This study distills evidence from six countries (Bangladesh, Ghana, Kyrgyz Republic, Nepal, Malawi, and Tanzania) to address four questions regarding Sector-wide Approaches (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?
This paper draws on the findings of Project Performance Assessment Reports conducted by Independent Evaluation Group (IEG) on health SWAp support operations in Bangladesh, Ghana, and the Kyrgyz Republic, and of field-based case studies that assessed the Bank’s lending and non-lending support to health, population, and nutrition in Malawi and Nepal. This paper also incorporates the findings of an evaluation of Tanzania’s health SWAp, commissioned by the Government of Tanzania, and financed by development partners.
This study draws on a review of Bank support for SWAps in its lending portfolio and it distills health SWAp experience to date. It was undertaken as input to IEG’s recent evaluation of the World Bank’s support to health, nutrition, and population: “Improving Effectiveness and Outcomes for the Poor in Health, Nutrition and Population: An Evaluation of World Bank Group Support since 1997.” The paucity of health SWAp evaluations in the literature, the richness and complexity of the preliminary findings, and the strong demand for more distillation of SWAp experiences and lessons all were justification for the undertaking of a more in-depth analysis.