Ensuring access to quality reproductive health and family planning services is fundamental to human development results and is a top priority in the Bank’s 2007 Healthy Development strategy.
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Road traffic injuries place an enormous strain on health systems in low- and middle-income countries. In Kenya, it is estimated that up to 60 percent of all trauma patients were injured in road traffi... Show More +c crashes. Further, road crash victims and their families in low- and middle-income countries risk falling back into – or being stuck in – poverty due to overwhelming medical costs, poor rehabilitative services, and lack of safety nets.Risks for pedestriansWalking is the most fundamental form of mobility, yet it is also the most vulnerable to road traffic injury. According to the World Health Organization's 2013 Global Status Report on Road Safety, over one-fifth of all road traffic deaths (270,000 annually) are pedestrians. In some countries, such as Ghana, the proportion of pedestrians among road traffic deaths is as high as 40 percent. Many risk factors contribute to the high vulnerability of pedestrians, including the speed of vehicles, alcohol, inadequate visibility, lack of pedestrian safety facilities, and inadequate enforcement of traffic laws. This is documented in a recent best practices manual jointly commissioned by the World Health Organization, the FIA Foundation, the Global Road Safety Partnership, and the World Bank. Mitigating measures, better dataWhile there is no single measure to address all pedestrian risks, many steps can be taken to improve their safety. For example, a 5 percent cut in speed can reduce fatal crashes by 30 percent. Road design, land-use planning, and vehicle design are other important factors.Collecting reliable data is also essential to improving road safety and reducing risks for pedestrians. According to the WHO study, data systems in most countries remain poor, with 71 percent of countries relying on police data systems only. Many deaths occur after a crash victim has been transported to a hospital, so data from health systems are also needed to complete the picture.Through the Global Road Safety Facility, the World Bank is helping countries tackle this challenge. The Bank supported the creation of the Ibero-American Road Safety Observatory (OISEVI), which 22 countries in Latin America and the Caribbean are using to exchange experiences and develop statistics to design effective policy solutions. “As the world continues to motorize, walking needs to be made safer and, particularly in urban environments, promoted as a healthy and less expensive mobility option,” said Marc Juhel, World Bank sector manager for transport. “Unless action is taken, the sheer scale of pedestrian injuries will undermine country efforts to reduce poverty, enhance living standards, and improve public health.” Show Less -
Washington D.C., April 20, 2012 –The developing world’s progress is seriously lagging on global targets related to food and nutrition, with rates of child and maternal mortality still unacceptably hig... Show More +h, says the Global Monitoring Report (GMR) 2012, released today by the World Bank and the International Monetary Fund (IMF).Recent spikes in international food prices have stalled progress across several of the Millennium Development Goals (MDGs), the report says.GMR 2012: Food Prices, Nutrition and the Millennium Development Goals reports good progress across some MDGs, with targets related to reducing extreme poverty and providing access to safe drinking water already achieved, several years ahead of the 2015 deadline to achieve the MDGs. Also, targets on education and ratio of girls to boys in schools are within reach.In contrast, the world is significantly off-track on the MDGs to reduce mortality rates of children under five and mothers. As a result, these goals will not be met in any developing region by 2015. Progress is slowest on maternal mortality, with only one-third of the targeted reduction achieved thus far. Progress on reducing infant and child mortality is similarly dismal, with only 50 per cent of the targeted decline achieved.“High and volatile food prices do not bode well for attainment of many MDGs, as they erode consumer purchasing power and prevent millions of people from escaping poverty and hunger, besides having long-term adverse impacts on health and education,” said Justin Yifu Lin, the World Bank’s Chief Economist and Senior Vice President for Development Economics. “Dealing with food price volatility must be a high priority, especially as nutrition has been one of the forgotten MDGs,” he added.GMR 2012 details solutions for making countries and communities more resilient in the face of food price spikes. Countries should deploy agricultural policies to encourage farmers to increase production; use social safety nets to improve resilience; strengthen nutritional policies to improve early childhood development; and design trade policies that enhance access to food markets, reduce food price volatility and induce productivity gains. However, the challenges countries face in responding to high food prices have been made more difficult as a result of the global recession.“The fragile global economy could very well slow developing countries’ progress on human development goals, since the fiscal, debt, and current account positions, particularly of low income countries, have been weakened by the global financial crisis,” said Hugh Bredenkamp, Deputy Director of the IMF’s Strategy, Policy and Review Department.Regional progress towards the MDGs is uneven. While upper middle income countries are on track to achieve most targets, low-income or fragile countries are lagging, with only two goals achieved or on-track. While food prices have declined from their 2011 peaks, commodity prices remain volatile.“To help deal with volatility, more developing countries are complementing their fiscal and monetary policy responses with insurance or hedging operations, such as selling crops in forward markets. This can be part of a broader strategy for managing risks like natural disasters and swings in commodity prices,” said Lynge Nielsen, Senior Economist at the IMF.Jos Verbeek, Lead Economist at the World Bank and lead author of GMR 2012, cautioned that declining development assistance, population growth and high food prices will make the need to focus on nutrition programs for the poor even more challenging.“According to our projections, an estimated 1.02 billion people will still be living in extreme poverty in 2015. Clearly, assistance must be leveraged in new ways if we are to improve food security and nutrition, particularly for the poor and vulnerable,” said Verbeek.Regional HighlightsIn East Asia and Pacific, the targets on extreme poverty, gender parity and access to water and sanitation have been reached. Progress is substantial with regards to primary completion and the goal should be achieved in the years remaining to 2015. Child and maternal mortality are the targets lagging the most.In Europe and Central Asia, the targets on poverty and access to water have been reached. Universal primary education and gender goals are currently on track. Increased efforts must be undertaken with regards to improving maternal health and access to basic sanitation.Latin America and the Caribbean has already reached extreme poverty, primary school completion, gender equality and access to safe water targets. The region is performing well in terms of child mortality, but progress on maternal mortality is lagging.Middle East and North Africa has reached the targets on poverty and provision of improved sanitation facilities. The region is making fast progress towards achieving universal primary education and gender equality. However, progress towards ensuring safe drinking water and reducing maternal mortality is lagging.South Asia has reached the target on access to safe drinking water and will most probably eliminate gender disparity in primary and secondary education by 2015. Progress has also been made on primary school completion and, to a lesser extent, extreme poverty reduction. However, progress on reducing child and maternal mortality and improving access to sanitation facilities is off-track.Sub-Saharan Africa is lagging on most MDGs. Although the region has achieved more than 60 per cent of the progress required on goals such as gender parity, primary school completion, access to safe water and extreme poverty, health-related MDGs, particularly maternal mortality, require urgent attention. Show Less -
World Bank announces new focus on Social Protection and Labor and releases new open data tool to help countries close the gap in coverage for the poorestWASHINGTON, April 18, 2012 – The World Bank tod... Show More +ay released new data showing that at least 60 percent of people in developing countries – and nearly 80 percent in the world’s poorest countries – lack effective safety net coverage as countries struggle to protect their most vulnerable citizens from the negative impacts of global financial volatility and food and fuel price hikes.Sixty six million children around the world go to school hungry and struggle to concentrate and learn, a deficit that can be addressed with school feeding programs for the poorest. More than 2.8 million newborns die in the first week of their lives. Many of these deaths can be prevented by providing more pre- and post-natal care for mothers and their children. Food insecurity leads to greater family conflict and divorce rates.Expanding cost-effective safety nets – including cash transfers, food assistance, public works programs, and fee waivers – to help countries respond to crises and address persistent poverty will be a main item for discussion by finance and development ministers at the World Bank-IMF Development Committee meeting on April 21.“Safety nets can transform people’s lives and provide a foundation for inclusive growth without busting budgets,” says Robert B. Zoellick, President of the World Bank Group. “Effective safety net coverage overcomes poverty and promotes economic opportunity and gender equality by helping people find jobs, cope with economic shocks, and improve the health, education, and well-being of their children.”The Bank’s new 2011 Atlas of Social Protection: Indicators of Resilience and Equity (ASPIRE) provides the first-ever online snapshot of household-level data on safety nets and other social protection and labor (SPL) programs in developing countries, and was launched together with the Bank’s new Social Protection and Labor global strategy for the next 10 years. While sustained growth in many developing countries has pulled hundreds of millions of people out of poverty and into the middle class, this economic progress has yet to reach a majority in the poorest countries that face unemployment, disability, illness, and struggle to protect themselves against economic shocks, persistent poverty, natural disasters, or other crises.A new strategy for expanding coverage to the poorest peopleThe Bank’s new strategy calls for investing in stronger SPL systems in countries to improve the quality and reach of safety nets and other SPL programs in four areas:First, extending coverage to the poorest countries and poorest and most vulnerable people, where the needs are greatest.Second, building a coherent and integrated portfolio of national SPL policies and programs that help people deal with multiple risks, and can be scaled up or down in response to crises.Third, increasing access to jobs and economic opportunities, with a strong focus on investing in early childhood development and in workers’ skills and productivity.Fourth, emphasizing evidence-based action and South-South sharing of knowledge of what works.“With this new strategy, the Bank will help countries move their social protection and labor coverage from a set of isolated interventions to a smarter, more inclusive, and more responsive approach,” says Arup Banerji, World Bank Director of Social Protection and Labor. “This systemic approach helps countries address fragmentation and duplication across programs and create solutions tailored to their own contexts. With stronger social protection and labor systems, countries can expand effective coverage to the people who need it most.”Well-designed SPL programs, such as Bolsa Família in Brazil and Oportunidades in Mexico, are cost-effective, costing countries as little as half a percent of GDP.The Bank developed its new SPL strategy following extensive global consultations with governments, international development agencies, trade unions, and other civil society organizations. The three-tiered strategy discusses why and how the Bank can help countries invest in well-designed safety nets and other SPL programs that promote resilience by insuring people against risk; increase equity by protecting against dire poverty and catastrophic loss of human capital; and create opportunity through investments in young children, skills development, and improving ways for people to find jobs.“It’s not a question of whether countries can afford to have safety net programs,” says H.E. Ato Sufian Ahmed, Minister of Finance and Economic Development of Ethiopia, where the Productive Safety Nets Program has protected millions from famine during recent droughts in the Horn of Africa. “It’s whether we can afford not to have them.”“Our experience in Brazil shows that a strong safety net can help the poorest children grow up healthy and well-fed, go to and stay in school. In the future, we also expect that they will graduate, and get better jobs – so we can close the gap between rich and poor,” says Rômulo Paes da Sousa, Vice Minister of Social Development and Fight Against Hunger in Brazil. “The World Bank’s new strategy to help expand safety net coverage to the poorest countries and poorest populations is the right one – because safety nets are a critical investment to reduce poverty, promote equity and sustainable growth, and be prepared for the next crisis.”New data on social protection in countriesAs a companion to the new strategy, the Bank’s ASPIRE online tool is the most up-to-date compilation of global SPL estimates, including data from 57 countries – mostly in the developing world – from 2005-2010. ASPIRE provides open and accessible household-level data on populations’ social and economic status; assessments of SPL programs, including weaknesses such as low coverage and poor targeting; SPL program impacts on poverty and inequality; and ways to improve household data collection for SPL programs. Data from additional countries – especially those in Africa and the Middle East – will be added in the coming months, and the database will be updated twice a year.World Bank support for social protection and laborWorld Bank Group support for SPL programs reached $11.5 billion in 83 countries during the last decade. In response to the global financial, food, and fuel crises, the Bank almost tripled its SPL financing from an annual average of $1.6 billion in 1998-2008 to an annual average of $4.2 billion in 2009-2011. During the last six years, Bank-financed safety net projects have directly benefited more than 267 million people, mainly through conditional cash transfer programs (94.5 million), other cash assistance transfers (78.5 million), and public works (12.8 million). Show Less -
WASHINGTON, January 24, 2012 - The World Bank Board of Executive Directors today approved Program-for-Results (PforR), an innovative new financing instrument for the World Bank’s client countries that... Show More + links the disbursement of funds directly to the delivery of defined results. Money will flow once the results have been delivered and verified. PforR would support government programs in a diverse range of countries and sectors. In some countries, PforR would help deliver and improve the coverage of antenatal care for mothers and newborns or increase immunization coverage for children. In others, PforR would help provide sustainable water supply and sanitation services; strengthen the coverage and quality of early childhood and primary education; or contribute to a government program to reduce the number of rural households living below the poverty line. “Enhancing development effectiveness by helping developing countries achieve results is central to the mission of World Bank,” said Robert B. Zoellick, President of the World Bank Group. “Program-for-Results financing demands greater accountability from partner countries and in turn will help these countries continue to deliver sustainable results long after the Bank’s involvement has ended. The time is right for this innovative development approach.” PforR will also help improve the transparency and accountability of developing country programs, and strengthen systems to fight fraud and corruption. Under the new instrument, the Bank will provide part of the overall funding for a larger, developing country-financed program but will be able to provide its technical expertise to the larger government program. For example, the Bank’s commitment to openness and transparency will be applied to the entire program supported – including through the application of the Bank’s Access to Information policy to PforR operations. Key assessments – fiduciary, environmental & social - of program systems are an important feature of this new instrument and will help provide assurance that Bank financing is used appropriately and that the environmental and social impacts of the program are adequately addressed. These assessments will all be publically disclosed. PforR financing will also help partner countries improve the design and implementation of their development programs, strengthen institutions, and build capacity. Says Joachim von Amsberg, World Bank Vice President for Operations Policy and Country Services, "Building effective and accountable institutions in partner countries is key to achieving better development outcomes and results. We believe that with this new instrument, the World Bank jointly with others – government, development partners, civil society, the private sector and others - will be a better partner focused on results, focused on institution building and focused on better partnerships." Feedback from an extensive global consultations process, held in two phases over the last twelve months, in 34 client countries and seven donor countries with a broad range of stakeholders, including government officials, development partners, civil society organizations, the private sector, and academics has informed the design of PforR. Show Less -
The majority of these countries are in sub-Saharan Africa and South Asia, and many qualify for zero-interest credits under the Bank’s fund for the poorest countries, the International Development Asso... Show More +ciation.The action plan focuses on strengthening health systems for better reproductive health outcomes, including use of various innovations in financing, service delivery and human resource management. The Bank’s aim is to provide reproductive health services to the poorest families, with a special focus on reaching young people with better access to services and information.Results-Based FinancingThe Bank also is making good on its pledge at the 2010 UN Millennium Development Goals Summit to provide an additional $600 million for results-based financing over 5 years to countries that face challenges in achieving their MDGs because of high fertility and poor child and maternal nutrition and disease.So far, the Bank has committed $314 million to seven countries in keeping with this pledge, including $233 million in IDA financing, linked to an additional $81 million from the Health Results Innovation Trust Fund, supported by the governments of the United Kingdom and Norway. The seven countries are: Benin, Burkina Faso, Burundi, Democratic Republic of Congo, Ethiopia, Laos, and Nigeria.In addition, from July 26-28 in Washington, D.C., the Bank, along with the U.S. Agency for International Development, Norwegian Agency for Development Cooperation, the Bill and Melinda Gates Foundation and Grand Challenges Canada, will co-host the finals of a global competition, “Saving Lives at Birth: Grand Challenge for Development,” which identifies and funds life-saving technologies and innovations targeting mothers and newborns. Of the 600 submissions received from civil society organizations, universities, and business, 76 finalists were selected to compete for the awards. Show Less -
July 9, 2009 – Regular doctor visits, sonograms and various tests constitute routine prenatal care for pregnant women in developed countries. But for Adwoa, an expectant mother in Ghana, access to suc... Show More +h health care is unavailable.Instead, for too many other women in sub-Saharan Africa, pregnancy often can lead to painful long-term disability or death for the woman or her children.This wide discrepancy on maternal health is the unfortunate message on the 20th anniversary of World Population Day, July 11.Reducing maternal mortality by three quarters, and achieving universal access to reproductive health services is one of the Millennium Development Goals the international community set to achieve by 2015 to improve the lives of poor people. But the world is showing the least progress on this goal, according to the latest Global Monitoring Report.“One of the best guarantees for getting countries on the faster track to less poverty and more opportunity is investing in maternal health and reproductive health programs,” says Joy Phumaphi, World Bank Vice President for Human Development, Chair of the Partnership for Maternal and Child Health and former health minister in Botswana.But support for population and reproductive health programs has significantly declined as a percentage of overall global health aid, from about 30 percent in 1994 to 12 percent in 2008.Every minute, a woman dies of complications related to pregnancy and childbirth from mostly preventable and treatable medical problems, which adds up to more than 500,000 women each year, according to UNFPA.For every woman who dies, another 20 suffer injuries and disabilities that can last a lifetime, robbing them of livelihoods and physical well-being. In sub-Saharan Africa, a woman’s risk of dying from treatable or preventable complications of pregnancy and childbirth over the course of her lifetime is 1 in 16, compared to 1 in 2,800 in the industrialized world. And 1 in 11 children in Africa is likely to die before reaching his or her first birthday.Also, fertility rates continue to be high—more than five live births per woman--in 35 poor countries in the world, mostly in Africa.Progress So FarIn recent decades, many countries have made progress in reducing maternal mortality and lowering fertility rates. For example, maternal mortality rate in Egypt fell from 174 to 84 per 100,000 live births through better access to family planning and births in health facilities supervised by trained birth attendants. Bangladesh reduced fertility rates from over 7 children per woman in 1970 to about 2.7 children per woman today, while infant mortality fell from 105 per 1,000 live births in 1990 to 47 in 2007.Also, national public information campaigns have galvanized support to reduce maternal-related disabilities such as fistula, a painful rupture in the birth canal that occurs during prolonged, obstructed labor, which leaves women incontinent, isolated and ashamed.But huge challenges remain as aid for family planning and reproductive health programs has not kept pace with demand.Fertility Rates Impact Economic GrowthHigh fertility rates, along with inadequate health care, impede development and economic growth.Investing in family planning and reproductive health programs is not only vital to saving women’s lives, but also to boosting women’s economic and social well-being, improving the lives of their children and families, and reducing endemic poverty.“The longer it takes for countries to move to a low-fertility, low-mortality pattern, the greater the danger that high-birth rate countries will continue to experience greater inequalities in education, jobs, life expectancy, and adult prevalence of HIV/AIDS, than their wealthier counterparts,” says Phumaphi.Family size can also greatly affect women’s jobs in the workplace, according to a recent World Bank report, Population Issues in the 21st Century: The Role of the World Bank. One cross-national survey suggests that the percentage of women in the labor force is directly related to national birth rates. In Bolivia, there were strong links between women using contraception and having jobs outside of the home. In the Philippines, the average income growth for women with 1-3 pregnancies was twice that of women who had been pregnant more than 7 times.Ensuring Health Systems Can DeliverThe World Bank and several of its international development partners —including UNFPA, the UN Children’s Fund (UNICEF) and the World Health Organization (WHO)—have pledged to work together over the next five years to help countries strengthen their health systems, from rural clinics to major urban hospitals -- to achieve the MDG5 targets.For its part, the Bank has provided about $950 million in loans and grants for maternal and reproductive health programs, with another nearly $350 million in the pipeline. This financial support is provides an array of vital services to poor women and their families, including access to contraception information and services, health insurance, improved pre-natal care, provision of skilled birth attendants, access to insurance and emergency obstetric services, and post-natal care.Population and Reproductive Health Facts:More than 500,000 women die each year during pregnancy and childbirth – mostly in developing countries and mostly from preventable and treatable medical problems.1 in 16 women is likely to die from pregnancy-related causes in Sub-Saharan Africa, with the world’s highest rates of maternal mortality — at least 100 times those in developed countries.35 countries, also mainly in Sub-Saharan Africa, continue to have a total fertility rate of more than 5 live births per woman -- adversely affecting progress in reducing poverty.Access to voluntary family planning could reduce maternal deaths by 25 to 40 percent, and child deaths by as much as 20 percent.Maternal and newborn mortality costs an annual $15 billion in lost productivity. 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