Implementing a sector wide approach in health: the case of Mozambique

This paper, from HLSP Institute, explores the experience of sector wide approaches (SWAps) in Mozambique. The paper considers how the key elements of the SWAp have been developed, how processes and mechanisms are working now, and what the successes and challenges are. Challenges include that the health strategy does not focus enough on sector priorities, is too broad and centralised, and lacks a coherent policy dialogue framework. Other issues include: fragmentation of health sector financing; a lack of systematic follow up to regular reviews; a lack of availability and poor quality of indicators; and the persistence of high transaction costs due to multiple disease interventions.

The paper concludes that while structures, processes and outputs linked to the SWAP need to be in place, they do not guarantee its successful implementation. Attention needs to be placed on: the quality of the policy dialogue; enabling the government to exercise leadership without overburdening it; and ensuring that all development partners play and abide by the same rules. The author emphasises that in a rapidly changing health policy and financing environment, leadership, drive, coordination and mutual accountability require constant efforts and renewed commitments from all parties.