The Bangladesh Health SWAp: Experience of a New Aid Instrument in Practice

Sector-wide approaches are being widely adopted as a new aid modality, incorporating government ownership, partnership and a move from project to programme support. The literature to date on their performance in practice is, at best, mixed. This article reviews these issues in the light of the experience of arguably the world's oldest and largest SWAp, the Bangladesh health sector programme. A positive picture emerges of an evolutionary institutional adaptation towards a programme approach, with positive systemic effects on government processes and a reduction in transaction costs in dealing with donors. There are, however, negative aspects, notably, donor dominance in 'dialogue', though with limited influence on the government's actual strategy. Copyright 2007 Blackwell Publishing Ltd.