Investing in Health

by Stout, Susan; Johnston, Timothy A.

• ISBN13: 9780821343104
• ISBN10: 0821343106
• Format: Paperback
• Copyright: 1999-12-01
• Publisher: World Bank

Summary

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.

Table of Contents

Acknowledgments	v
Foreword, Prefacio, Preface	vii
Executive Summary, Resumen, Resume Analytique	ix
Abbreviations and Acronyms	xix
Introduction and Evaluative Framework	1	(4)
Health Outcomes and the Health System	1	(1)
Evaluating the Bank's Performance	2	(3)
Evolution of Bank HNP Strategy and Lending	5	(4)
1970s: Early Population Projects	6	(1)
1980s: Direct Lending for Primary Health Care	6	(1)
1990s: Health Financing and Health System Reform	6	(3)
Project Performance and Determinants	9	(10)
Project Performance Trends	9	(1)
Borrower Performance and Country Context	10	(1)
Bank Performance	10	(6)
Institutional Factors Influencing Performance	16	(3)
Development Effectiveness of HNP Investments and Policy Dialogue	19	(10)
Strengthening the HNP Service Delivery Structure	19	(5)
Enhancing Health System Performance	24	(2)
Health Financing	26	(1)
Instruments and Strategies for Reform	27	(2)
Recommendations	29	(4)
Increase Strategic Selectivity	29	(1)
Strengthen Quality Assurance and Results-Orientation	30	(1)
Enhance Learning and Increase Institutional Development Impact	30	(1)
Enhance Partnerships	31	(2)
Annexes	33	(32)
Annex A. Precis of Case Studies	33	(24)
Health Care in Brazil: Addressing Complexity	33	(6)
Health Care in India: Learning from Experience	39	(6)
Health Care in Mali: Building on Community Involvement	45	(6)
Meeting the Health Care Challenge in Zimbabwe	51	(6)
Annex B. Project Outcome---Sources of Information	57	(2)
Annex C. Ledger of OED Recommendations and Management Response	59	(4)
Annex D. Report from the Committee on Development Effectiveness (CODE)	63	(2)
Endnotes	65	(2)
Bibliography	67