Austerity and the "sector-wide approach" to health: The Mozambique experience

Social Science & Medicine
James PfeifferKenneth Sherr

Abstract

Fiscal austerity policies imposed by the IMF have reduced investments in social services, leaving post-independence nations like Mozambique struggling to recover from civil war and high disease burden. By 2000, a sector-wide approach (SWAp) was promoted to maximize aid effectiveness. 'Like-minded' bilateral donors, from Europe and Canada, promoted a unified approach to health sector support focusing on joint planning, common basket funding, and streamlined monitoring and evaluation to improve sector coordination, amplify country ownership, and build sustainable health systems. Notable donors - including US government and the Global Fund - did not participate in the SWAp, and increased vertical funding weakened the SWAp in favor of non-governmental organizations (NGOs). In spite of some success in harmonizing aid to the health sector, the SWAp experience in Mozambique demonstrates how continued austerity regimes that severely constrain public spending will continue to undermine health system strengthening in Africa, even in the midst of high levels of foreign aid with the ostensible purpose of strengthening those systems. The SWAp story provides a poignant illustration of how continued austerity will impede progress toward Susta...Continue Reading

Citations

Nov 30, 2019·Globalization and Health·James Pfeiffer, Rachel R Chapman
Jul 3, 2021·International Journal of Environmental Research and Public Health·Charlotte ScheerensIlse Ruyssen
Aug 28, 2021·Globalization and Health·Catherine DecouttereNico Vandaele

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