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World Bank Group Support to Health Services: Achievements and Challenges


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The presentation summarizes the effectiveness and lessons of the World Bank Group's support for health services in client countries, as outlined in IEG's evaluation.

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World Bank Group Support to Health Services: Achievements and Challenges

  1. 1. The World Bank Group’s Support to Health Services Maria Elena Pinglo, Evaluation Officer February 28, 2019 The Independent Evaluation Group
  2. 2. Today’s presentation 1. Sector Context 2. WBG Support 3. Key Findings 2Independent Evaluation Group 4. Recommendations
  3. 3. 1. Sector Context
  4. 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. 5. │ WBG Support
  6. 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. 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. 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. 9. WB is broadly aligned with country health needs
  10. 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. 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. 12. │ Key Findings
  13. 13. Global Partnerships Pandemics Public-Private Interactions Focus on three key drivers of UHC 01 02 03 04
  14. 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. 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. 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. 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. 18. │ Recommendations
  19. 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. 20. Thank you! Visit