Sector Investment Program (SIP) is an integrated program comprising: i) a management framework providing for common implementation procedures for donors to the sector; and ii) funding commitments from donors (often involving the World Bank playing a role as 'donor of last resort' to ensure the agreed program is fully financed). SIPs have been seen as an instrument for overcoming weaknesses in the management of development assistance that are especially severe in many countries of Sub-Saharan Africa (SSA). These include lack of ownership of programs by governments and other local stake holders, weak public expenditure management, and fragmented management of donor assistance. In practice, SIPs are often also a vehicle for radical institutional reforms, such as decentralization of planning and decision-making to the district level. The study found that while the preconditions of macroeconomic stability and allocations of public expenditure between sectors identified for SIP implementation were broadly met in the case studies, institutional capacity remained weak compared to the requirements to achieve donor acceptance of common implementation arrangements. As a result, little progress was made in establishing common financial arrangements, with the exception of the district basket which formed part of the Zambian health program. Common review and reporting procedures were however established in all four cases. There appeared to be only partial linkages between the sector expenditure program and the broader medium- and long-term macroeconomic framework, although it is recognized that the review processes established provide an opportunity for adjusting expenditure programs over time.