Improving health, nutrition, and population outcomes in Sub-Saharan Africa: the role of the World Bank
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Washington, DC
World Bank
2005
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| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Item Description: | Includes bibliographical references and index |
| Physical Description: | LI, 243 S. graph. Darst., Kt. |
| ISBN: | 0821359630 |
Staff View
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Record in the Search Index
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| adam_text | Contents
Preface xiii
Acknowledgments xix
Abbreviations and Acronyms xxi
Executive Summary xxv
Chapter I:Today s Realities I
Health, nutrition, and population outcomes are advancing
too slowly to reach the Millennium Development Goals 1
Africa s health sector faces special challenges 17
Conclusion 25
Chapter 2: Why and How the World Bank Should Be
Involved 27
Poverty and health in Sub Saharan Africa
are interrelated 28
Health outcomes are affected in complex ways by a broad
set of determinants 36
The World Bank should focus its work on its areas of
comparative advantage 40
Conclusion 48
Chapter 3: Improving Health, Nutrition, and Population
Outcomes through Economic and Fiscal Policy 49
The Bank can help to ensure that public expenditure
recognizes the role of health, nutrition, and population
in poverty reduction 50
Improved health outcomes and reduced poverty require
more effective policies, implementation, and resource
allocation within the sector 57
The health sector could benefit from working more closely
with central ministries 63
Health sector expertise can help ensure that economic and
fiscal policy contributes to health outcomes 67
Conclusion 71
Chapter 4: Multisector Action to Improve Health,
Nutrition, and Population Outcomes 73
Actions across multiple sectors can affect health, nutrition,
and population outcomes 74
The response to HIV/AIDS sets an example 77
Reducing malnutrition requires multisector action 80
Multisector action can reduce disability and death
from many causes 82
Conclusion 93
Chapter 5: Effective Systems for Delivering Health,
Nutrition, and Population Interventions 95
Health workforce limitations pose the
greatest challenges to health care delivery 97
Access to and use of Pharmaceuticals must be improved 105
The institutional and organizational
frameworks must also be right 115
The private sector can play an important role in
service delivery 122
Household and community factors also affect
system effectiveness 129
Conclusion 132
Chapter 6: Sustainable Financing of Health, Nutrition,
and Population Interventions 135
Spending on health, nutrition, and population is lower in
Africa than anywhere else 136
Countries are employing a range of strategies to manage
health financing 146
Countries are trying to improve the efficiency and equity
of health financing 155
Conclusion 164
Chapter 7: Implications for World Bank Operations 165
World Bank operations in Sub Saharan Africa aim to achieve
sustainable improvements 165
Lending operations and resource transfers are taking a new
approach 166
Nonlending opportunities can also be exploited 176
The World Bank cannot achieve its objectives without
partnerships 182
Conclusion 186
Notes 187
References 195
Index 221
Figures
1.1 Few African countries are on track to achieve the
MDGs for infant and child mortality and malnutrition 2
1.2 Under five mortality has declined more slowly in
Africa than in South Asia 4
1.3 Life expectancy at birth declined in the 1990s 5
1.4 Poor and rich experience big differences in under five
mortality 5
1.5 Poor and rich experience big differences in under three
mortality 6
1.6 The mortality plus disability gap is even wider than
the mortality gap 7
1.7 The burden of disease for the four leading causes
of death is related to the prevalence of AIDS in
Sub Saharan Africa 8
1.8 Africa s share of child mortality is rising 10
1.9 World population under age 15 12
1.10 Will Africa have 1.8 billion people in 2050? 13
1.11 Not many married women use modern contraception 15
1.12 Sub Saharan Africa has the highest fertility rates 15
1.13 The unmet demand for family planning is great in
Sub Saharan Africa 17
1.14 Africa has the fewest physicians 23
1.15 Tuberculosis cases are rising fast in Sub Saharan Africa 24
1.16 Africa has more orphans than Asia or Latin America 25
2.1 Health and poverty are linked in a cycle 28
2.2 Africa s window of opportunity is still decades away
as dependency rates remain high 32
2.3 Health, nutrition, and population outcomes have many
determinants 38
2.4 The Bank s institutional comparative advantage overlaps
with the most critical strategic HNP issues faced by
client countries in Africa today 41
2.5 The World Bank can help integrate the matrix of
individual health care initiatives 44
3.1 Health expenditures in Sub Saharan Africa were flat
in the 1990s 51
3.2 The incidence of illness was lower among children
enrolled in PROGRESA 55
3.3 Public spending on health correlates with under five
mortality rates 58
3.4 Higher expenditures on health do not always result in
better health outcomes 59
3.5 Few nursing staff are in rural areas 61
3.6 A number of African countries have reduced or
waived taxes and tariffs on bednets, netting material,
and insecticide 66
3.7 Cigarette consumption in South Africa plunges with
higher prices 67
3.8 High proportions of health workers intend to
migrate 70
4.1 The environment related burden of disease is high in
Sub Saharan Africa 76
4.2 Environmental factors cause great health damage in
developing countries 77
4.3 The Benin multisector AIDS project supports more
activities in civil society 78
4.4 Malnutrition in the Senegal Community Nutrition
Project was reduced from 60 70 percent to less than
30 percent in six months 82
4.5 Sanitation and water coverage are limited in Africa 85
4.6 More Africans are dying on the roads or suffering
disabilities 87
4.7 Mother s education is associated with lower infant
mortality 91
5.1 Tanzania will meet only half its staff needs by 2015 99
5.2 The percentage of overseas trained nurses registered
in the United Kingdom is increasing 100
5.3 Most Nigerian registered physicians are in private
hospitals 102
5.4 Per capita pharmaceutical expenditures are lowest
in Africa 106
5.5 Prices for antiretrovirals are declining 110
5.6 Botswana traditional healers far outnumber physicians,
2001 124
5.7 Community directed treatment can improve control of
onchocerciasis, schistosomiasis, and lymphatic filariasis 131
6.1 The flow of funds for health in a typical Sub Saharan
African country 137
6.2 Households account for the largest share of spending
on health in Tanzania 138
6.3 Estimated development assistance for health was
significant in Sub Saharan Africa, 1998 2000 141
6.4 Sub Saharan Africa had the largest proportion of
World Bank supported health, nutrition, and population
projects in fiscal 2004 142
6.5 Patterns of use changed when fees were abolished in
Uganda 153
7.1 SWAps vary in application, but share building blocks 168
7.2 The traditional project cycle has sequential processing
steps 169
7.3 A focus on results demands a more continuous and
flexible use of Bank tools 170
7.4 The World Bank has defined a new strategic framework
for assistance to Africa 174
Tables
1.1 Under five mortality rates worsened in many African
countries, 1997 2002 4
1.2 HIV/AIDS affects Sub Saharan Africa disproportionately
(December 2002) 9
1.3 All scenarios project a shortfall in resources for
population and reproductive health (billions of US $) 16
2.1 Population indicators are high in Africa (selected
countries) 32
2.2 Households in Zimbabwe with an AIDS death
suffered reduced crop production 34
3.1 The public resources available for health following
debt relief decision points increased in selected
heavily indebted poor countries 53
4.1 Health outcomes are strongly affected by interventions
outside the health sector 74
4.2 Government agencies other than ministries of health
have responsibilities that relate to health outcomes 75
4.3 Changes in food imports and food production in
Sub Saharan Africa are dramatic 81
4.4 Urban and peri urban water and sanitation investments
are cost effective 85
4.5 Motor vehicle accidents in Africa contribute
significantly to the burden of disease (fatalities per
10,000 vehicles in 1995) 87
4.6 On site assessment of vaccine refrigerators at rural
primary health care facilities in the Eastern Transvaal
shows dramatic correlation of function to energy source 90
5.1 Measurable factors affect the health sector s interactions
with clients 96
5.2 Average monthly salaries for junior doctors are low
(1999 US $) 97
5.3 Various pharmaceutical supply systems exist in Africa 108
5.4 Africa has several types of private providers 123
6.1 Revenues from cost recovery vary across African
countries 140
6.2 Benefit incidence of public spending on health in
selected countries shows the disparity between rich
and poor 158
Boxes
1.1 Five conditions account for more than half of all deaths 3
1.2 Rapid population growth in Sub Saharan Africa leads
to high dependency ratios 13
1.3 Feel Good Risks 21
1.4 New Government Institutions Lack Accountability 22
2.1 The Millennium Development Goals 36
2.2 Households are the main producers of health 37
2.3 The Malawi paradox: Health services alone do not
determine outcomes 38
2.4 The nature of health investments is long term and complex 40
2.5 How do global priorities respond to country priorities? 44
3.1 Conditional cash transfers improve health and nutrition 55
3.2 What is required to more effectively address health
in PRSPs? 56
3.3 Reducing taxes and tariffs on insecticide treated bednets:
How fiscal policy can affect health outcomes 66
4.1 The highway sector in Ethiopia is responding to
HIV/AIDS 79
4.2 Nutrition interventions can be successful 83
4.3 Brazil has significantly reduced accidents and deaths
through road safety 89
4.4 Health interventions in schools succeed in Tanzania 92
5.1 Health systems extend beyond the ministry of health 97
5.2 The migration of health professionals is a severe problem 99
5.3 Push and pull factors contribute to the medical brain
drain out of Africa 100
5.4 African countries partner with international drug
manufacturers 112
5.5 Eritrea says, Thanks, but no thanks to drug donations 113
5.6 Health sector decentralization has potential advantages 118
5.7 Hospital autonomy differs from privatizing 121
5.8 Health reform is intensely political 122
5.9 Malawi s government partners with mission health
services 125
5.10 The private sector has an advantage in promoting
behavior change 127
5.11 Accreditation improves the quality of drug dispensing
in Tanzania 129
6.1 Grant financing has been supported for the first time
under IDA 13 142
6.2 Absorption of external financing can be increased by
working outside the public sector 143
6.3 Tanzania s National Health Insurance Fund may
provide a model 149
6.4 The Addis Ababa Forum identified principles for cost
sharing in health and education 151
6.5 Community financing faces multiple challenges 155
6.6 The Bank and client countries need to make rational
investments in new medical technology 161
7.1 The Bank s strategy for Africa outlines principles for
a new aid relationship 168
7.2 A PRSP can incorporate health, nutrition, and
population effectively 177
7.3 The World Bank Institute shares knowledge on health,
nutrition, and population in Africa 180
7.4 APOC represents a unique health partnership for the
World Bank 185
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| spelling | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank Washington, DC World Bank 2005 LI, 243 S. graph. Darst., Kt. txt rdacontent n rdamedia nc rdacarrier Includes bibliographical references and index Banque mondiale Banque mondiale rasuqam aWorld Bank Nutrition rasuqam Santé publique - Afrique noire Santé publique rasuqam Économie de la santé - Afrique noire Économie de la santé rasuqam aPublic health zAfrica, Sub-Saharan aMedical economics zAfrica, Sub-Saharan Öffentliches Gesundheitswesen (DE-588)4139691-1 gnd rswk-swf Gesundheitsökonomie (DE-588)4130935-2 gnd rswk-swf Afrique noire rasuqam Subsaharisches Afrika (DE-588)4053770-5 gnd rswk-swf Subsaharisches Afrika (DE-588)4053770-5 g Öffentliches Gesundheitswesen (DE-588)4139691-1 s Gesundheitsökonomie (DE-588)4130935-2 s DE-604 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=013052254&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank Banque mondiale Banque mondiale rasuqam aWorld Bank Nutrition rasuqam Santé publique - Afrique noire Santé publique rasuqam Économie de la santé - Afrique noire Économie de la santé rasuqam aPublic health zAfrica, Sub-Saharan aMedical economics zAfrica, Sub-Saharan Öffentliches Gesundheitswesen (DE-588)4139691-1 gnd Gesundheitsökonomie (DE-588)4130935-2 gnd |
| subject_GND | (DE-588)4139691-1 (DE-588)4130935-2 (DE-588)4053770-5 |
| title | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank |
| title_auth | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank |
| title_exact_search | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank |
| title_full | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank |
| title_fullStr | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank |
| title_full_unstemmed | Improving health, nutrition, and population outcomes in Sub-Saharan Africa the role of the World Bank |
| title_short | Improving health, nutrition, and population outcomes in Sub-Saharan Africa |
| title_sort | improving health nutrition and population outcomes in sub saharan africa the role of the world bank |
| title_sub | the role of the World Bank |
| topic | Banque mondiale Banque mondiale rasuqam aWorld Bank Nutrition rasuqam Santé publique - Afrique noire Santé publique rasuqam Économie de la santé - Afrique noire Économie de la santé rasuqam aPublic health zAfrica, Sub-Saharan aMedical economics zAfrica, Sub-Saharan Öffentliches Gesundheitswesen (DE-588)4139691-1 gnd Gesundheitsökonomie (DE-588)4130935-2 gnd |
| topic_facet | Banque mondiale aWorld Bank Nutrition Santé publique - Afrique noire Santé publique Économie de la santé - Afrique noire Économie de la santé aPublic health zAfrica, Sub-Saharan aMedical economics zAfrica, Sub-Saharan Öffentliches Gesundheitswesen Gesundheitsökonomie Afrique noire Subsaharisches Afrika |
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