For Immediate Release
Date: October 13, 2024
Location: PPRC Office, Dhaka, Bangladesh
Organised by: PPRC & Forum for UHC
Bangladesh Reflects on 20+ Years of Sector-Wide Approaches (SWAp) in Health Sector Planning
Dhaka, Bangladesh, October 13, 2024 – A critical review of the Sector-Wide Approaches (SWAp) in Bangladesh’s health sector took place today at a policy dialogue session, titled “Navigating Health Sector Challenges: Is SWAp Still the Right Path for Bangladesh?” The session, held at the PPRC office and organized by the Forum for UHC and PPRC, brought together former government officials, development partners, health experts, and financial institutions.
Since the adoption of the first SWAp in 1998, this framework has guided the coordination of contributions from development partners and the government’s health policies. Over four iterations, SWAp has succeeded in aligning donor efforts with national health priorities and improving the delivery of essential services, particularly in maternal and child healthcare and preventive health services.
SWAp has played a crucial role in expanding primary healthcare services across Bangladesh, particularly in rural areas. Improvements in maternal and child healthcare, as well as preventive services, were noted. However, challenges remain, including a shortage of community health workers (CHWs) and an inadequate referral system between primary, secondary, and tertiary care levels.
The review discussed the gaps in equitable healthcare access, particularly in urban areas, where primary healthcare services are virtually non-existent. Despite improvements in rural service delivery, urban populations and marginalized communities still face significant barriers to accessing basic health services. These disparities call for urgent reforms in urban healthcare governance.
While SWAp has contributed to infrastructure development, such as the expansion of community clinics, the quality of resources remains inconsistent. Many facilities are plagued by poor-quality equipment and insufficient drug supplies. The need for better maintenance and resource alignment based on population needs was emphasized.
SWAp has improved coordination between various stakeholders, including government agencies, donors, and the private sector. However, fund utilization often takes priority over service quality, and there are still inefficiencies in coordinating between different levels of care.
Despite SWAp’s contributions, the review identified significant challenges that limit its long-term sustainability and adaptability. The reliance on external funding has raised concerns about the health sector’s ability to maintain service delivery if donor priorities shift. Additionally, SWAp’s rigid framework has struggled to address emerging health crises like the COVID-19 pandemic.
As Bangladesh moves toward achieving Universal Health Coverage (UHC) by 2030, stakeholders are considering whether a return to a revenue-based financing model or a hybrid approach combining domestic funding with donor contributions would offer a more sustainable and flexible solution for the health sector.
A transition roadmap involving stakeholder consultation and phased implementation of alternative models is being developed to ensure that future health financing aligns with national needs while maintaining flexibility and sustainability.
The review took place during the policy dialogue session titled “Navigating Health Sector Challenges: Is SWAp Still the Right Path for Bangladesh?” The event brought together former government officials, development partners, health experts, and financial institutions to evaluate the relevance of SWAp and explore future financing models to address Bangladesh’s evolving healthcare needs.