I M P ROV I N G E F F E C T I V E N E S S A N D OUT C O M E S F O R T H E P OO R I N H E A LT H , N UT R IT I O N , A N D P O P U L AT I O N
Box 1.2: Evaluation Building Blocks
World Bank • Review of strategy documents and construction of a timeline of World Bank HNP support and policies and international events. • Desk review of Country Assistance Strategies (CASs) with respect to their prioritization of health, attention to health outcomes among the poor, and planning of multisectoral operations. • Desk review of the objectives, strategies, and development effectiveness a of all 220 HNP projects approved during fiscal years 1997–2006 under the responsibility of the HNP sector, as well as analysis of projects with HNP objectives or components under the responsibility of the transport and water supply and sanitation sectors. • Field evaluations (Project Performance Assessment Reports, PPARs) of completed HNP projects in Bangladesh, the Arab Republic of Egypt, Eritrea, Ghana, Kyrgyz Republic, Peru, the Russian Federation, and Vietnam; a road safety project in Romania; and a rural water supply and sanitation project in Nepal that had objectives to improve HNP outcomes. Fieldbased country case studies to evaluate the entirety of World
Bank lending and nonlending support in Egypt, Malawi, and Nepal. • Background papers reviewing the evidence from the portfolio review and field studies on key evaluation themes, such as communicable diseases, sectorwide approaches, and M&E.
IFC • Review of IFC health sector strategies. • Review of the objectives, characteristics, design features, and implementation status of the portfolio of all 54 committed health investment projects approved between fiscal 1997 and 2007 and an assessment of the performance of mature health projects against established benchmarks and their stated objectives. • Desk review of all completed and ongoing Advisory Service projects in health and follow-up interviews with World Bank and IFC staff, as appropriate. • Field visits to Argentina, China, Egypt, Philippines, and Turkey to interview IFC clients and other stakeholders, and to review the performance of 12 investment projects, IFC support for public-private partnerships, and IFC-World Bank collaboration.
a. Development effectiveness is the extent to which a program has attained its major relevant objectives efficiently.
depth investigation of purposive samples. The samples of projects reviewed are described in appendix B, and the World Bank HNP sector projects and IFC health projects included in the portfolio review are listed in appendixes C and D. The evaluation also draws on findings and lessons from other IEG evaluations that are relevant to the World Bank Group’s HNP support, in particular, evaluations of social funds (IEG 2002b), middle-income countries (IEG 2007b), public-sector reform (IEG 2008f), economic and sector work (IEG 2008h), and an impact evaluation of maternal and child health and nutrition in Bangladesh (IEG 2005b).
Organization of the Report The evaluation results are presented in six chapters. Chapters 2–4 evaluate the World Bank’s support since 1997 with respect to the key evaluation themes.
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• Chapter 2 examines the evolution and outcomes of the portfolio of HNP lending and analytic work. Key issues include: trends in the objectives, composition, and performance of the HNP portfolio; the poverty focus and outcomes for the poor of the Bank’s investments; and whether M&E of HNP activities have improved the evidence base for decision making. • Chapter 3 distills the performance and lessons from a decade of experience supporting three approaches that are closely related to the strategic actions to be taken in the 2007 HNP strategy: communicable disease control, health system reform, and sectorwide approaches (SWAps) in health, which aim to improve the efficiency and effectiveness of donor assistance in support of developing country health objectives. • The 2007 HNP strategy maintains that multisectoral action to improve HNP outcomes is a comparative advantage of the World Bank.12 Chapter 4 highlights the contribution of other sectors to HNP results: the extent to which