The Uganda health SWAp: new approaches for a more balanced aid architecture?

Claes Örtendahl, October 2007

The early years of the Uganda health SWAp are generally considered a success story, but its performance has declined in recent years. A number of factors, including decreased government health spending, changes in aid modalities used by development partners, weakening government leadership, and poor governance in the health sector can help to explain this decline in performance. Discussions between government and donors on how to reform SWAp processes have begun, and a number of initiatives have emerged in this respect.

The Uganda experience with the health SWAp offers useful insights into the present realities of the aid architecture for health, as well as lessons for the future. It shows that leadership capacity is fundamental to the success of SWAp processes. It also points to the need for a more balanced funding architecture, which should include global financing partnerships, support long term macroeconomic balance, and enable effective use of non-financial resources.