This study was commissioned by the Brazil office of the UK Department for International Development in response to the growing interest in the role of sector wide approaches (SWAps) in middle income countries (MICs) such as Brazil. The aim of this study is to provide a synthesis of lessons learned from SWAps supported by the World Bank in Brazil, and to offer recommendations on how to take the experience forward. The study was undertaken through a desk review of the relevant literature and interviews with officials of development agencies, the Government of Brazil and the Government of the state of Ceará, focusing on three SWAp cases.