Approaches for delivering aid

A range of approaches are available to distribute aid. They differ by whether or not aid is targeted towards a specific sector or project; the channels through which it is distributed (government institutions, private sector, civil society organisations); the economic, political or technical conditions that might be placed on aid; and the accountability arrangements used to ensure that aid is spent in accordance with donor requirements. Aid can also be provided in the form of technical cooperation (sharing knowledge, expertise or human resource) and policy engagement which aims to influence policies and practice.

In the health sector key approaches for delivering aid include, but are not limited to, stand alone projects, sector wide approaches and budget support.

Stand Alone Projects

In Stand Alone Projects donors support activities that are separate from government channels of financing, management and evaluation. They appear to be the most feasible instrument for delivering aid in fragile states or in weak policy environments. The shortcomings of stand alone projects is that they only provide fragmented improvements and can have unintended negative effects, for instance by diverting human and technical resources away from the public sector.

Sector Wide Approaches

Since the mid 1990s, many health policy-makers have preferred to use a Sector Wide Approach (SWAp) for delivering aid. This is a process whereby donors direct funding towards a single sector strategy and expenditure programme, led by the recipient country. SWAps promote government ownership and leadership which are essential for development. They also enable donors to be better coordinate and for funding to be more predictable, thus reducing aid fragmentation and duplication.

Budget Support

This is a form of aid that is channelled directly to partner government’s national treasuries and is spent on national policies rather than specific project or sector activities. Budget support means the aid is dispersed in accordance with the national priorities set through the general budget process. This enables countries to spend according to their priorities and similar to SWAps, promotes government ownership.


The type and mix of instruments used to deliver aid is not the same for all countries but will depend upon the local context, capacity and development objectives. As shown above, different approaches have distinct benefits and limitations, and selecting the right instruments for use in the right context is important. Emphasis is increasingly moving away from stand alone projects and towards more sustainable approaches that focus on building government capacity to implement effective health policy.