similar arrangements have all adapted their management mechanisms to suit local circumstances and needs. Despite this, a few common trends appear, including formal annual or biannual sector reviews, monthly sector coordination meetings and a secretariat within the MOH that manages the dayto-day elements of the SWAp. In countries with many donors, some have tried separate donor coordination forums to allow for a coordinated donor perspective. Separate disease-specific coordination bodies have also been attempted, but the trend seems to be towards a more streamlined whole-of-sector approach. Importantly, most countries management arrangements have changed over time in response to challenges and shortcomings, suggesting that SWAp governance must be dynamic and must be evaluated frequently to ensure that it is functioning effectively.
Governance and management arrangements for health Sector-Wide Approaches (SWAPs): 11 Examples from Africa, Asia and the Pacific
CITED REFERENCES AND OTHER SOURCES

Boesen, N. and D. Dietvorst. 2007. SWAps in motion: Sector wide approachesfrom an aid delivery to a sector development perspective. http://www.swisstph.ch/fileadmin/user_upload/Pdfs/swap/swap456_Boesen_2007. pdf (accessed 14 January 2010). Carlson, C., M. Boivin, A. Chirwa, Simon Chirwa, Fenwick Chitalu, Geoff Hoare, Mechtild Huelsmann, Wedex Ilunga, Ken Maleta, Andrew Marsden, Tim Martineau, Chris Minett, Albert Mlambala, Friedrich von Massow, Hatib Njie and Ingvar Theo Olsen. 2008. Malawi health SWAp mid-term review: Summary report. Norad Collected Reviews 22/2008. Oslo: Norwegian Agency for Development Cooperation. Chansa, C. 2007. Zambian health SWAp revisitedhas it made the intended effects? http://www.gtz.rhp.com/ conferences/madagascar07/ChansaCollins_final.pdf (accessed 14 January 2010). Chansa, C., J. Sundewall, D. McIntyre, G. Tomson and B.C. Forsberg. 2008. Exploring SWAps contribution to the efficient allocation and use of resources in the health sector in Zambia. Health Policy & Planning 23(4): 244251. DFID. 2004. Improving health in Malawi. 100 million UK aid (2005/6-2010/11). A sector wide approach including essential health package and emergency human resources programme. Programme memorandum. UK Department for International Development. http://www.u4.no/themes/health/dfidmalawifinalreport.pdf (accessed 14 January 2010). Hutton G. 2004. Case study of a successful sector-wide approach: the Uganda health sector SWAp. A lessons learned paper established in the frame of the SDC-STI SWAp Mandate 2003-4. http://www.sti.ch/fileadmin/ user_upload/Pdfs/swap/swap351.pdf (accessed 14 January 2010). International Health Partnership. 2008. Cambodia Taking Stock Report. http://www. internationalhealthpartnership.net/pdf/03_CAMBODIA_TSR_EN_FINAL.pdf (accessed 14 January 2010). International Health Partnership. 2008. Madagascar Taking Stock Report. http://www. internationalhealthpartnership.net/pdf/05_MADAGASCAR_TSR_EN_FINAL.pdf (accessed 14 January 2010). International Health Partnership. 2008. Mali Taking Stock Report. http://www.internationalhealthpartnership.net/ pdf/06_MALI_TSR_EN_FINAL.pdf (accessed 14 January 2010). International Health Partnership. 2008. Mozambique Taking Stock Report. http://www. internationalhealthpartnership.net/pdf/07_MOZAMBIQUE_TSR_EN_FINAL.pdf (accessed 14 January 2010). International Health Partnership. 2008. Nepal Taking Stock Report. http://www.internationalhealthpartnership. net/pdf/08_TSR_Nepal_FINAL_July_2008.pdf (accessed 14 January 2010). International Health Partnership. 2008. Zambia Update: Scaling-Up for Better Health. http://www. internationalhealthpartnership.net/pdf/IHP%20Update%2013/MINISTERIAL/Zambia.pdf (accessed 14 January 2010). Jeppsson, A. 2002. SWAp dynamics in a decentralized context: experiences from Uganda. Social Science & Medicine. 55(11): 2053-2060. Lake S., and C. Musumali. 1999. Zambia: The role of aid management in sustaining visionary reform. Health Policy & Planning 14(3): 254-263. Malawi Ministry of Health and Malawi Health SWAp Donor Group. 2007. Human resources / capacity development within the health sector needs assessment study: Final report. http://www.jica.go.jp/cdstudy/ library/pdf/c20071127_05.pdf (accessed 14 January 2010). Martinez, J. 2006. Implementing a sector wide approach in health: the case of Mozambique. London: HLSP Institute. Martinez, J. 2008. Sector wide approaches at critical times: the case of Bangladesh. London: HLSP Institute.
12
rtendahl C., 2007. The Uganda health SWAp: new approaches for a more balanced aid architecture? London: HLSP Institute. Pavignani, E. and J.R. Durao. 1999. Managing external resources in Mozambique: building new aid relationships on shifting sands? Health Policy & Planning 14(3): 243-253. Sundewall, J., B.C. Forsberg and G. Tomson. 2006. Theory and practicea case study of coordination and ownership in the Bangladesh health SWAp. Health Research Policy and Systems 16, 4: 5. Sundewall, J. and K. Sahlin-Andersson. 2006. Translations of health sector SWApsa comparative study of health sector development cooperation in Uganda, Zambia and Bangladesh. Health Policy 76(3): 277-287. Walt, G., E. Pavignani, L. Gilson and K. Buse. 1999. Managing external resources in the health sector: are there lessons for SWAps (sector-wide approaches)? Health Policy and Planning 14(3): 273-284. White, H. 2007. The Bangladesh health SWAp: Experience of a new aid instrument in practice. Development Policy Review 25(4): 451-472. World Bank. 2008. Project appraisal document of the World Bank on a proposed credit in the amount of SDR 1.9M to the independent state of Samoa in support of health sector management project. http://www-wds. worldbank.org/external/default/wdscontentserver/wdsp/iv/2008/06/03/000333037_20080604000524/rendered/ pdf/411300pad0p0861ly10ida1r20081017911.pdf (accessed on 14 January 2010).
Governance and management arrangements for health Sector-Wide Approaches (SWAPs): 13 Examples from Africa, Asia and the Pacific
KNOWLEDGE HUBS FOR HEALTH

Strengthening health systems through evidence in Asia and the Pacific
A strategic partnerships initiative funded by the Australian Agency for International Development
The Nossal Institute for Global Health
14

Governance and Management Arrangements For Health Sector-Wide Approaches (SWAps) (WP8)

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Governance and Management Arrangements For Health Sector-Wide Approaches (SWAps) (WP8)

Transféré par

Droits d'auteur :

Formats disponibles

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

WORKING PAPER SERIES NUMBER 8 | NOVEMBER 2010

The Nossal Institute for Global Health

KNOWLEDGE HUBS FOR HEALTH

WORKING PAPER SERIES

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

ABOUT THIS SERIES

NUMBER 8 | NOVEMBER 2010

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

WORKING PAPER SERIES

NUMBER 8 | NOVEMBER 2010

WORKING PAPER SERIES

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

NUMBER 8 | NOVEMBER 2010

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

WORKING PAPER SERIES

SWAp GOVERNANCE STRUCTURES: INTERNATIONAL EXAMPLES

NUMBER 8 | NOVEMBER 2010

WORKING PAPER SERIES

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

Bangladesh 162 million

Date of establishment 2007 of SWAp

SWAp secretariat (composition, funding)

Program Steering Committee.

Policy Consultative Meeting (12 per year).

Members: MOH, DPs.

Function: address general health sectorrelated issues.

Details: presided over by the PS.

Details: Meets quarterly. Chaired by MOH or Finance.

NUMBER 8 | NOVEMBER 2010

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

WORKING PAPER SERIES

Development partner only coordination forums

Annual consultative meeting; sector advisory group meeting (2 per year).

Yes, including financing, human resources, procurement and technical areas.

Health MOU and Joint Assistance Strategy both signed.

NUMBER 8 | NOVEMBER 2010

WORKING PAPER SERIES

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

EXAMPLES OF SWAp MANAGEMENT STRUCTURES

Health Sub- Groups

Departmental Meetings and Committees Zonal Offices

NUMBER 8 | NOVEMBER 2010

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

WORKING PAPER SERIES

Sector Working Group*

Inter-Agency Coordinating Committees*

NUMBER 8 | NOVEMBER 2010

WORKING PAPER SERIES

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

Annual Programme Review/Policy Dialogue

HPSO Steering Committee (Pool funders)

Ministry of Health and Family Welfare

Donor Consortium (All development partners)

Directorate of Family Planning

Directorate of Health Services

NUMBER 8 | NOVEMBER 2010

HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB

WORKING PAPER SERIES

SUMMARY OF GOVERNANCE AND MANAGEMENT ISSUES

Development-Partner-Only Coordination Forums

NUMBER 8 | NOVEMBER 2010

WORKING PAPER SERIES