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Topic:Health, Nutrition, & Population
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How to establish a nationwide social protection program: Five lessons from the Philippines

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How to establish a nationwide social protection program: Five lessons from the Philippines
This brief captures the lessons from evaluating a World Bank project implemented in the Philippines—the Social Welfare and Development Reform Project (SWDRP).This brief captures the lessons from evaluating a World Bank project implemented in the Philippines—the Social Welfare and Development Reform Project (SWDRP).

Burundi CLR Review FY13-16

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This review of the World Bank Group’s (WBG) Completion and Learning Review (CLR) covers the period of the Country Assistance Strategy (CAS), FY13-16, and updated in the Performance and Learning Review (PLR) dated February 25, 2015. The World Bank Group’s (WBG) CAS had three focus areas: (i) improving competitiveness, (ii) improving resilience by consolidating social stability, and (iii) Show MoreThis review of the World Bank Group’s (WBG) Completion and Learning Review (CLR) covers the period of the Country Assistance Strategy (CAS), FY13-16, and updated in the Performance and Learning Review (PLR) dated February 25, 2015. The World Bank Group’s (WBG) CAS had three focus areas: (i) improving competitiveness, (ii) improving resilience by consolidating social stability, and (iii) strengthening governance. The CAS was broadly aligned with the Government’s Second National Poverty Reduction Strategy (PRSP II), 2012-2015, which seeks to improve governance, growth and job creation, social services, and environmental/spatial management. Specifically, the CAS focus areas and objectives supported PRSP II objectives on quality of economic infrastructure, promotion of the private sector and job creation, strengthening the social safety net, capacity building and improved performance in the healthcare system, and fiscal management.

Ethiopia: Nutrition Project (PPAR)

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Although Ethiopia has achieved substantial progress in economic, social, and human development over the past decade, the ranking of its Human Development Index remains low. Malnutrition is widespread, and it lowers resistance to infections and affects the intellectual development of children and productivity among adults. The project development objectives were “to improve child and maternal care Show MoreAlthough Ethiopia has achieved substantial progress in economic, social, and human development over the past decade, the ranking of its Human Development Index remains low. Malnutrition is widespread, and it lowers resistance to infections and affects the intellectual development of children and productivity among adults. The project development objectives were “to improve child and maternal care behavior, and increase utilization of key micronutrients, in order to contribute to improving the nutritional status of vulnerable groups.” Direct beneficiaries consisted of pregnant and lactating women, and under-five children in food insecure regions with high malnutrition rates. Ratings for the Nutrition Project are as follows: Outcome was satisfactory, Risk to development outcome was moderate, M&E Quality was substantial, Bank performance was moderately satisfactory, and Borrower performance was moderately satisfactory. Lessons from the project include: (i) The use of interactive approaches at the community level can facilitate behavior change. (ii) In very poor communities, CBN needs to complement behavior change interventions with income support to achieve the desired goals fully because behavior change also depends on the means to keep or to buy healthful and nutritionally rich food. (iii) Favorable institutional conditions, programmatic arrangements, and incentives facilitate the unfolding of multisectoral engagement. (iv) Integration of nutrition operations with an existing and institutionalized service delivery mechanism at the community level facilitates CBN implementation. (v) External collaboration with development partners, under government leadership, catalyzes international expertise and good practices that benefit and reinforce government policy and its nutrition agenda.

IEG Work Program and Budget (FY20) and Indicative Plan (FY21-22)

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To maximize its relevance and value added for the World Bank Group (WBG), IEG will align its work program with WBG strategic priorities. IEG also aims to maintain a clear line of sight with the WBG mission and the Sustainable Development Goals (SDGs), as well as with commitments made in the IBRD and IFC Capital Packages and in the context of IDA replenishments. Furthermore, IEG will keep an Show MoreTo maximize its relevance and value added for the World Bank Group (WBG), IEG will align its work program with WBG strategic priorities. IEG also aims to maintain a clear line of sight with the WBG mission and the Sustainable Development Goals (SDGs), as well as with commitments made in the IBRD and IFC Capital Packages and in the context of IDA replenishments. Furthermore, IEG will keep an increased focus on outcomes, countries, clients, and beneficiaries in its work, and aim to foster a greater outcome orientation throughout the WBG. To achieve this strategic vision, IEG will focus its work program on the key development effectiveness questions that the institution and its clients are most concerned about. For each of these questions, we will strive to answer “why”, “how, “where”, “when”, and “for whom” specific interventions or programs have achieved results or not. By working more closely with operational units and other evaluation initiatives across the WBG, we will seek to significantly enhance IEG’s value added for the Board and WBG management. The work program will be anchored around a series of “streams”, building evidence over time on connected themes and trying to bridge between project, country, sector and strategic impact: Fragility, Conflict and Violence (FCV), Gender, Maximizing Finance for Development, Human Capital, Climate Change, Growth and Transformation. In addition, IEG will work along an ‘effectiveness’ cross-cutting stream, aimed at examining systemic issues in WBG effectiveness, as well as working towards building a stronger outcome focus for WBG operations and strategies.

Peru: Juntos Results for Nutrition Project (PPAR)

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This is the Project Performance Assessment Report (PPAR) for the Juntos Results for Nutrition Project in Peru. The project objectives were to (i) increase demand for nutrition services by strengthening the operational effectiveness of Juntos and (ii) improve coverage and quality of the supply of basic preventive health and nutrition services in the communities covered under the program, including Show MoreThis is the Project Performance Assessment Report (PPAR) for the Juntos Results for Nutrition Project in Peru. The project objectives were to (i) increase demand for nutrition services by strengthening the operational effectiveness of Juntos and (ii) improve coverage and quality of the supply of basic preventive health and nutrition services in the communities covered under the program, including Juntos. The project targeted 3 of the 14 poorest regions of Peru: Amazonas, Cajamarca, and Huánuco. Ratings for the Juntos Results for Nutrition Project are as follows: Outcome was satisfactory, Bank performance was moderately satisfactory, and M&E quality was substantial. Lessons from the project include: (i) Long-term engagement is critical to a deep understanding of complex malnutrition challenges. (ii) Attitudes toward nutrition need to change at all levels to make a difference. (iii) It is important to address both the supply and demand for health and nutrition services. (iv) Understanding the causes, consequences, and corrective actions required to reduce malnutrition can lead to changes in behaviors. (v) Changes in beneficiaries’ behaviors cannot be assumed; they must be monitored.

World Bank Support to Aging Countries (Approach Paper)

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Population aging – resulting from falling fertility rates, declining mortality, and increased longevity – shapes the profile and the needs of an increasing number of countries. How effective has the World Bank been in tailoring its toolkit to provide an adequate response? This proposed evaluation is the first at IEG to assess the World Bank contribution to diagnosing client countries’ demographic Show MorePopulation aging – resulting from falling fertility rates, declining mortality, and increased longevity – shapes the profile and the needs of an increasing number of countries. How effective has the World Bank been in tailoring its toolkit to provide an adequate response? This proposed evaluation is the first at IEG to assess the World Bank contribution to diagnosing client countries’ demographic issues related to population aging; understanding the variance in policy needs and context specificities; and providing vision, tools, and resources to respond to challenges in countries at different stages of aging.

How incentive payments support Universal Health Coverage, in theory and in practice

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How incentive payments support Universal Health Coverage
What IEG found evaluating the World Bank Group's portfolio of PBF programs.What IEG found evaluating the World Bank Group's portfolio of PBF programs.

Vietnam: Education Projects - School Readiness and Escuela Nueva

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The government and people of Vietnam place a high value on education. The government’s Socio-Economic Development Strategy 2010–20 and the Socio-Economic Development Plan 2016–20 emphasize the importance of investment in human capital to develop people’s skills in support of a knowledge-based economy. This assessment covers two projects: Vietnam School Readiness and Promotion Project, and the Show MoreThe government and people of Vietnam place a high value on education. The government’s Socio-Economic Development Strategy 2010–20 and the Socio-Economic Development Plan 2016–20 emphasize the importance of investment in human capital to develop people’s skills in support of a knowledge-based economy. This assessment covers two projects: Vietnam School Readiness and Promotion Project, and the Global Partnership for Education-Vietnam Escuela Nueva Project. Objectives for these projects are: (i) to raise school readiness for five-year old children, in particular for those most vulnerable to not succeeding in a school environment, through supporting selected elements of Vietnam’s Early Childhood Education (ECE) program, and (ii) to introduce and use new teaching and learning practices in the classroom targeting the most disadvantaged groups of primary students. Ratings for the Vietnam School Readiness and Promotion Project are as follows: Outcome was satisfactory, Bank performance was satisfactory, Quality of M&E was substantial, and Risk to development outcome was low. Ratings for the Global Partnership for Education – Vietnam Escuela Nueva Project are as follows: Outcome was satisfactory, Risk to development outcome was modest, Bank performance was satisfactory, and Borrower performance was satisfactory. IEG identified the following lessons from its evaluation of the two operations: (i) In addition to lending, the World Bank can add value through the transmission of knowledge from experiences and lessons that help shape reforms. (ii) When significant pedagogical changes are required of teachers, incentives, support, and long-term commitment are needed (probably more than education systems realize). (iii) When scaling up or adopting a systemwide approach, it is important to understand and design this approach in accordance with the decentralized context and challenges faced at the various levels of administration. (iv) Targeting disadvantaged areas does not translate into targeted efforts for specific vulnerable groups. (v) When scaling up, the importance of consultation and communication cannot be underestimated.

Croatia CLR Review FY14-17

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This review of the Croatia's Completion and Learning Review (CLR) of the World Bank Group's (WBG) Country Partnership Strategy (CPS) covers the CPS period, FY14-FY17, and the Performance and Learning Review (PLR) of 2016.The World Bank Group program had three focus areas: (i) promoting fiscal consolidation, (ii) improving competitiveness to spur growth, and (iii) maximizing the benefits of EU Show MoreThis review of the Croatia's Completion and Learning Review (CLR) of the World Bank Group's (WBG) Country Partnership Strategy (CPS) covers the CPS period, FY14-FY17, and the Performance and Learning Review (PLR) of 2016.The World Bank Group program had three focus areas: (i) promoting fiscal consolidation, (ii) improving competitiveness to spur growth, and (iii) maximizing the benefits of EU membership. These were broadly congruent with the government's 2013 Economic Program, which covered fiscal consolidation with a particular focus on pension reform and rationalizing hospitals; growth and competitiveness through a sustainable development strategy based on the knowledge economy; and absorption of EU funds available to Croatia. The CPS addressed key challenges facing the country, including EU accession, and was congruent with the Government's 2013 Economic Program and aligned with the WBG's twin goals. The analytical work undertaken by the World Bank contributed to the 2018 Systematic Country Diagnostic Study (SCD), and addressed fiscal issues as well as issues in the justice system, energy, and smart specialization. Portfolio performance was comparable with the ECA region and the World Bank, but some interventions were affected by changes in government priorities.

Armenia: Achievements and Challenges in Improving Health Care Utilization – A Multiproject Evaluation of the World Bank Support to the Health System Modernization (2004-2016) (PPAR)

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This is the multiproject Project Performance Assessment Report (PPAR) for the Adaptable Program Loan (APL) Health System Modernization series (comprising a first phase P073974, a second phase P104467, and an additional financing P121728). It evaluates the extent to which the APL series achieved its intended outcomes and offers an opportunity to draw lessons from the long-term engagement of the Show MoreThis is the multiproject Project Performance Assessment Report (PPAR) for the Adaptable Program Loan (APL) Health System Modernization series (comprising a first phase P073974, a second phase P104467, and an additional financing P121728). It evaluates the extent to which the APL series achieved its intended outcomes and offers an opportunity to draw lessons from the long-term engagement of the World Bank in reform of the Armenia health sector aiming to inform and guide future investments in the health sector. The APL series was selected for an indepth field-based assessment due to its potential for learning from long-term engagement of the World Bank in health sector reforms; its clustering nature that allows coverage of multiple lending operation in the same country; and the relatively low coverage of previous IEG project evaluations in the country. Ratings for the Health System Modernization Project I are as follows: Outcome was satisfactory, Risk to development outcome was negligible to low, Bank performance was satisfactory, and Borrower performance was satisfactory. Project II ratings are as follows: Outcome was satisfactory, Risk to development outcome was moderate, Bank performance was satisfactory, and Borrower performance was satisfactory. Lessons from both projects include: (i) An approach that exploits synergies and lessons from other World Bank engagements in the health sector is important for undertaking complex reforms and helping the government stay the course of the reform. (ii) Macro and micro health policies need to be combined in a manner that the unintended consequences of policy changes are not overlooked. (iii) A shortened period between the approval dates of successive phases of an APL can limit the opportunity to incorporate lessons from previous phases into the design of new ones. (iv) In country contexts with strong social and cultural factors affecting uptake of health care services, supply-side and systemwide policy reforms need to be combined with demand-side interventions addressing the health-seeking behavior of patients. (v) While investments in infrastructure are not enough for health system modernization, they can help ensure acceptance of the proposed organizational changes involving strong stakeholders in the hospital sector.