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.

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 fin.

The Bank Group now funds a smaller share of global support for health, nutrition, and population (HNP) than it did a decade ago, but its support remains significant-$17 billion in country-level project financing, in addition to policy advice, analytic work, and engagement in global partnerships by the World Bank and $873 million in private health and pharmaceutical investments by International Finance Corporation (IFC) from 1997 to mid-2008. The Bank Group continues to play an important role and add value in HNP. About two-thirds of the Bank's HNP projects show satisfactory outcomes. Performance can be substantially improved by reducing project complexity, strengthening risk assessment and mitigation, conducting more up-front institutional analysis, and incorporating more evaluation to promote evidence-based decisions. The performance of IFC health investments, mainly hospitals, has improved markedly, but IFC has had limited success at diversifying its health portfolio. The Bank's investments often have a pro-poor focus, but their objectives need to address the poor explicitly and outcomes among the poor need to be monitored. Importantly, the Bank needs to increase support to reduce high fertility and malnutrition among the poor and ensure discussion of HNP in poverty assessments. IFC-financed hospitals mainly benefit the non-poor; IFC needs to support more activities that both make business sense and yield broader benefits for the poor. Adding HNP objectives to Bank projects in other sectors, such as water supply and sanitation, raises the incentive to deliver health benefits. Strengthening the complementarity of investments in HNP and other sectors can also improve outcomes. In IFC, incentives, institutional mechanisms, and an integrated approach to health are needed to improve coordination across units.

World Bank lending for health, nutrition, and population (HNP) activities is accelerating. The Bank's emphasis has evolved from expanding HNP service delivery capacity to encouraging systemic reform. The Bank is now the major source of external finance for the sector in the developing world. The policy influence of its nonlending services is potentially significant.With the current generation of projects, the Bank and its partners are attempting to address underlying constraints to sector performance, while remaining cognizant of the difficulty of improving health sector effectiveness and efficiency, even in developed countries. This volume recommends that the Bank seek to: • do better, not more, in the HNP sector, • improve project monitoring and evaluation, and • strengthen its ties with the World Health Organization and other interested organizations.

Annotation This book takes an in-depth look at health, nutrition and population challenges faced by Sub-Sharan Africa, particularly how disease, malnutrition and high fertility affect poverty reduction.

"The past three decades have seen impressive advances in development in the East Asia and Pacific (EAP) region. Gains in income and education have been accompanied by reductions in high levels of infant and child mortality and fertility, improved nutritional levels, better hygiene and sanitation and increased access to health care."This book is intended to help address the development challenges and policy directions for the World Bank's Health, Nutrition, and Population (HNP) sector in the region. It highlights key lessons learned in the EAP region and presents policy options and recommendations to strengthen the quality and effectiveness of Bank-supported HNP operations.The development of this strategy is closely linked to the Bank's overall sector strategy that identified three major development priorities: • Improve the health, nutrition, and population outcomes of the poor • Enhance the performance of health care systems • Secure sustainable health care financing.A Health, Nutrition, and Population Strategy for the East Asia and Pacific Region is meant to provide the guidelines and parameters to be used at the country-level. Strategy development will be ongoing, building on best practices within the region as well as internationally.This book is an invaluable resource for all those interested in the field of health, nutrition, and population in the context of international development.

This volume presents eleven case studies that document how well or poorly health, nutrition, and population programs have reached disadvantaged groups in the countries of Africa, Asia, and Latin America where they were undertaken. The studies were commissioned by the Reaching the Poor Program, undertaken by the Word Bank in cooperation with the Bill and Melinda Gates Foundation and the Dutch and Swedish governments, in an effort to find better ways of ensuring that health, nutrition, and population programs benefit the neediest. These case studies, reinforced by other material gathered by the.