Good Work--But Not Enough of It : A Review of the World Bank's Experience in Nutrition
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World Bank, Washington, DC
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The World Bank has been a leader in
nutrition policy analysis, and many of the nutrition
projects it has supported have been innovative and
successful. But though the Bank has developed the economic
justification for large-scale investment in nutrition, and
has the experience needed to scale up, it has failed to do
so. Nutrition lending is an insignificant proportion of the
Bank's business, no more than 2.5 per cent of its
lending for human development. This level of effort is
inconsistent with what the Bank's analytical work has
found--that nutrition lending is one of the best economic
investments, and critical to progress toward the Millennium
Development Goals (MDG). There are significant institutional
constraints to scaling up in nutrition. The paper therefore
recommends that, if nutrition is to be put higher on the
Bank's agenda, its top management will need to be
involved in changing the institutional signals, through: (1)
emphasizing that, as a precondition of faster progress
toward the MDGs, improving nutrition is a Bank-wide
responsibility, not just the business of health staff; (2)
making 'improvement in nutritional status' a key
development outcome and measure of poverty reduction; (3)
creating institutional incentives for staff to focus on
nutrition; (4) increasing the Bank's staff capacity in
nutrition; and (5) raising a grant fund to help countries
and Bank country departments scale up.
Palabras clave
AGRICULTURAL RESEARCH, ANEMIA, ANEMIA PREVALENCE, BASIC HEALTH, CAPACITY-BUILDING, CARE CENTERS, CARE FOR CHILDREN, CDD, CENTER FOR HEALTH, CHILD DEVELOPMENT, CHILD FEEDING, CHILD GROWTH, CHILD HEALTH, CLINICS, COMMERCIAL FIRMS, COMMUNICABLE DISEASES, COMMUNITY DEVELOPMENT, COMMUNITY NUTRITION, COMMUNITY NUTRITION WORKERS, COST-EFFECTIVENESS, DAY CARE, DEVELOPMENT ASSISTANCE, DEVELOPMENT INTERVENTIONS, DEVELOPMENT PLANNING, DEVELOPMENT STRATEGIES, DISSEMINATION, EARLY CHILDHOOD, ECONOMIC GROWTH, FOOD CONTROL, FOOD COUPONS, FOOD FORTIFICATION, FOOD POLICY, FOOD SECURITY, FOOD SUPPLEMENTATION, FOOD SUPPLEMENTATION PROGRAMS, FORMAL EDUCATION, GROWTH MONITORING, GROWTH PROMOTION, HEALTH PROMOTION, HEALTH SECTOR, HOME AFFAIRS, HOME VISITS, HOUSEHOLD FOOD SECURITY, HUMAN DEVELOPMENT, IMMUNODEFICIENCY, INCOME GENERATION, INCOME POVERTY, INSTITUTIONAL CAPACITY, INTERVENTION, IODINE, IODINE DEFICIENCIES, IODINE DEFICIENCY, IODINE DEFICIENCY CONTROL, IRON, IRON DEFICIENCY, LOCAL COMMUNITIES, LOCAL COMMUNITY, MALNOURISHED CHILDREN, MALNUTRITION, MCH, MICRONUTRIENT MALNUTRITION, MICRONUTRIENT SUPPLEMENTATION, MICRONUTRIENTS, MILLENNIUM DEVELOPMENT GOAL, MILLENNIUM DEVELOPMENT GOALS, MINERAL, NURSES, NUTRITION, NUTRITION COUNSELING, NUTRITION EDUCATION, NUTRITION IMPROVEMENT, NUTRITION INDICATORS, NUTRITION INTERVENTIONS, NUTRITION MONITORING, NUTRITION POLICY, NUTRITION PROGRAMS, NUTRITION PROJECTS, NUTRITION SERVICES, NUTRITIONAL STATUS, OUTREACH WORKERS, OVERNUTRITION, PEM, PERSONAL RELATIONS, PILOT PROJECTS, POLICY ANALYSIS, POLICY DIALOGUE, POLICY PROCESS, POOR WOMEN, POVERTY ANALYSIS, POVERTY REDUCTION, POVERTY REDUCTION STRATEGY, POVERTY REDUCTION STRATEGY PAPER, POVERTY REDUCTION STRATEGY PAPERS, PREGNANT WOMEN, PREVALENCE OF MALNUTRITION, PRIMARY EDUCATION, PRODUCTIVITY, PROGRESS, PROTEIN, PROTEIN-ENERGY MALNUTRITION, PUBLIC AWARENESS, PUBLIC POLICY, QUALITY CONTROL, RELIGIOUS LEADERS, REPRODUCTIVE HEALTH, SAFETY NETS, SALT IODIZATION, SERVICE DELIVERY, SOCIAL ACTION, SOCIAL PROTECTION, SOCIAL WELFARE, SUB-SAHARAN AFRICA, SUPPLEMENTARY FEEDING, TECHNICAL ASSISTANCE, UNDERNUTRITION, VITAMIN, VITAMIN A, VULNERABLE GROUPS, VULNERABLE POPULATIONS, WATER SUPPLY, WELFARE EXPENDITURES, WOMAN, WORKERS, YOUNG CHILDREN, YOUTH CLUBS