Health

The global movement toward universal health coverage (UHC) provides an umbrella under which many governments and development partners, including the World Bank Group, focus their work to ensure all people receive quality, affordable care without suffering financial hardship. UHC aims to achieve better health and development outcomes in line with the Millennium Development Goals, including reduced maternal and child mortality; improved nutrition for infants and children; and prevention and treatment of communicable disease.

In recent years, the global UHC movement has gained momentum, with the World Health Assembly and the United Nations General Assembly calling on countries to “urgently and significantly scale up efforts to accelerate the transition towards universal access to affordable and quality health care services.” 

Last Updated: Sep 30, 2014

In line with its global strategy for health, nutrition, and population, the World Bank Group provides financing, state-of-the-art analysis, and policy advice to help countries expand access to quality, affordable health care; protects people from falling into poverty or worsening poverty due to illness; and promotes investments in all sectors that form the foundation of healthy societies.

Universal health coverage: In promoting universal health coverage (UHC) in particular, the Bank Group supports developing countries’ efforts to provide quality, affordable health care to everyone—regardless of their ability to pay—reducing financial risks associated with ill health, and increasing equity. The path to UHC is specific to each country. Whatever the path, the Bank Group’s aim is to help countries build healthier, more equitable societies, as well as to improve fiscal performance and country competitiveness—toward the goals of ending extreme poverty by 2030 and boosting shared prosperity.

In May 2014, the Bank Group and the World Health Organization (WHO)  released a joint framework for monitoring progress toward UHC, with two goals : 1) Financial protection: By 2030, no one is pushed into or kept in poverty by paying for health care; and 2) Service delivery: By 2030, everyone has access to essential health services.  

Results-based financing for health: One of the key approaches to implement the Bank Group’s overall health strategy is results-based financing (RBF), an innovative approach to expand the quality and reach of health care services in the poorest countries by linking financing to results. RBF focuses on paying for outputs and outcomes—for example, increasing the percentage of women receiving antenatal care or having a trained health worker deliver their baby—rather than for simply inputs or processes.

Global Financing Facility: In September 2014, the World Bank Group and governments of Canada, Norway, and the United States announced that they would jumpstart the creation of an innovative Global Financing Facility in support of Every Woman Every Child to mobilize support for developing countries’ plans to advance women’s and children’s health.  A unique aspect of the facility is to support countries in their transition to long-term sustainable domestic financing as they grow from low- to middle-income economies. It will also support countries to expand Civil Registration and Vital Statistics efforts toward universal registration of every pregnancy, every birth, and every death by 2030.

Ebola response: In mid-2014, the Bank Group accelerated its emergency response to the Ebola crisis in West Africa. The response aims to help contain the spread of infections, assist countries in coping with the economic impact, and improve public health systems throughout West Africa. The Bank Group supports country responses in line with the World Health Organization (WHO) Roadmap, and coordinates assistance closely with the United Nations (UN) and other international and country partners.

In line with its commitment to reaching the MDGs by 2015, the Bank Group also focuses on preventing HIV/AIDS and other communicable diseases, and scaling up support for early childhood nutrition. The Bank Group’s investments in nutrition and food security more than tripled between 2011-12 and 2013-14, rising from $260 million to $750 million.

Increasing effectiveness of global health aid is also a key aim. The Bank Group is a proud partner in the International Health Partnership and the H4+ and is scaling up civil society engagement in health.

Last Updated: Sep 30, 2014

Through the International Development Association (IDA), the Bank Group has helped save lives and improve the health of millions in developing countries. During the past decade (2003-2013), IDA has:

• Provided more than 117 million people with access to basic packages of health, nutrition, or reproductive health services
• Trained more than 2.6 million health personnel
• Constructed, renovated, and/or equipped more than 10,000 health facilities
• Immunized nearly 600 million children
• Provided more than 194 million pregnant women with antenatal care during a visit to a health care provider
• Ensured that more than 29 million births were attended by skilled health personnel
• Ensured that more than 210 million pregnant/lactating women, adolescent girls, and/or children under age five were reached by basic nutrition services
• Purchased and/or distributed more than 149 million long-lasting, insecticide-treated malaria bed nets
• Purchased and/or distributed more than 386 million condoms
• Provided more than 7.6 million people with TB treatment according to WHO DOTS recommendations
• Ensured that more than 1.3 million adults and children received antiretroviral combination therapy

 Here are some examples where the Bank Group has made a difference in the countries and regions:

• In Argentina, improved health services and accessibility for poor pregnant women and children led to a decrease in low birth weight and in-hospital deaths of babies in the first 28 days of life for program beneficiaries.
• In Armenia, the Bank Group contributed to the implementation of the government’s health reform program through the expansion of access to quality primary health care, which led to a tremendous increase—from 17% in 2004 to 85% in 2010—in the population served by qualified family medicine practices. Overall satisfaction with the quality of and access to primary health care services rose from 87.6% to 95%.
• In Brazil, the Bank Group helped strengthen the health surveillance system and expanded access to and improved the effectiveness of health, water, and sanitation services for especially vulnerable groups, including indigenous peoples. As a result, 74% of the indigenous population was immunized by 2010 and malaria-related deaths declined by 60% from 2003 to 2007.
• In Burundi, over just one year, births at health facilities rose by 25%, prenatal consultations went up by 20%, and the number of children fully vaccinated increased by 10%.
• In the China TB Control Project, the case detection rate for new smear-positive TB cases increased from 23% in 2002 to 77% in 2010 (target: 70%) and the cure rate for smear-positive TB cases increased from 80% in 2002 to 93% in 2010 (target: 85%).
• In India, the national AIDS program with support from the Bank Group prevented an estimated 3.5 million of India’s expected 5.5 million HIV infections.
• In Nepal, the Bank Group supported the national health sector program in expanding access to and increasing the use of essential health services, especially to underserved populations. As a result, contraceptive prevalence increased from 35% in 2001 to 51.7% in 2010 with a concomitant decrease in total fertility rate from 4.1 to 2.9 births per woman. Skilled attendance at birth also increased from 8% to 35%, and the percentage of children immunized against measles/DPT3 increased from 62% in 2001 to 83% in 2009 for the lowest income quintile.
• In Rwanda, Bank Group support has led to an increase in health insurance enrollment from 7% to more than 70% of the population; a 50% increase in utilization of health services by poor children; a 63% increase in the use of insecticide-treated mosquito nets; a doubling of use of family planning services; a 62% decrease in malaria incidence; and a 30% decrease in child mortality.
• In Senegal, the Bank Group supports an innovative nutrition health program that operates at the community level in collaboration with local governments, district health authorities, and civil society organizations. National underweight malnutrition rates dropped from 22% in 2005 to 17% in 2012, bringing Senegal—among very few countries globally—within reach of achieving the MDG to halve the rate of malnutrition.
• In Vietnam, as of 2013, 68% of the population was covered by fully subsidized health insurance. Though nationwide coverage for the “near-poor” (those living within 130% of the poverty threshold) is estimated at 30%, with Bank Group support, coverage for this group in the central north region reached 64% as of 2013.

Last Updated: Sep 30, 2014