Despite its status of middle-income country in terms of GDP, Panama still remains a society of sharp contrasts. The robust economic growth of today is a historic opportunity for progress in reducing poverty and inequality.
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Panama is one of the fastest growing economies in Latin America, but its growth has not been translated into poverty reduction or economic inclusion. Although between 1997 and 2003 real per capi... Show More +ta gross domestic product (GDP) grew at 1.5 percent per year, poverty fell only by about a half a percentage point, from 37.3 to 36.8 percent. Nearly all (98.4 percent) of the communities in the indigenous areas live in poverty. In this context, a major challenge for Panama was to formulate and implement policies that would translate its solid growth performance into effective and sustainable poverty reduction. SolutionThe government of Panama launched the CCT program, Opportunities Network (Red de Oportunidades), to provide access to basic social services and improve the living standards of the poorest and indigenous groups. The program was part of the government’s efforts to foster a more comprehensive and coherent social protection strategy. The World Bank supported the program through the Social Protection Project. The objectives of the project were to (i) improve the management and operation of the CCT program to enhance its effectiveness in reaching the poorest and indigenous groups, (ii) provide beneficiaries with an incentive framework to increase their participation in the CCT program, which would boost their demand for education and maternal and infant health services, (iii) strengthen the supply of nutrition and child growth promotion interventions in the indigenous areas, and (iv) enhance government capacity to develop coherent and efficient social sector policies and interventions on the basis of evidence.ResultsThe project supported the government’s efforts to improve the management of the Opportunities Network program, provide the beneficiary population with family services and program information, and provide health services to indigenous areas. The main achievements of the project are as follows:Coverage of 75,000 families, with more than 91 percent of children between 5 and 17 years of age enrolled in school.Establishment of a targeting mechanism that allowed the program to reach the poor in an objective and transparent way. More than 90 percent of beneficiaries are in the poorest 40 percent of the population (74.4 percent are in the poorest quintile)Provision of health services to a population previously excluded from vaccinations or health check-ups, due to their geographical or socio-economic conditions: 234,523 beneficiaries received PAISS+N health interventions (immunization and nutrition) in indigenous areas. Establishment of a network of social workers (promotores sociales) that allows for the provision of family support and close contact to address the needs of beneficiary households. The proportion of beneficiaries that have been informed about the program through a visit from a social worker reached 92 percent by October 2013.Bank Group ContributionThe Bank provided financing of US$24 million to support the deployment and training of the network of social workers at the local level and the provision of health services by non-governmental organizations hired by the Ministry of Health. The Bank also provided technical assistance and consultancy services to develop the beneficiary roster, revise the proxy means test, and develop the management information system and define a strategy for the verification of co-responsibilities.PartnersThe Ministry of Social Development was the implementing agency for the Opportunities Network program, and the Ministry of Health was implementing agency of the expansion of health services to rural and indigenous areas. The program was co-financed by a loan from the Inter-American Development Bank. Moving ForwardThe new administration is working to develop further the Opportunities Network program and has maintained an active dialogue with the World Bank. As part of this dialogue, the government has requested a follow-up operation supporting a broader agenda to strengthen the targeting and coverage of social programs, and enhance the efficiency of the administration of social programs. This is in line with pending challenges related to the inclusion new families with children in the Opportunities Network, especially in the indigenous communities, and complementing cash transfers with additional social and productive services that promote social inclusion and help beneficiary families to escape poverty.BeneficiariesThe main beneficiaries of the project included the poor and extreme poor households in the Opportunities Network program. These include around 25,000 families in the indigenous territories, 38,000 families in the rural areas and 11,000 families in the urban areas."It’s been helpful to me. For example, at the beginning of the school year, we always receive a payment. Then I always use that money for the school materials for the kids" Beneficiary mother from Chiriqui River, Comarca Ngäbe Buglé (indigenous territory), 2014. Show Less -
Moving ForwardThrough HEPI implementation support missions, by virtue of the Bank’s comparative advantage, it provides technical expertise to review the implementation of the RBF scheme and makes sugg... Show More +estions to strengthen the processes involved.In light of the fact that the HEPI project closes in December 2014, the Bank continues to maintain an open dialogue with the Government of Panama and to work in close coordination with the IDB. Once the HEPI project closes, the beneficiary groups of the project would be absorbed by an IDB-supported Health Reform Project. Continued Bank engagement in Panama’s health sector would be in the form of analytical work to produce and share knowledge with the Government to better understand the use and distribution of financial and human resources in the health sector. BeneficiariesHilaria Palacios is a mother of five children and is four months’ pregnant with her sixth. Before, it was very difficult for Hilaria to access health services, due to the distance she had to travel to reach the fixed health unit, which involved walking long distances or prohibitive transport costs. Thanks to the visits to her community by the mobile team of health professionals, access to health services is brought to Hilaria by the mobile team. The mobile teams are comprised of a six-person team, including a doctor, nurse, nurse technician, nutritionist, health sanitation and environment specialist, and a driver. Thanks to this approach, Hilaria now has access to quality, basic health services, every month during her pregnancy.Hilaria Palacios, project beneficiary commenting on the difficulty accessing care prior to the mobile health teams. “I had to walk or take a boat to receive check-ups. It was very difficult.” Today, Hilaria receives care from the mobile health teams. “Here, I receive monthly check-ups from the Doctor." Show Less -
Bank Group ContributionThe Bank provided US$829,700 over 7 years. The success of the project design can be measured in the considerable leveraging of funds. The project attracted a significant amount ... Show More +of resources (approximately US$23 million) in the form of co-financing that far exceeded the GEF allocation of US$6 million. PartnersAn estimated 145 institutions from 23 countries and regional or international institutions participated in the thematic networks. Organizations responsible for project include the Implementing Agency, an Executing Agency, the IABIN Secretariat, the IABIN Council and the IABIN Executive Committee, the Coordinating Institutions of the Thematic Networks, the IABIN Focal Points, and the Governments and institutions of the Americas who are both data-providers and information users. Staff from the U.S. Geological Survey invested considerable amounts of time and energy towards the implementation of IABIN. NGOs provided close to half of the co-financing, followed by Government contributions which corresponded to 40 percent with the U.S. Government contributing more than half of total Government contributions. Multilateral organizations participated with close to 8 percent followed by academic institutions who contributed 3 percent. The co-financing materialized in the form of time of technical experts, hosting IABIN and meeting site locations, web-site development, launching and hosting amongst others.In addition, Since IABIN’s inception in 1996, all 34 countries have designated official IABIN focal points. Four IABIN Council meetings have been held with the IABIN focal points and a broad representation from international, NGO, and private sector communities. Show Less -
Moving Forward This is the first project of its kind in the region and will most likely lead to subsequent initiatives using similar models in other regions. The GRSF is interested in replicating this... Show More + project in Africa and Asia. The next phase of this project will serve to utilize baseline statistics that now exist thanks to the Observatory to measure the region’s compliance and progress towards the UN’s Decade for Action Road Safety indicators and goals. The results of this evaluation and analysis will subsequently guide future road safety efforts in the region and beyond. Beneficiaries Monica Gangemi, who lost her daughter in 2007 to a fatal traffic accident in Rosario, founded the non-profit organization “Compromiso Vial por Ursula y Carla” through which she works to improve road safety. According to Ms. Gangemi:“The Observatory is so important. The press uses OISEVI’s data for statistics on road safety; they used to use data from a non-profit because official data didn’t exist. OISEVI helps to explain the logic behind the numbers. When do we count the number of victims? Every 30 days? How do we compare to other countries? The OISEVI gives the figures the publicity and legitimacy they didn’t have before, and empowers us as citizens to make demands based on real data.” Show Less -