Sector wide approaches for health in small island states: lessons learned from the Solomon Islands.

Sector Wide Approaches (SWAps) have increasingly been implemented in countries around the world as a mechanism for effective delivery of health sector funding from various sources. Despite the global focus on aid effectiveness, SWAps have been under-examined. In 2007, the Solomon Islands and development partners began discussing a health SWAp making the Solomon Islands one of the first fragile states globally to adopt a SWAp. This paper explores the establishment and implementation of a health SWAp in the Solomon Islands as a specific case study with lessons learned for the region as well as for aid architecture in fragile states more generally. Tensions between donors and the government impeded agreement and early implementation and country ownership of the SWAp idea was muted. Since mid-2009, however, the Solomon Islands SWAp has made strong progress with greater government ownership and with more focus on partnership and harmonisation rather than on funding mechanisms. The SWAp mechanism has been a challenge for the capacity-constrained Solomon Islands health sector and for development partners familiar with other aid modalities, but current momentum suggests that the SWAp will have a positive impact on adherence to agreed aid effectiveness principles.