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

Page 55

E VO L UT I O N A N D P E R F O R M A N C E O F T H E WO R L D BA N K ’ S C OU N T RY S U P P O RT

Figure 2.2: IDA and IBRD Commitments Declined; the Number of IBRD Projects Also Fell, But IDA Projects Rose in Number A. Commitments

B. Number of Projects 100

3,500

89

3,117 2,514

2,376

2,500

2,024 2,000 1,500 1,000

Number of projects approved

Millions of dollars

3,000 80 61 60

40

35 28

20

500 4

3 0

0 1997–2001

2002–2006

1997–2001

Fiscal year IDA

IBRD

2002–2006 Fiscal year

IDA

IBRD

Blend

Source: IEG portfolio review.

aimed to reduce communicable disease, while only 1 in 10 had nutrition objectives and only 4 percent had an objective to reduce high fertility. Health reform–related objectives collectively were addressed by a third of the projects.

Trends in the Level and Composition of Health, Nutrition, and Population Support, Fiscal 1997–2006 Although IDA and IBRD commitments fell, the number of IDA projects rose, resulting in a larger number of small projects in the portfolio by the end of the decade. IDA’s share of commitments remained about the same, accounting for 55 percent of total commitments in the second period (figure 2.2A). The total number of HNP projects approved increased from 99 to 121 between fiscal 1997–2001 and 2002–06. All of this increase was created by IDA project approvals; the number of IBRD projects declined (figure 2.2B).3 There were other major developments in the composition of the HNP portfolio over the decade. Africa’s share of HNP project approvals increased from more than a quarter in fiscal years 1997–2001 to more than a third in fiscal

2002–06. The number of new HNP proj- While commitments ects in Africa rose by more than 60 declined over the period, percent (from 28 to 45), and in Latin the number of projects America and the Caribbean by 30 per- increased, as did the cent (from 20 to 26). The share of com- share in Africa. municable disease and multisectoral HNP projects also increased dramatically. The increase in Africa Region, communicable disease, and multisectoral projects reflected a rise in HIV/AIDS project approvals; in the second half of the period, the HIV/AIDS projects reached nearly 40 percent of the HNP portfolio. In line with inter- Communicable disease national efforts to improve donor har- projects rose to 44 percent monization and alignment, the share of approvals, while health of HNP projects financing SWAps in reform objectives declined. health also climbed.4 Although more HNP projects were approved during the second half of the decade, both the share and the absolute number of projects financing health reform–type objectives declined (table 2.2, lower panel).5 This includes projects with objectives of reform, financing, insurance, decentralization, and government actions with respect to the private health 17


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