Integrating development aid into social policy: Lessons on cooperation and its challenges learned from the example of health care in Kyrgyzstan

Abstract

In many low- and lower-middle-income countries, development aid accounts for a large share of social expenditures. However, its fragmentation is among the major challenges to the efficiency and sustainability of policy measures. In reaction to this challenge, the Sector-Wide Approach (SWAp) to development aid proposes pooling resources in order to improve cooperation and increase ownership by the recipient state. The SWAp to health care in Kyrgyzstan, which started in 2005, is treated as one of the major success stories in the expert community and the academic literature. To allow for systematic analysis of the many-fold principles incorporated into the SWAp blueprint, we re-conceptualise it as an ideal-type causal mechanism leading from improved cooperation to efficient aid implementation. Based on a case study of the second phase (2012–2018) of the SWAp to health care in Kyrgyzstan we highlight critical junctures in the implementation of a donor-supported social policy.