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Published in: Health Research Policy and Systems 1/2006

Open Access 01-12-2006 | Research

Theory and practice – a case study of coordination and ownership in the Bangladesh health SWAp

Authors: Jesper Sundewall, Birger Carl Forsberg, Göran Tomson

Published in: Health Research Policy and Systems | Issue 1/2006

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Abstract

Background

In the past decade the sector-wide approach (SWAp) model has been promoted by donors and adopted by governments in several countries. The purpose of this study is to look at how partners involved in the health SWAp in Bangladesh define ownership and coordination, in their daily work and to analyse the possible implications of these definitions.

Methodology

The study object was a process of decision-making in the Government of Bangladesh in 2003. Information was collected through participant observations, interviews and document review.

Results

During the study period the Government of Bangladesh decided to reverse a decision to unify the two wings of the Ministry of Health and Family Welfare. The decision led to disagreements with development partners, which had serious implications for cooperation between key actors in the Bangladesh health sector leading to deteriorated relationships and suspension of donor funds. The donor community in itself was also in disagreement which led to inconsistencies in the dialogue between the development partners and the Government of Bangladesh.

Conclusion

The case shows that main actors in the Bangladesh health SWAp interpret ownership and coordination, fundamental aspects of SWAp, differently. As long as work ran smoothly, the different definitions did not create any problems, but when disagreements arose they became an obstacle. It is concluded that partners in development should devote more effort to their working relationships and that responsibilities within a SWAp need to be more clearly delineated.
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Literature
1.
go back to reference WHO: International Development Assistance and Health, The report of Working Group 6 of the Commission on Macroeconomics and Health. World Health Organization. 2002 WHO: International Development Assistance and Health, The report of Working Group 6 of the Commission on Macroeconomics and Health. World Health Organization. 2002
2.
go back to reference Brown A, Foster M, Norton A, Naschold F: The status of sector-wide approaches. 2001, Centre for Aid and Public Expenditure. Overseas Development Institute Brown A, Foster M, Norton A, Naschold F: The status of sector-wide approaches. 2001, Centre for Aid and Public Expenditure. Overseas Development Institute
3.
go back to reference Foster M, Brown A, Conway T: Sector-wide approaches for health development: a review of experience. 2000, Overseas Development Institute. World Health Organization Foster M, Brown A, Conway T: Sector-wide approaches for health development: a review of experience. 2000, Overseas Development Institute. World Health Organization
4.
go back to reference IHSD: Mapping of Sector-Wide Approaches in Health. 2003, Institute for Health Sector Development IHSD: Mapping of Sector-Wide Approaches in Health. 2003, Institute for Health Sector Development
5.
go back to reference Peters D, Chao S: The sector-wide approach in health: what is it? where is it leading?. International Journal of Health Planning and Management. 1998, 13: 177-190. 10.1002/(SICI)1099-1751(199804/06)13:2<177::AID-HPM504>3.0.CO;2-T.CrossRefPubMed Peters D, Chao S: The sector-wide approach in health: what is it? where is it leading?. International Journal of Health Planning and Management. 1998, 13: 177-190. 10.1002/(SICI)1099-1751(199804/06)13:2<177::AID-HPM504>3.0.CO;2-T.CrossRefPubMed
6.
go back to reference Walt G, Pavignani E, Gilson L, Buse K: Managing external resources in the health sector: are there lessons for SWAps (sector-wide approaches)?. Health Policy Plan. 1999, 14: 273-284. 10.1093/heapol/14.3.273.CrossRefPubMed Walt G, Pavignani E, Gilson L, Buse K: Managing external resources in the health sector: are there lessons for SWAps (sector-wide approaches)?. Health Policy Plan. 1999, 14: 273-284. 10.1093/heapol/14.3.273.CrossRefPubMed
7.
go back to reference Cassels A: A guide to sector-wide approaches for health development – concepts, issues and working arrangements. 1997, World Health Organization Cassels A: A guide to sector-wide approaches for health development – concepts, issues and working arrangements. 1997, World Health Organization
8.
go back to reference Hutton G: Decentralisation and the sector-wide approach in the health sector. 2002, Swiss Tropical Institute Hutton G: Decentralisation and the sector-wide approach in the health sector. 2002, Swiss Tropical Institute
10.
go back to reference Jahan R: Restructuring the health system: experiences of advocates for gender equity in Bangladesh. Reprod Health Matters . 2003, 11: 183-191. 10.1016/S0968-8080(03)02173-6.CrossRefPubMed Jahan R: Restructuring the health system: experiences of advocates for gender equity in Bangladesh. Reprod Health Matters . 2003, 11: 183-191. 10.1016/S0968-8080(03)02173-6.CrossRefPubMed
11.
go back to reference Walford V: Defining and evaluating SWAps. 2003, Institute for Health Sector Development Walford V: Defining and evaluating SWAps. 2003, Institute for Health Sector Development
12.
go back to reference Foster M: What can we learn from experience with implementing sector-wide approaches?. 2000, Overseas Development Institute Foster M: What can we learn from experience with implementing sector-wide approaches?. 2000, Overseas Development Institute
13.
go back to reference Hill PS: The rhetoric of sector-wide approaches for health development. Social Science & Medicine. 2002, 54: 1725-1737. 10.1016/S0277-9536(01)00340-9.CrossRef Hill PS: The rhetoric of sector-wide approaches for health development. Social Science & Medicine. 2002, 54: 1725-1737. 10.1016/S0277-9536(01)00340-9.CrossRef
14.
go back to reference Jeppsson A: SWAp dynamics in a decentralized context: experiences from Uganda. Social Science & Medicine. 2002, 55: 2053-2060. 10.1016/S0277-9536(01)00345-8.CrossRef Jeppsson A: SWAp dynamics in a decentralized context: experiences from Uganda. Social Science & Medicine. 2002, 55: 2053-2060. 10.1016/S0277-9536(01)00345-8.CrossRef
15.
go back to reference Buse K: Keeping a tight grip on the reins: donor control over aid coordination and management in Bangladesh. Health Policy and Planning. 1999, 14: 219-228. 10.1093/heapol/14.3.219.CrossRefPubMed Buse K: Keeping a tight grip on the reins: donor control over aid coordination and management in Bangladesh. Health Policy and Planning. 1999, 14: 219-228. 10.1093/heapol/14.3.219.CrossRefPubMed
16.
go back to reference Cassels A, Janovsky K: Better health in developing countries: are sector-wide approaches the way of the future?. The Lancet. 1998, 352: 1777-1779. 10.1016/S0140-6736(98)05350-1.CrossRef Cassels A, Janovsky K: Better health in developing countries: are sector-wide approaches the way of the future?. The Lancet. 1998, 352: 1777-1779. 10.1016/S0140-6736(98)05350-1.CrossRef
17.
go back to reference Hutton G, Tanner M: The sector-wide approach: a blessing for public health?. Bulletin of the World Health Organization. 2004, 82: 893-894.PubMed Hutton G, Tanner M: The sector-wide approach: a blessing for public health?. Bulletin of the World Health Organization. 2004, 82: 893-894.PubMed
18.
go back to reference Harrold P: The broad approach to investment lending. Sector investment programs. 1995, World Bank Harrold P: The broad approach to investment lending. Sector investment programs. 1995, World Bank
19.
go back to reference Sundewall J, Sahlin-Andersson K: Translations of health sector SWAps-A comparative study of health sector development cooperation in Uganda, Zambia and Bangladesh. Health Policy. 2006, 76: 277-287. 10.1016/j.healthpol.2005.06.009.CrossRefPubMed Sundewall J, Sahlin-Andersson K: Translations of health sector SWAps-A comparative study of health sector development cooperation in Uganda, Zambia and Bangladesh. Health Policy. 2006, 76: 277-287. 10.1016/j.healthpol.2005.06.009.CrossRefPubMed
20.
go back to reference Patton MQ: Qualitative evaluation and research methods. 1990, London: Sage publications Patton MQ: Qualitative evaluation and research methods. 1990, London: Sage publications
21.
go back to reference Kluckhohn F: The participant-observer technique in small communities. American Journal of Sociology. 1940, 46: 331-343. 10.1086/218650.CrossRef Kluckhohn F: The participant-observer technique in small communities. American Journal of Sociology. 1940, 46: 331-343. 10.1086/218650.CrossRef
22.
go back to reference Lancet T: Population control versus health. The Lancet. 1984, 30 (1): 1458-1459. Lancet T: Population control versus health. The Lancet. 1984, 30 (1): 1458-1459.
23.
go back to reference HSRC, DFID: Development of Administrative and Financial Capacity for Sector-Wide Approaches (SWAps): the Experience of the Bangladesh Health Sector. 2001, Health System Resource Centre. Department for International Development HSRC, DFID: Development of Administrative and Financial Capacity for Sector-Wide Approaches (SWAps): the Experience of the Bangladesh Health Sector. 2001, Health System Resource Centre. Department for International Development
24.
go back to reference Merkle A: Experiences and lessons learned from 2 years planning and 1 year implementation of a SWAp in the health and population sector in Bangladesh. 1999 Merkle A: Experiences and lessons learned from 2 years planning and 1 year implementation of a SWAp in the health and population sector in Bangladesh. 1999
25.
go back to reference Shiffman J, Wu Y: Norms in tension: democracy and efficiency in Bangladeshi health and population sector reform. Social Science & Medicine. 2003, 57: 1547-1557. 10.1016/S0277-9536(02)00547-6.CrossRef Shiffman J, Wu Y: Norms in tension: democracy and efficiency in Bangladeshi health and population sector reform. Social Science & Medicine. 2003, 57: 1547-1557. 10.1016/S0277-9536(02)00547-6.CrossRef
26.
go back to reference Ensor T, Dave-Sen P, Ali L, Hossain A, Begum S, Moral H: Do essential service packages benefit the poor? preliminary evidence from Bangladesh. Health Policy and Planning. 2002, 17: 247-256. 10.1093/heapol/17.3.247.CrossRefPubMed Ensor T, Dave-Sen P, Ali L, Hossain A, Begum S, Moral H: Do essential service packages benefit the poor? preliminary evidence from Bangladesh. Health Policy and Planning. 2002, 17: 247-256. 10.1093/heapol/17.3.247.CrossRefPubMed
27.
go back to reference Jahan R, Germain A: Mobilising support to sustain political will is the key to progress in reproductive health. Lancet. 2004, 364: 742-744. 10.1016/S0140-6736(04)16954-7.CrossRefPubMed Jahan R, Germain A: Mobilising support to sustain political will is the key to progress in reproductive health. Lancet. 2004, 364: 742-744. 10.1016/S0140-6736(04)16954-7.CrossRefPubMed
28.
go back to reference Government of Bangladesh: Co-Financier's Memorandum of Understanding relating to the funding of the Health and Population Program Project in Bangladesh. 1999, Ministry of Health and Family Welfare Government of Bangladesh: Co-Financier's Memorandum of Understanding relating to the funding of the Health and Population Program Project in Bangladesh. 1999, Ministry of Health and Family Welfare
29.
go back to reference Government of Bangladesh: Health & Population Sector Program Annual Program Review. Independent Technical Report. 2003, Ministry of Health and Family Welfare Government of Bangladesh: Health & Population Sector Program Annual Program Review. Independent Technical Report. 2003, Ministry of Health and Family Welfare
31.
go back to reference Government of Bangladesh: HNP Strategic Investment Plan July 2003 – June 2010. 2004, Ministry of Health and Family Welfare Government of Bangladesh: HNP Strategic Investment Plan July 2003 – June 2010. 2004, Ministry of Health and Family Welfare
32.
go back to reference Government of Bangladesh: Aide Memoire Bangladesh Health, Nutrition and Population Sector Program – Pre-appraisal mission for development partners' support August 8–20 2004. 2004, Ministry of Health and Family Welfare Government of Bangladesh: Aide Memoire Bangladesh Health, Nutrition and Population Sector Program – Pre-appraisal mission for development partners' support August 8–20 2004. 2004, Ministry of Health and Family Welfare
33.
go back to reference Jönsson K: Translating foreign ideas into domestic practice. Pharmaceutical policies in Laos and Vietnam. 2002, Lund University, Department of Political Science Jönsson K: Translating foreign ideas into domestic practice. Pharmaceutical policies in Laos and Vietnam. 2002, Lund University, Department of Political Science
34.
go back to reference Government of Bangladesh: Conceptual Framework for Health, Nutrition and Population Sector Programme (HNPSP), July 2003 – June 2006. 2003, Ministry of Health and Family Welfare Government of Bangladesh: Conceptual Framework for Health, Nutrition and Population Sector Programme (HNPSP), July 2003 – June 2006. 2003, Ministry of Health and Family Welfare
35.
go back to reference Buse K, Gwin C: The World Bank and global cooperation in health: the case of Bangladesh. The Lancet. 1998, 351: 665-669. 10.1016/S0140-6736(97)11453-2.CrossRef Buse K, Gwin C: The World Bank and global cooperation in health: the case of Bangladesh. The Lancet. 1998, 351: 665-669. 10.1016/S0140-6736(97)11453-2.CrossRef
36.
go back to reference World Bank: Health Program Support Office Annual Report (July 2002-June2003) Annual Workplan (July 2003-December 2003) and Annexes. 2003, World Bank Office World Bank: Health Program Support Office Annual Report (July 2002-June2003) Annual Workplan (July 2003-December 2003) and Annexes. 2003, World Bank Office
Metadata
Title
Theory and practice – a case study of coordination and ownership in the Bangladesh health SWAp
Authors
Jesper Sundewall
Birger Carl Forsberg
Göran Tomson
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Health Research Policy and Systems / Issue 1/2006
Electronic ISSN: 1478-4505
DOI
https://doi.org/10.1186/1478-4505-4-5

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