Since the 2005 country case-study of Senegal, confidence has waned in the SWAp as a mechanism for effective coordination of donor support for the health sector. With frequent changes of the minister of health and senior staff impacting on the continuity of administration and policy directions, donors and MOH planners are looking to discussions around a proposed compact through IHP+ to provide a new focus for coordination. For SRH, this risks some of the progress in prioritization at the national level, with donors increasingly focusing on MDG4 and 5, and the comprehensive ICPD Programme of Action (3) appears as less.