Improving Effectiveness and Outcomes for the Poor in Health, Nutrition, and Population

An Evaluation of World Bank Group Support Since 1997

World Bank

• Publisher: World Bank Publications
• Year: 2009
• Topic: Social Sciences
• eBook ISBN:
  9780821379516
• Subtopic: Social Science Research & Methodology
• Index: Social Sciences

This study evaluates the effectiveness of the World Bank Group's support for health, nutrition, and population (HNP) in developing countries from 1997 to 2008 – totaling more than $17 billion – and distills lessons for greater impact in the future. It finds that the Bank Group now funds a smaller share of global support for HNP than a decade ago, but its support remains substantial and adds considerable value. About two-thirds of the Bank's HNP support has had satisfactory outcomes, often in difficult environments. But in a number of country settings, particularly in Africa, it has not performed well, in part due to high complexity and weak capacity. Only half of HNP support had a pro-poor focus, while support to reduce high fertility and promote family planning has dwindled. The evaluation highlights the contribution of investments in water supply, sanitation, and hygiene to improving the health of the poor and the lessons from support for sector-wide approaches, communicable disease control, and health reform. Moving forward, the World Bank needs to improve the performance of its HNP support and the Bank and IFC need to take actions to ensure their support reaches the poor and contributes greater social benefits, respectively.

Table of contents

• Contents
• Abbreviations
• Acknowledgments
• Foreword
• Executive Summary
• Management Response Summary
• Chairperson's Summary: Committee on Development Effectiveness (CODE)
• Advisory Panel Statement
• 1 Introduction
• 2 Evolution and Performance of the World Bank's Country Support for Health, Nutrition, and Population
• 3 Lessons from Three Approaches to Improve Outcomes
• 4 The Contribution of Other Sectors to Health, Nutrition, and Population Outcomes
• 5 IFC's Health Strategy and Operations
• 6 Conclusions and Recommendations
• Appendixes
• Endnotes
• References
• Boxes
• Figures
• Tables
• 1.1 Objectives and Strategic Directions of Healthy Development, the 2007 World Bank HNP Strategy
• 1.2 Business and Developmental Objectives of IFC's 2002 Health Strategy
• 2.1 Objectives of HNP Projects Approved in Fiscal 1997–2006
• 2.2 Key Developments in the HNP Portfolio
• 2.3 More Project Appraisal Documents Have Baseline Data, but There Is Still Some Distance to Go, Fiscal Years 1997 and 2007
• 2.4 Few HNP Projects Have Objectives That Explicitly Mention the Poor
• 2.5 The Poverty Focus of HNP Analytic Work Declined
• 3.1 Outcomes and Bank Performance Are Lower for Health Reform Projects than for Other HNP Projects in Middle-Income Countries
• 3.2 HNP Projects Supporting Health SWAps in IEG Country Cases or Project Evaluations
• 4.1 Distribution of Multisectoral HNP Projects by Management and Implementation Arrangements
• 5.1 IFC Health Investments by Type of Investment and Period
• 5.2 Geographic Distribution of IFC Projects by Period
• 5.3 Profitability of IFC Health and Pharmaceutical Investments
• 5.4 IFC Advisory Services in Health (1997–2007)
• 5.5 Percent of Health and IFC Projects Rated High, PCR Pilots 1 and 2