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shar e -n e t NETHERLANDS NETWORK ON SEXUAL & REPRODUCTIVE HEALTH AND AIDS

shar e -n e t NETHERLANDS NETWORK ON SEXUAL & REPRODUCTIVE HEALTH AND AIDS. — Summary of the SWAp Seminar (A’dam, Sep 2002) for EuroNGOs/Rome, 25 October 2002. shar e -n e t : SWAp Seminar. 1 of 6 regular seminars in 2002 Organised by Working Group on SWAp (>>now WG on Health System Devel.)

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shar e -n e t NETHERLANDS NETWORK ON SEXUAL & REPRODUCTIVE HEALTH AND AIDS

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  1. share-netNETHERLANDS NETWORK ON SEXUAL& REPRODUCTIVE HEALTH AND AIDS — Summary of the SWAp Seminar (A’dam, Sep 2002) for EuroNGOs/Rome, 25 October 2002

  2. share-net: SWAp Seminar • 1 of 6 regular seminars in 2002 • Organised by Working Group on SWAp (>>now WG on Health System Devel.) • Keynote speakers: • Rene Dubbeldam, ETC Crystal, NL • Helen Elsey, DFID/Liverpool School TM, UK • Susannah Mayhew, London School HTM, UK • NOW: Summary (not own work)

  3. (1)SWAps in Health:General Key Issues

  4. SWAp – Goal Increase sustainable, efficient and equitable use of ALL available (national and external) resources

  5. SWAp – Characteristics SWAp is an APPROACH, alternative for project/vertical approach: • Identifies all sector funding • Supports single sector programme • Led by government • Adopts common approach • Aiming at single set of procedures

  6. SWAp – Central assumption Stakeholders can and will pool their interests and resources, and collaborate towards common agenda of health development

  7. SECTOR-WIDE Funders Owners Providers APPROACHES Vision Policies Strategies M&E Checks&balances SWAp = SW + A

  8. SWAp – Performance criteria Multi-sectoral! • Poverty, gender, … Sector/system focus • Equity, efficiency • Consumer satisfaction • Procurement • HRD

  9. SWAp – Opportunities • Strengthening district health care • Equitable resource allocation • Resource mobilisation • Stakeholder involvement in policy dialogue • Sector-wide info for evidence-based planning + budgeting

  10. SWAp – Limitations • MoH mostly lead agency, but: capacity? • Health sector: ‘health development’ or ‘health services’? • Cure vs. care/prevention/CBS • SWAps under decentralisation?? (deconcentration vs. devolution/local government)

  11. SWAp – Risks • Too ambitious • Focus on efficiency/streamlining, not on equity and quality/client perspective • No CSO involvement; ownership? • ‘Sector-wide’ turns out to be ‘sector narrow’: no attention for multi-sectoral issues • Donors do not give up own interests • If major donors not involved?

  12. SWAp – Discussion issues • ‘Old way’ of earmarking donor funds for NGOs/vertical progr. do not solve basic health sector problems >> alt. • SWAps necessary…but not sufficient • SWAp OK as policy framework, but NOT to use to channel funds • SWAp is nonsense, too complex, unclear, not major issue in many countries, big % out-of-pocket

  13. (2)SWAps and S&RH, HIV/AIDS:Opportunities and Pitfalls

  14. Opportunities • SWAp-goal is essential for improving basic health services, this is crucial for S&RH and HIV/AIDS activities • Opportunity to mainstream S&RH in whole sector, IF stakeholders agree on importance • Also CSO-opportunities • On local level, if devolution/Local Govt. planning • In principle: resource mobilisation and equity, also important for S&RH

  15. Pitfalls • Risk of ‘sector-narrow’: How to organise intersectoral collaboration re. S&RH/AIDS? Whom? What level? • S&RH is not a priority, unaddressed • Capacity health sector remains too limited to adeq. address wide range of S&RH/AIDS issues • Emphasis on cure vs. prevention

  16. Discussion issues (1) • CSO-input essential for S&RH/AIDS, this is problematic in SWAps • OR: NGOs involved, but dependent on Government • Donors should still fund CSO as advocates • Attn. for quality/client persp. is essential, also problematic

  17. Discussion issues (2) • Global Fund is threat to SWAps • SWAp and AIDS: sustainability vs. speedy action? • S&RH and HIV/AIDS: still separate circuits, this weakens influence!

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