Fund and Bank activity: Fund transactions; Bank loans and IDA credits; new sector paper on health

This paper highlights that in a shift of policy, the World Bank decided to finance directly health projects in developing countries. Under its old policy, formulated in 1974, health components providing basic health care for low-income individuals were incorporated into projects in other sectors, such as agriculture and rural development, urban development, and water supply and sewerage. Lending for such components will continue. After reviewing the World Bank’s experience in financing health-related activities in 44 countries, the report recommends the adoption of a three-tier pyramidal structure for delivery of health services, adapted to local conditions.

Abstract

This paper highlights that in a shift of policy, the World Bank decided to finance directly health projects in developing countries. Under its old policy, formulated in 1974, health components providing basic health care for low-income individuals were incorporated into projects in other sectors, such as agriculture and rural development, urban development, and water supply and sewerage. Lending for such components will continue. After reviewing the World Bank’s experience in financing health-related activities in 44 countries, the report recommends the adoption of a three-tier pyramidal structure for delivery of health services, adapted to local conditions.

Fund Activity

Summary of Fund operations in the General Resources Account, January 1,1977-March 31,1980

(In millions of SDRs)

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Source: IMF, Treasurer’s Department.Note: Details may not add to totals due to rounding.

Includes Swiss National Bank.

Bank Activity

IDA credits approved during third quarter of fiscal year 1980

(Ended March 31, 1980)

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Figures in parentheses are the number of credits approved for the respective country.

With a $16.5 million World Bank loan.

With a $105 million World Bank loan.

With a $10 million World Bank loan.

World Bank loans approved during third quarter of fiscal year 1980

(Ended March 31, 1980)

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Figures in parentheses are the number of loans approved for the respective country.

With a $15 million IDA credit.

With a $20 million IDA credit.

With a $28 million IDA credit.

Bank will directly finance health projects

In a shift of policy, the World Bank recently decided to finance directly health projects in the developing countries. Under its old policy, formulated in 1974, health components providing basic health care for low-income people were incorporated into projects in other sectors, such as agriculture and rural development, urban development, and water supply and sewerage. Lending for such components will continue. The new policy, approved by the Executive Directors of the Bank, is outlined in a report entitled Health Sector Policy Paper.

After reviewing the World Bank’s experience in financing health-related activities in 44 countries, the report recommends the adoption of a three-tier pyramidal structure for delivery of health services, adapted to local conditions. The first level comprises community health workers who can treat simple, common ailments and refer other cases to a health center or a district hospital. The second-level facility can be staffed by at least a medical assistant and midwife, and deal with accidental injuries, high-risk pregnancies, and the diagnosis and treatment of complex and less common diseases. The third level can comprise the referral hospital attended by qualified physicians and other trained staff.

The Bank’s new lending program for health will begin with one project in fiscal year 1981 (July 1,1980 to June 30,1981) and expand to four or five projects annually by fiscal year 1984. The projects will be designed to strengthen the primary health care systems of the countries being assisted in order to reduce mortality and morbidity, and to improve access to basic health services for the poor.

Emmanuel D’Silva

Finance & Development, June 1980
Author: International Monetary Fund. External Relations Dept.