Population, health, and nutrition : fiscal 1991 sector review

The theme of this year's annual sector review blends two special topics: poverty alleviation and the development of management and institutional capacity. Based on a review of project experience, both within and outside of the population, health and nutrition (PHN) sector, this report distills lessons that should assist task managers in the design and implementation of interventions to develop poverty-sensitive management and institutional capacity in the PHN sector. The Bank's ability to strengthen institutions, especially those needed to alleviate poverty, are constrained by the number and the skills mix of PHN staff, by the absence of standards and guidelines for analyzing and addressing institutional and management issues, and by too little time to spend on institutional and management issues. Therefore, the sector review recommends : a) improving the sector staff not only in numbers but in access to guidelines and training; b) revising Bank priorities and practices to ensure that enough time is spent on supervision and on upstream diagnostic work; c) grounding PHN policies in a macroeconomic and multisectoral framework oriented toward growth with poverty reduction, together with a sound strategy for building institutions and the capacity to implement and manage policy; and d) seeking more creative use of Bank instruments through a review and assessment of the best use of lending instruments for PHN sector interventions.