Suchergebnisse

At the start of the new millennium, malnutrition in Senegal was of great concern. Among children under five years of age almost one-third (30 percent) were stunted (low height for age), 10 percent were wasted (low weight for height), and 20 percent were underweight (weight for age), each of these levels categorized as high severity by the World Health Organization (WHO). Rates vary greatly, with the poor and rural, and residents of the north, south and central zones, suffering disproportionately. Malnutrition contributes to child and maternal mortality and morbidity, undermines children's prospects of reaching their physical and intellectual potential, and undercuts income-earning potential for households and overall productivity and economic development. Its two principal causes are inadequate food intake and illness. In 2001, the government of Senegal issued a new nutrition policy, supporting a 10-year goal to improve nutrition through a community-based, multisectoral approach. The policy was translated into the 10-year Nutrition Enhancement Program (NEP), financed by the government of Senegal, the World Bank, and eventually others. This report assesses the performance of three projects: (1) the NEP, (2) the Nutrition enhancement project in support of the second phase of the NEP, and (3) the Rapid response child-focused social cash transfer and nutrition security project

This technical paper distills the emerging experience and lessons of Sector-wide Approaches (SWAps) in the health sector, supported by the World Bank and other Development Partners (DPs), in six countries: Bangladesh, Ghana, Kyrgyz Republic, Nepal, Malawi and Tanzania. It draws on the findings of Project Performance Assessment Reports (PPARs) conducted by the Independent Evaluation Group (IEG) on health SWAp support operations in Bangladesh, Ghana and the Kyrgyz Republic, and of field-based case studies that assessed the Bank's lending and non-lending support to Health, Population and Nutrition (HNP) in Malawi and Nepal, where SWAps are more recent. This paper also incorporates the findings of an evaluation of Tanzania's health SWAp, commissioned by the Government of Tanzania, and financed by DPs. The design, substantiation, and validation of the findings and lessons of this study have benefited from a review of the SWAp literature and vetting of preliminary findings and lessons with SWAp practitioners. This study grew out of the SWAp portfolio review and the distillation of health SWAp experience to date, undertaken as input to IEG's recent evaluation of the World Bank's support to HNP, improving effectiveness and outcomes for the poor in health, nutrition and population: an evaluation of World Bank Group support since 1997. The paucity of health SWAp evaluations in the literature, the richness and complexity of the preliminary findings, and the strong demand, inside and outside of the Bank for more distillation of SWAp experience and lessons all were justification for the undertaking of a more in-depth analysis.

This evaluation assesses the development effectiveness of the World Bank's country-level HIV/AIDS assistance defined as policy dialogue, analytic work, and lending with the explicit objective of reducing the scope or impact of the AIDS epidemic. The evaluation identifies findings from this experience and makes recommendations to improve the relevance, efficiency and efficacy of ongoing and future activities. This is the first comprehensive evaluation of the World Bank's HIV/AIDS support to countries, from the beginning of the epidemic through mid-2004. Because the Bank's assistance is for impl