1.
The World Bank Group’s
Support to Health Services
Maria Elena Pinglo, Evaluation Officer
February 28, 2019
The Independent Evaluation Group

2.
Today’s presentation
1. Sector
Context
2. WBG
Support
3. Key
Findings
2Independent Evaluation Group
4. Recommendations

3.
1. Sector Context

4.
At least 400 millionpeople are not receiving
essential health services.
6 % of people pushed into extreme poverty
because of health spending
4Independent Evaluation Group
Health ServicesAre Rapidly Expanding, But
Progress Is Uneven
2.5
28.7
Low
Income
High
Income
Gap in physicians per 10,000 people

5.
│ WBG Support

6.
Strategies and Initiatives Have Emphasized the
Importance of Health Services InAchieving The Twin
Goals
2007
Strategy for Health,
Nutrition and
Population
2014-15
Universal Health
Coverage and SDGs
2016
Human Capital
Project
Increased focus on
governance and
results
focus on
comparative
advantages to
improve health
outcomes
The World Bank
joins the global
coalition for
Universal Health
Coverage
SDG 3: Ensure
healthy lives and
promote wellbeing
for all at all ages
The goal of the HCP is a
world in which all
children arrive at school
ready to learn, and
grow up healthy, skilled,
and productive adults.
Central role that health
services will play in the
WBG strategic focus.

7.
The World Bank has invested nearly $23billion
in health over the past decade.
IFC, 2.7billion
22%
38%
10%
22%
6%
1% 2%
30%
21%
17% 16%
7% 7%
2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
Africa Latin America
and the
Caribbean
Europe and
Central Asia
South Asia East Asia and
Pacific
Regional
Projects
Middle East
and North
Africa
2005 - 2010 2011 - 2016

8.
World Bank support covers a large scope of areas.
Health Systems, supply and demand-side interventions
Latin America and
the Caribbean
0%
10%
20%
30%
40%
50%
60%
70%
80%
Health
Financing
Health
Monitoring
Info.
Systems
Stewarship
Function
INFRA EQUIP MED Financial
Incentives
to Service
Providers
CCT Info.
Campaigns
HealthSystems Supply Demand
Leftbar:Closed–Rightbar:Open

9.
WB is broadly aligned with country health needs

10.
14%
19%
31%
56%
51%
33%
28%
19%
17%
1%
9%
17%
0%
10%
20%
30%
40%
50%
60%
LIC LMIC UMIC
General Health Maternal & child
Communicable Diseases Non-Comunicable diseases
Health focus is also consistent with country
epidemiological transitions and income levels

11.
IFC is also aligned to health needs
Low Health Needs
Low Commercial
attractiveness
High Health Needs
Low Commercial
attractiveness
High Health Needs
High Commercial
attractiveness
Low Health Needs
High Commercial
attractiveness

12.
│ Key Findings

13.
Global
Partnerships
Pandemics Public-Private
Interactions
Focus on three
key drivers of
UHC
01 02 03 04

14.
1. The WBG has made progress in improving
access but faces challenges in quality and equity
Improve Access
 better results overtime
 incentives approaches perform better
Improve Quality
 greater emphasis on quality overtime
 limited monitoring of all quality dimensions
 partial achievement
 performance-basedfinancingbetterM&E&greaterachievements
Improve Equity
 implicit target specific population groups
 no explicit objectives for the poor or other disadvantage groups
 limited monitoring on distributional impacts

15.
2. The complexity of the global health landscape
shapes the WBG’s role in partnerships programs
 25 GPP, 6 MDTF and
disbursed 35 billion since
2010.
 risk for fragmentation and
overlapping mandates
and objectives.
 Call for greater strategic
focus - selectivity and
alignment
1990
2015

16.
3. The WBG
performance in
pandemic response
has improved . Yet
progress is needed
to mainstream
preparedness in
client countries
health systems.
63
$1.62
Billion
2016
Countries received
WBG financial support
Avian Influenza and
zoonotic diseases
Mobilized for
Ebola virus
outbreak
Pandemic
Emergency
Financing Facility

17.
4. Limited Public
Private interaction  The private sector plays a role in most health
systems
 Engaging the private sector in UHC remains a
challenge.
 But the WBG support in this area remains limited.
 There have been efforts to foster stronger WB-IFC
collaboration (eg, Joint lead and Cascade)
 But successful implementation requires
adequate resources to attend the needs of client
countries and seize stronger opportunities for
working together.

18.
│ Recommendations

19.
Improve
Strategic
Alignment
Global
Partnership
Programs.
Integrate
Pandemic
Preparedness
Within Client
Countries
Health
Systems.
Strengthen
WB and IFC
Synergies to
Support
Public-Private
Interactions
In Client
Countries.
Strengthen
Quality
Measurement
and
Distributional
Effects.
1 2 3 4

20.
Thank you!
Visit
http://ieg.worldbankgroup.org