CHAPTER 4: MAKING IT HAPPEN
BOX 4.6 A WHOLE-OF-GOVERNMENT APPROACH TO STRENGTHEN HUMAN CAPITAL The World Bank’s Human Capital Project (HCP) is a global, multisectoral effort to accelerate more and better investments in people for greater equity and economic growth. The HCP contributes to a whole-of-government approach in three ways: by sustaining efforts across political cycles; by linking different sectoral programs; and by expanding the policy design evidence base (World Bank 2018c). This approach recognizes that getting children into school, reducing child mortality, tackling communicable diseases, increasing life expectancy, and expanding social safety nets in low- and middle-income countries are not simply moral imperatives; they are also economic imperatives, as they will allow people to compete and thrive in a rapidly-changing environment (World Bank 2018c). While technology brings opportunity, paving the way to create new jobs, increase productivity and deliver effective public services, it also changes the skills that employers seek; workers need to be better at complex problem solving, teamwork, and adaptability (World Bank 2019b). The HCP therefore encourages and supports countries to spend on health, education, and social protection programs, in addition to sectors beyond human development. For example, in Nepal, investments in sanitation are contributing significantly to preventing anemia (World Bank 2018c).
be prevented by making PHC work better for these minority populations, including by tackling language and cultural barriers (New Zealand Treasury 2019). Other whole-of-government models target a specific problem. Peru used such an approach to reduce its chronic child malnutrition rate from 28 percent to 13 percent between 2005 and 2016. This success can be largely attributed to strong leadership by the Ministry of Economy and Finance, which lasted through successive changes of political administration. The approach encouraged multilevel, cross-government coordination and used a results-based approach to allocate resources only to evidence-based interventions across sectors. It incorporated a communications strategy, education, and demandside incentives provided through a conditional cash transfer program. Strong leadership is needed at the national level to ensure effectiveness, but whole-of-government PHC strengthening approaches must be supported by bottom-up participation, reliable funding, and a strong accountability structure. Even well-organized efforts at the national level may be limited in their capacity to influence social determinants of health, if they are not aligned with local initiatives that express communities’ concerns, priorities, and preferred solutions (Marmot et al. 2008; Public Health Agency of Canada and WHO 2008).
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