Evidence to Policy, a monthly note series on learning what works, highlights studies that evaluate the impact of programs in the critical areas of human development --health, education, social protection, water and sanitation and labor. From how to best supply rural health clinics with drugs to what helps students do better in school, World Bank-supported impact evaluations provide governments and development experts with the information they need to use resources most effectively. As impact evaluations increasingly become more important to policymakers, this series offers a non-technical review of the many innovations the World Bank is supporting, and the growing number of rigorous studies analyzing the impacts of those innovations. The note series is managed by SIEF, which receives generous funding from the British government's Department for International Development and the Children’s Investment Fund Foundation (CIFF).
More people around the world are dying from noncommunicable diseases than ever before. These diseases, which include cancer, chronic respiratory diseases, diabetes, and heart disease, prematurely kill more than 15 million people between ages 30 and 69 each year. Many of these health conditions also make individuals more susceptible to severe forms of other diseases like COVID-19.
Tuberculosis is an infectious bacterial disease spread through the air that can lead to death when left untreated. The disease killed some 1.6 million people in 2017, according to the World Health Organization, making it one of the top ten causes of death worldwide and one of the leading causes of deaths from infectious disease. TB is treatable and patients are usually cured with a standard six-month course of medications. Treatment often is free of charge, but many cases of TB aren’t diagnosed or treated properly, particularly in low-income countries. Improving the detection of TB is crucial to ensure that infected individuals receive proper treatment and to prevent them from infecting others.
In Uganda, an impact evaluation found that communities and health clinics made better decisions on how to improve care when they first received specific data on health clinic functioning and health outcomes.
An evaluation measured whether providing a temporary increase in financial incentives to clinics would encourage them to initiate care for pregnant women in the first trimester—and whether this would continue even after the increase stopped.
The World Bank, in collaboration with the Ifakara Health Institute in Tanzania and the University of California, Berkeley, supported the evaluation of a program in Tanzania that gave people cash payments for practicing safe sex.
In Argentina, the World Bank supported a government program, Plan Nacer, to improve maternal-child health outcomes through increased coverage and quality of health services.
Also available in Spanish
With HIV/AIDS a critical problem in sub-Saharan Africa, improving the rate of HIV testing is important. This evaluation found that pay-for-performance could be a route for improving testing (and thus making available information on how to prevent HIV transmission) among those who face risk of infection from their partner.
Also available in French
The impact evaluation of a conditional cash transfer program targeting nutrition in young children showed good results, and now the Government of Bangladesh is scaling up the nutrition component of the program to reach more poor households.
Also available in French
The Philippines is successfully using conditional cash transfers to improve health and education for the poorest families, but the program hasn't been effective at raising school enrollment for older children. Based on the evaluation, the government has increased the transfer amount for older children.
In Tanzania, an innovative conditional cash transfer program that relies on local communities to administer the payments has succeeded in helping the country’s poorest citizens. As the results of a recent impact evaluation indicate, cash transfer systems can be adapted to work well in low-income countries that don’t have a strong central government to administer them.
Power Point Summary
This bulletin showcases a World Bank supported project in Zambia, where researchers tested two new models for helping rural health facilities stay better supplied with essential medicines. One of the models worked so well that Zambian officials and donors are now considering how to extend it throughout the country. [View original Note - 2010]
Also available in French
In Indonesia, the World Bank worked with the Government of Indonesia on a community grant program to boost the use of health and education services. The impact evaluation built into the program found that cash transfers to rural communities led to positive impacts on average across health and education indicators, with a strong decline in malnutrition.
To help build a body of evidence on how to encourage and support quality healthcare, the World Bank supported a study of government-run and faith-based health clinics in Rwanda. The 23-month evaluation, the first rigorous one of its kind in a low-income country, found that performance-based bonuses helped raise the quality and use of health services for women and children.
To help policymakers better understand the effects of conditional cash transfers on encouraging parents to take children for regular check-ups, the World Bank supported a study of a pilot cash transfer program in Burkina Faso. The evaluation found that conditional cash transfers boosted routine preventive health care visits, regardless of whether the money was given to the mother or father. On the other hand, unconditional cash transfers, regardless of which parent received the money, did not lead to more regular health visits.
Researchers supported by the World Bank evaluated three Save the Children school feeding programs in Burkina Faso, Laos and Uganda. The results point to the possibilities and limitations of school feeding programs: when properly implemented, they can raise enrollment and possibly lead to better learning. But even then, feeding programs are unlikely to make up for the cognitive and physical lags that result from poor nutrition during pregnancy and the first two years of life.
A World Bank-supported a study of a program in Indonesia that gave young children special high-nutrition snacks found that the program reduced stunting in children aged 12 months to 24 months. This study provides useful lessons into how governments and policy experts can work to support proper mother and child nutrition during times of economic crisis.