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The housing finance market in Mali remains small and under developed. Few banks currently offer a full mortgage product with Banque Malienne de Solidarite, Mali Housing Bank (BHM), Bank of Africa, and EcoBank being the main lenders although at minimal levels. The total annual housing need in Mali based on the household formation rate amounts to 82,500, split between 51,100 urban units and 31,400 rural units. Overall some social housing is constructed and support is provided by the state for low income housing through the Office Malienne de l’Habitat (OMH), but the numbers remain small. The Malien authorities have been working to strengthen financial sector stability which includes measures to stabilize the BHM and put it in a position where it begins to fulfill its mandate of providing credit for the housing sector. A strategy was approved by the council of Minister for a strategic disengagement by the state from the share capital of BHM. Initially the agreed plan was for BHM to be privatized. Overall progress in delivery of affordable housing will require a concerted effort among all stakeholders both in public and private sector. This should be supported through establishment of stakeholder coordination group to oversee change across the housing value chain.

Worldwide, deaths from cancer exceed those caused by human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), tuberculosis, and malaria combined. Seventy percent of deaths due to cancer occur in low-and middle-income countries, which are often poorly prepared to deal with the growing burden of chronic disease. Over a period of 18 months, the cancer care and control South-South knowledge exchange brought together a group of stakeholders from five countries in Africa - Botswana, Kenya, Rwanda, Uganda, and Zambia to share experiences, lessons, and good practices through a set of video conferences and a site visit to Zambia. All five countries have demonstrated commitment, initiated various cancer control and cancer screening programs, and expressed interest in sharing their experiences. The knowledge exchange on cancer care and control aimed to raise awareness, increase knowledge of effective strategies, and strengthen regional collaboration in cancer control planning and expanding equitable access to cancer treatment. This paper presents highlights of the country experiences shared, common challenges discussed, and innovative solutions explored during the knowledge exchange. Topics addressed include population-based surveillance and data collection to better document the burden of cancer; strategies for designing and implementing successful national cancer care and control programs; innovative approaches for strengthening cancer prevention efforts such as human papilloma virus (HPV) vaccination programs; task sharing and other strategies to build capacity and increase access to services; analytical tools for understanding the costs of programs; financing models, including public private partnerships, to increase cancer prevention and care; policy reforms needed to improve access to palliative care; and opportunities for regional collaboration.

With 2015 marking the transition from the Millennium to the Sustainable Development Goals, the international community can celebrate many development successes since 2000. Three key challenges stand out: the depth of remaining poverty, the unevenness in shared prosperity, and the persistent disparities in non-income dimensions of development. First, the policy discourse needs to focus more directly on the poorest among the poor. While pockets of ultra-poverty exist around the world, Sub-Saharan Africa is home to most of the deeply poor. To make depth a more central element in policy formulation, easy-to-communicate measures are needed, and this note attempts a step in this direction with person-equivalent measures of poverty. Second, the eradication of poverty in all of its forms requires steady growth of the incomes of the bottom 40 percent. Yet, economic growth, a key driver of shared prosperity, may not be as buoyant as before the global financial crisis. Third, unequal progress in non-income dimensions of development requires addressing widespread inequality of opportunity, which transmits poverty across generations and erodes the pace and sustainability of progress for the bottom 40. To meet these challenges, three ingredients are core to the policy agenda: sustaining broad-based growth, investing in human development, and insuring the poor and vulnerable against emerging risks.

Skills development is one of the priorities for national economic development strategies of Bangladesh. The vision 2021 of the Government of Bangladesh gives the highest priority to building a large base of skilled workers in order to achieve a poverty-free middle-income country by 2021. The skills development sector is highly complex due to multiple service providers, a vast spectrum of target audiences, a large range in modalities of service provision, and varied emphases in terms of skills levels and types. The short-term training, a formal channel of six months training, is an important instrument for bridging the gap between the needs of the labor market for increasing the pool of skillful workers and the aspiration of the students for finding a good job. In order to assess the performance of short-term training and interventions by Skills and Training Enhancement Project (STEP), a tracer study was conducted between December 2013 and January 2014. Skills and Training Enhancement Project (STEP) is jointly financed by the World Bank, Canada and the Government of Bangladesh (GoB), which started in 2010 for contributing to Bangladesh’s medium to long-term objective of developing its human resources as a cornerstone of its strategy for poverty alleviation and economic growth. It supports competitively selected 42 public and 8 private short-term training institutions for improving the quality of training and providing opportunities to the disadvantaged youth for obtaining skills from the select training providers.

Traditional benchmarks to assess performance rely on unconditional rankings or regional averages. This paper uses a recently developed methodology based on quantile regressions and initial conditions to propose alternative benchmarks for social sectors in Kyrgyz Republic. Covering a wide set of indicators, the analysis reveals mixed results for Kyrgyz Republic. The country has made important strides in many social areas, with outstanding results in reducing child mortality and undernourishment. However, other areas are still key challenges and demand further attention and resources, as evidenced by the underachievement in maternal mortality, educational performance, and increasing informality in labor markets.

In the 20th Century, Brazil rapidly urbanized and is now not only an urban nation but a metropolitan one. Brazils sprawling regioes metropolitanas (metropolitan regions, or RMs, which are municipal clusters) are now home to almost 50 million people and much of the countrys economic vitality. The RM spatial level and its supporting governmental institutions have thus become critical to Brazils future development. While challenges remain for tackling deprivation in rural areas, poverty in Brazil is now predominantly urban. More than six in 10 Brazilians in extreme poverty were living in urban settings as of 2012. Of these, over a fourth was concentrated in the 10 largest RMs.

Myanmar is a country in transition with great regional diversity. It is still a relatively young country with the highest share of its population at active working age. Myanmar’s more pressing needs are the following: a) reducing the incidence of poverty and improving human development outcomes, with a particular emphasis on reaching the poor and vulnerable. Children from poor families fare worse when it comes to nutrition, and education outcomes; and b) addressing the insecurity of incomes and developing mechanisms to reduce exposure to risks and ability to cope with ill-health, disasters and other shocks. This suggests a critical role for social protectionpolicies and programs in Myanmar’s strategy for poverty reduction and people-centered development.

Several government and development partner programs employ different approaches to ensure the inclusion of poor and vulnerable areas and people in Myanmar’s development. Buildingon this experience, this note aims to identify feasible options to effectively reach these groups, as government programs expand. Depending on program-specific choices about geographic focus andindividual, household eligibility, identifying poor and vulnerable areas and people in Myanmar can become more evidence-based, effective, and systematic, as better data become available and administrative systems develop. While targeting is currently done by individual programs, there can be important economies of scale in sharing and developing these systems in a coordinated manner so as to support multiple programs.

This paper defines economic inclusion as the ability of all people, including the disadvantaged, to share in economic gains, that is, the conditions that allow for broadly shared prosperity. Beyond the “right” to access consumption in cities, and beyond relatively standardized safety net policies that support economic security, inclusion demands intentional, flexible, context-appropriate strategies aimed at shifting the dynamics of local land and labor markets, public education, and other institutions. The paper analyzes the varied contexts for designing and supporting such strategies in a rapidly changing society, where urban regions have long been critical to incorporating a broad cross-section of people, including immigrant newcomers. Four dimensions are particularly crucial: an urban area’s level of economic growth, the quality of its jobs, its demographic profile, and its geography of opportunity (degree and form of spatial inequality). Economic inclusion is particularly urgent in America’s strongest local markets, which are pricing out the lowest-wage workers and showing a disturbing tendency to import rather than grow the talent needed for the emerging, innovation-driven economy. But weak-market regions face important challenges—and a range of options for leveraging demographic and other changes—as well. And for now, in all types of cities, innovative and promising strategies remain small in scale, in part because they are competing for support with entrenched, underperforming systems.

Since 1991 the national poverty rate of Ghana has more than halved. The estimated national headcount poverty ratio fell by 31.2 percentage points from 52.6 percent in 1991 to 21.41 percent in 2012. Heterogeneity of poverty outcomes is, however, high both across urban and rural areas and across regions. The robustness of these poverty trends is checked with trends of five correlates: urbanization and rural-urban migration, remittances, asset growth, labor market transformations, and agricultural productivity growth. Urbanization turns out to be highly correlated with poverty reduction. Poverty trends and asset index trends turn out to follow a similar pattern in both urban and rural areas and by regions: asset index increase where poverty decreases. In the report the authors try to understand the drivers of recent decrease in poverty in northern regions. The attention is focused on two different aspects, the agricultural productivity growth and the inflation patterns. In northern regions, there is a generalized increase in production of main food crops and an increase in productivity. To test the contribution of most of these drivers to poverty reduction, the authors estimated unconditional quintile regressions over the 20th, 40th, and 60th percentiles and decomposed the results using the Oaxaca Blinder method. To further strengthen the spatial analysis of poverty the authors constructed a new poverty map based on sixth Ghana living standard survey (GLSS 6) (conducted in 2012-13) in combination with the 2010 census, which was then compared with the 2000 map. This profile focuses on inequalities seen from three different perspectives: consumption inequality, inequalities of opportunities, and polarization.

This synthesis report details the process, outputs and intermediate outcomes of the World Bank’s Water and Sanitation Program (WSP) Technical Assistance (TA) to pilot and operationalize city sanitation plans (CSPs) towards outcome oriented sector investments (P131967). This TA addresses issues of ad hoc planning though CSPs that are holistic, intended for city-wide implementation and address the full cycle of sanitation. However, prior to preparation and operationalization of CSPs, it was recognized that this needed to be anchored in a statewide sanitation program. The statewide sanitation program needed to: estimate and provide for the capital requirements to address the gaps in sanitation infrastructure across the sanitation service delivery chain (collection, treatment and disposal), estimate the operation and maintenance (OM) requirements, and set out the framework for prioritization of cities, and attendant institutional frameworks. This TA aimed at piloting and operationalization of CSPs towards outcome oriented sector investments, by supporting (i) select state and local governments with technical assistance to operationalize city sanitation plans by targeting outcome oriented investments, and (ii) improving the institutional and regulatory framework and strengthening state and local government capacity for efficient and sustainable delivery of Government of India or World Bank or other development partner funded programs.

This study discusses the impact of economic geography and (low) population density on development outcomes in Mali and explores how policies to reduce poverty can be made more effective by taking these two factors into account. The crisis in north Mali which started in 2012 and continues to date has brought questions of economic geography to the center of attention. To help answer such questions, and to analyze how to reduce poverty in Mali as a whole, this study uses different sources of information to analyze the diversity of livelihood patterns, in access to services and in living standards. The study uses quantitative information from household surveys, population and firm censuses, administrative and geographic data, and qualitative information about livelihoods. This study argues that the authorities will need to employ all three policy instruments, while emphasizing that if the objective is poverty reduction, most attention should be focused on spatially blind approaches. The study is organized as follows: chapter one gives introduction. Chapter two emphasizes differences in population density which allows distinguishing between types of agglomeration from villages, to rural town, to large cities. Chapter three categorizes the country into various livelihood zones and considers how the agro-physical environment affects the way people live. In chapter four authors turn to household welfare. Chapter five considers access to services. Chapter six is forward looking.

The last poverty assessment for Rwanda was conducted in 1997. Three years after the genocide, the country was characterized by deep and widespread poverty, rock-bottom health indicators, and pervasive hunger and food insecurity. In real terms, gross domestic product (GDP) per capita was lower than it had been in 1960. In real terms, the economy quadrupled between 1995 and 2013. Enrolment in primary school is near universal and infant and child mortality are among the lowest in Africa. A large part of the population, including the extreme poor, is covered by public health insurance. This poverty assessment focuses on the evolution of poverty and other social indicators over the past decade (2000-1 and 2010-11). Using data from a variety of sources, mainly the three household living standards surveys (EICV) and the three demographic and health surveys (DHS) conducted during the past decade, the poverty assessment documents trends in monetary and non-monetary dimensions of living standards and examines the drivers of observed trends. The aim of the poverty assessment is to provide policy makers and development partners with information and analysis that can be used to improve the effectiveness of their poverty reduction and social programs.

This paper builds on the global experience and Mali s context to identify an effective nutrition approach as well as costs and benefits of key nutrition programs, as part of a resilience agenda after the crisis. It is intended to help guide the selection of the most cost-effective interventions as well as strategies for scaling these up. The paper looks at both relevant nutrition-specific interventions, largely delivered through the health sector, and at multisectoral nutrition-sensitive interventions delivered through other sectors such as agriculture, social protection, and water and sanitation that have the potential to strengthen nutritional outcomes in Mali. We first estimate that the costs and benefits of implementing 10 nutrition-specific interventions in all regions of Mali would require a yearly public investment of $64 million. The expected benefits are large: annually about 480,000 Disability-adjusted Life Years (DALYs) and more than 14,000 lives would be saved and over 260,000 cases of stunting among children under five would be averted. However, because it is unlikely that the Government of Mali or its partners will find the $64 million necessary to reach full national coverage, we also consider three potential scale-up scenarios based on considerations of their potential for impact, the burden of stunting, resource requirements, and implementation capacity. Using cost-benefit analyses, we propose scale-up scenarios that represent a compromise between the need to move to full coverage and the constraints imposed by limited resources. We identify and cost six nutrition-sensitive interventions that are relevant to Mali s context and for which there are both evidence of positive impact on nutrition outcomes and some cost information. These findings point to a powerful set of nutrition-specific interventions and a candidate list of nutrition-sensitive approaches that represent a highly cost-effective approach to reducing child malnutrition in Mali.

This report explores the potential financing mechanism options that can be employed to catalyze more private sector investment in clean energy (renewable energy and energy efficiency) in the small island developing states (SIDS). Various financial instruments that have been used successfully to date are described and placed in the context of the issues and constraints of the SIDS, with suggested options for discussion and follow up. Green infrastructure finance, as defined in the report, makes the important point that is the combination of financial and nonfinancial interventions and instruments that can make green investments in infrastructure more affordable and less risky to private sponsors, financial markets, and governments. The objective of this report is to identify and assess options that can help increase investment in renewable energy and energy efficiency in SIDS through the adoption and funding of financing mechanisms by SIDS and development partners with special attention given to the role that the private sector can play. Many renewable energy technologies are characterized by high initial capital costs with relatively low operating costs compared to thermal alternatives. By providing an analysis of options for a financing facility to catalyze renewable energy and energy efficiency, this work is intended to inform the discussions among SIDS and development partners interested in actions to stimulate investment in renewable energy and energy efficiency. This report summarizes the results of the two stages. The assessment and selection of options identifies a number of measures that will be needed to stimulate increased private sector participation - project sponsors and developers, equity funds, lending institutions - for energy efficiency and renewable energy. The background material reviewed for this report has been summarized in the annexes.

This study explores the potential of prepaid meters for serving urban poor communities. It provides urban utilities, oversight agencies, and other stakeholders in Africa with a basis for decision-making on the suitability, introduction, and management of such meters. The need for the assessment emerged from prepaid meters increasingly being utilized by water and sanitation utilities in developing countries, including World Bank clients. The technologies adopted have expanded over this period, but there has been a lack of consolidated data and analysis that capture the service delivery, operational efficiency, and access to services aspects of such systems across utilities and regions systematically. The review initially aimed to research experiences in six African countries from the perspective of their communities, as well as from water sector bodies, governments, and other investors. The number of case studies was increased to eight with the addition of Windhoek in Namibia and Nakuru in Kenya, as it became apparent that they may offer additional lessons. Windhoek, for example, is one of the prepaid water pioneers in Africa. The study specifically canvased the perspectives of customers, including market research and opinion surveys on people s experience and views of prepaid water in practice. Women and children were well represented in many of these groups. The analysis aimed to be robustly investigative, deliberately not advocating for prepaid systems in principle, or making firm recommendations, but rather offering balanced analysis and assessment, and considerations to inform policymakers and sector leaders, as well as other stakeholders who may face decisions or challenges on such systems. One of the key conceptual bases that the analysis identified was the need to differentiate between prepaid applications of prepaid system for standpipes, individual connections, and institutional and commercial customers each of which have different implications for their users, as well as for cost effectiveness. Utilities must be able to justify the investment in a prepayment system and its opportunity costs specific to the application they choose, and relative to alternative means of improving services.

The growth of the private sector in higher education in Europe – in terms of the number of institutions and the share of enrolments in national systems – has been an educational phenomenon of post-communist transition countries. As Daniel C. Levy (2010: 10) points out, though: “one of the key trends in international higher education, the rapid expansion of the private sector now holds one-third of all global enrollments. However, the growth is not unbroken or inexorable and sometimes stalls and even reverses”. Poland is an example of the reversal in question. While the expansion era (1990-2005) was characterized by external privatization (that is, private sector growth, combined with internal privatization, or the increasing role of fees in the operating budgets of public universities), the current contraction era (2005-2025, and possibly beyond) is characterized by what we term “de-privatization”. De-privatization also has external and internal dimensions: the gradual decline in private sector enrolments is combined with a decreasing role of fees in public universities. The private sector in Poland cannot be explored outside of the context of the public sector: its future is closely linked to the changing public–private dynamics in the whole system. It is useful to explore its future in the context of two major ongoing processes: large-scale reforms of public higher education, and broad, long-term demographic changes. The Polish case study is important for several reasons: the public–private dynamics is rapidly changing in a system which has the highest enrolments in the private sector in the European Union today. In the global context of expanding higher education systems there are several systems in Central and Eastern Europe, and Poland is the biggest of those which are actually contracting. Their contraction is fundamental and rooted in declining demographics. In the global (rather than European) context of increasing reliance on cost-sharing mechanisms and on the private sector growth paradigm in university funding, the Polish system seems to be moving in the opposite direction: global trends towards privatization can be juxtaposed with the Polish counter-trend towards de-privatization.

Starting from the aggregate, this report first describes how Pernambuco has fared with respect to the rest of Brazil, both in terms of economic and social welfare performance, over the last decade (2001-2012). In a context of widespread economic growth, Pernambuco has done particularly well in recent years, similar to or above the national average. A key challenge concerns the longer-term, where – notwithstanding the positive performance of recent years-the same level of growth may not be as easily sustained. The solid economic performance has been reflected in an improvement of social indicators, also associated with the governments interiorizacao strategy, a policy developed explicitly to increase the coverage of public services in underserved areas, with a focus on the interior of the state. The decline in poverty rates displays a trajectory towards convergence with Brazil and recently, a faster than national decline of the Gini has brought Pernambucos income inequality below the national and Northeast level.

Uzbekistan is a lower middle-income country located in Central Asia with a population of 30 million people and an economy that has been growing by over 8 percent per annum since the mid-2000s. The composition of the workforce has also changed dramatically in recent years. The higher education system is characterized by low access and concerns about the quality and relevance of the skills of its graduates. A recent regional skills study concluded that Uzbekistan is experiencing a substantial shortage of university graduates. The internal management of the higher education system is fragmented, with different actors having overlapping responsibilities, thereby making it difficult to ensure system-wide accountability. In order to enable the Uzbek higher education system to serve the economy and student population well, the quality assurance system should be compliant with global best practices while remaining locally relevant. While reported overall state budget spending on education, at around 8 percent of GDP, is one of the highest in the world, the share of this spending on tertiary education, at around 0.4 percent of GDP, is one the lowest. In summary, Uzbekistan’s higher education system needs to modernize to better adapt to needs of the country’s economy. The report, having analyzed the sector in detail, proposes measures to modernize the higher education sector in Uzbekistan.

As Dubai has grown over the last two decades, the demand for private education has grown with it, a reflection of the number of expatriates settling in the city. Today, 88 percent of all students attend private schools. The surge in demand over this period had in fact been so significant that authorities, recognizing the need to establish a specific governmental entity to oversee the sector s expansion, moved to create the Knowledge and Human Development Authority (KHDA) in 2007. Given the city-state s unique context (in which a majority of the population are expatriates, not Emiratis), the immediate challenge for this new public institution was to identify an appropriate approach for regulating a private education sector. The main objective of the present review is to understand what has motivated KHDA s policy initiatives, what principles have guided design, how they were operationalized, and how they function in real life situations today. In what follows, we look first at the broader context of the issue by giving a brief overview of: (i) the growth of private sector education; and (ii) the rise of public governance reform initiatives in the global education policy agenda. The authors then turn to the case of Dubai: the authors present the argument in the road not traveled before reviewing how that policy framework was translated into its present institutional configuration in Dubai through the development of the institutions that came into being. The authors then reflect on the policy framework in operation, showing how the constituent components function together. The authors end by suggesting some options on potential ways forward that will further enhance the system.

European higher education systems in the last few decades have been in a period of intensive quantitative expansion. Both participation rates and student numbers in most European countries are still growing – but are the chances of young people from lower socioeconomic classes to enter universities higher than before? Under massification conditions, are the chances of young people from poorer backgrounds actually increasing, relative to increasing chances of young people from higher socioeconomic classes and wealthier backgrounds? Are both overall social mobility and relative social mobility of under-represented classes increasing at the same rate? That is a question about changing social mobility relative to the share of particular socioeconomic classes in the population as a whole. Social mobility in increasingly knowledge-driven economies is powerfully linked to equitable access to higher education. And the question of inequality in access to higher education is usually asked today in the context of educational expansion. Educational expansion, in most general terms, and in the majority of European countries studied, seems to be reducing inequality of access. There are ever more students with lower socioeconomic backgrounds, and ever more graduates whose parents had only primary education credentials. The chances of the latter to enter higher education are increasing across Europe but are still very low. The intergenerational patterns of transmission of education are still very rigid across all European systems: the offspring of the low-educated is predominantly low-educated; the offspring of the highly educated is predominantly highly educated. Structurally similar patterns can be shown for occupations: the offspring of those in the best occupations predominantly take best occupations, and the offspring of those in the worst occupations predominantly take the worst occupations, across all European countries (“best” being structurally similar and linked to both middle-class earnings and lifestyles in Europe. Equitable access to higher education is linked in this chapter empirically to the social background of students, viewed from two parallel perspectives: educational background of parents and occupational background of parents, and studied through the large-scale EU-SILC (European Union Survey on Income and Living Conditions) dataset.

The chapter explores access to higher education in Poland when demand-driven educational expansion is changing into educational contraction driven by demographic factors. It combines a theoretical framework with substantial original data analysis. The empirical evidence comes from educational statistics and statistical demographic projections. Educational expansion in Poland in 1995–2010 is related to four major dimensions: age, gender, sector (public/private) and status (full- and part-time). In addition, a section about access related to the intergenerational social mobility in Poland is based on microdata analysis of the EU SILC dataset (European Union Survey on Income and Living Conditions)– to explore the relative mobility of Polish society in Europe (in terms of educational attainment levels and occupational groups). The chapter contributes to academic discussions in four areas: global comparative research on private higher education (and related public/private dynamics), research on inter-sectoral and intra-sectoral differentiation of higher education, international comparative research on post-communist European higher education systems, and international comparative research on social stratification. The chapter refers to Poland and several post-communist European higher education systems which combine two features: a vast expansion following the fall of communism after 1989 and sharply falling demographics in the next two decades.

Since the Asian Financial Crisis in the late 1990s and through the Global Financial Crisis of the last decade, commendable progress has been made by the member states of the Association of South East Asian Nations (ASEAN) in improving economic and human development outcomes both within each country and across countries. Since 1997, the economies of the poorest countries in the ASEAN, Cambodia, Lao PDR, Myanmar and Vietnam, have generally grown faster than the richer economies, which has reduced gaps in per capita incomes. Overall, child mortality rates have been cut by two-thirds across the ASEAN. And significant reductions have occurred even in some of the poorer member countries such as Cambodia and Lao PDR. However, this report The ASEAN Equitable Development Monitor (henceforth referred to as The Monitor), also shows that much remains to be done to ensure that the poorest members of the ASEAN community, within countries and across countries, are not left behind as the countries of the ASEAN integrate further. In both policies and development outcomes, differences across the countries of the ASEAN remain large. In this context, the monitor is designed to facilitate further discussion on policies and programs that can promote inclusive growth within ASEAN member countries and across the ASEAN community. It presents a number of indicators that are intended to provide a summary of development outcomes across and within the ten ASEAN countries and over time. On this basis, the monitor is intended to help policymakers in ASEAN member states to identify areas of concerns and prioritize national and regional interventions. The monitor tracks indicators across two broad sets of development outcomes and policies: (i) economic development; and (ii) human development.

Investments in education, health and social protection are the key to improving the state of human development in any society. In recent years, Nepal too has invested heavily in these sectors, particularly in education and health. This note provides an overview of the progress and current state of access and equity in these three sectors. It also presents evidence on some aspects of quality in the education and social protection sectors. While the country has made substantial improvements in different indicators of access at the aggregate level, disaggregated data show that disparities in access continue to exist across demographic and geographical dimensions. There is some evidence of improvement in the quality of educational inputs over the years, but the quality of outcomes remains poor.

Grenada has faced various socioeconomic challenges within the last decade, including the destruction wrought by Hurricane Ivan in 2004 and the global financial crisis. As a result, economic indicators for Grenada illustrate unfavorable. Increases in the poverty and unemployment rates, especially among the youth and young adults. This report presents an assessment of the regulatory, legislative, and institutional landscape governing workforce development (WfD) in Grenada. The results of this analysis are based on a newly designed analytical tool developed by the World Bank under the Systems Approach for Better Education Results (SABER) initiative. The aim of this initiative is to garner data so as to provide systematic documentation and assessment of the policy and institution factors that influence the performance of education and training systems of SABER-participating countries. The SABER-WfD tool encompasses initial, continuing, and targeted vocational education and training that are offered through multiple channels, and focus largely on programs at the secondary and post-secondary levels. The results of the assessment presented in this report are expected to assist in clarifying priorities. They classify the WfD system according to four stages of maturity in policy and institutional development, as follows: (1) Latent, (2) Emerging, (3) Established, and (4) Advanced.

This report presents an analysis of the early childhood development (ECD) programs and policies that affect young children in the Gambia and recommendations to move forward. This report is part of a series of reports prepared by the World Bank using the systems approach for better education results (SABER) - ECD framework and includes analysis of early learning, health, nutrition, and social and child protection policies, and interventions in the Gambia, along with regional and international comparisons.

Access to higher education in Poland is changing due to the demography of smaller cohorts of potential students. Following a demand-driven educational expansion after the collapse of communism in 1989, the higher education system is now contracting. Such expansion/contraction and growth/decline in European higher education has rarely been researched, and this article can thus provide a possible scenario for what might occur in other European postcommunist countries. On the basis of an analysis of microlevel data from the European Union Survey on Income and Living Conditions, I highlight the consequences of changing demographics for the dilemmas of public funding and admissions criteria in both public and private sectors.

This section describes the priority nutrition interventions and cross-cutting approaches that are essential to promote and protect the nutritional status of mothers and children as well as a country's human capital in the short-, medium-, and long-terms. The main thrust of the guidance is that: (1) policies give special attention to the critical 'window of opportunity' represented by the first 1,000 days of life; (2) policies are aligned with the latest international recommendations in nutrition; (3) policies and interventions of key sectors are coordinated to provide synergy of action; and (4) resources allocated for disaster prevention and emergency management are invested in the most cost-effective way. Monitoring is a continuous process of collecting and analyzing information to better understand how well a program is operating against expected outputs and to allow remedial intervention to correct failures. Situation monitoring measures the change or lack of change, in a condition or a set of conditions and includes monitoring of the wider context. Performance monitoring, on the other hand, measures progress in achieving specific results in relation to an implementation plan. Evaluation is a systematic and objective assessment that attempts to determine the worth or significance of an intervention, strategy, or policy. It is used to appraise the effectiveness of an intervention to determine if it meets its goals, to estimate its results or impact, and to identify its costs vs. its benefits. Promote optimal breastfeeding practices. Provide all pregnant women with daily iron-folic acid supplements for at least six months. Provide deforming treatment to pregnant women, preschool-aged children, and school-aged children in areas where hookworms or soil-transmitted helminthes are prevalent. Establish strong links between agricultural, food security, social protection and nutrition policies that can be used to inform a robust communication program regarding maternal diet and critical infant and young child feeding practices. Support diversified agricultural production to increase availability of nutrient-dense foods, particularly those of animal sources.

In October 2010, the Government of Madhya Pradesh hosted, with World Bank technical advice, a Conference on higher education reform in the State. The Governor, the Chief Minister and the Minister of Higher Education all addressed the Conference and about 150 people attended the event. Subsequently, four regional Conclaves were organized, in which a total of more than 400 people participated, representing the leadership, administrators, faculty and students at universities and colleges across the State. This represents an impressive outreach to the sector stakeholders. This report is written on the cusp of the publication of the Government of India s 12th Five Year Plan. The indications are that the Government of India intends to push ahead with some significant reforms in the higher education sector. Of particular significance for this report is the emphasis, for the first time, on the need to support the improvement of State universities and colleges. The objective of this report is to provide policy makers in Madhya Pradesh with a menu of options for improving the equity, governance and financing of the higher education system in the State. Though the primary audience is policy makers, this report could serve as part of the continued dialogue with the higher education sector on the direction for reform.

The Kyrgyz Republic has made some progress in improving its poverty and social indicators but the gains have been fragile and significant disparities remain within the country. The slowdown in economic growth in 2009 and the resulting uptick in poverty underscored the susceptibility of the economy to external shocks. In this report, author's tackle the issue of inequality in the Kyrgyz Republic by framing it along the notion of equity as opposed to equality. The reason for doing so is that it is easier to galvanize social consensus and policy action when the overarching principle guiding policy is fairness in the allocation and access to opportunities as opposed to equality of outcomes. A girl born in a remote village in the oblast of Naryn to a single, uneducated mother with four other siblings ought to have the same shot at becoming a doctor or an engineer as a boy with one sibling, born in an educated, two-parent household in Bishkek. Basic opportunities are defined as subset of goods and services for children, such as access to education, safe water on site, or reliable electricity that are critical in determining opportunities for economic advancement in life. These are either already affordable by society at large or could be in the near future, given the available technology. Opportunities among children are measured in this report by the Human Opportunity Index (HOI), which is the coverage rate of a particular basic service adjusted by how equitably the service is distributed among groups differentiated by circumstances. In discounting inequitable access, the HOI reflects how personal circumstances- for which the children cannot be held accountable-affect their basic opportunities. The key finding of this report is that the goal of equal opportunity remains distant in the Kyrgyz Republic: a child's circumstances such as her parents' socioeconomic status, region of residence, whether it is urban and rural etc. have a substantial bearing on the extent to which certain services are available to her. Similarly, opportunities pertaining to a healthy start in life adequate access to household infrastructure and amenities that ensure a stable, safe and stimulating childhood also have strong regional dimensions with entire regions being underserved. Finally, what this report has done is taken a snapshot of the distribution of opportunities in the Kyrgyz Republic for a particular year.

This paper provides an overview of land reform in South Africa from 1994 to 2011, with the focus on the land redistribution. The government policies and associated implementation since 1994 have not generated expected social and economic results for a number of reasons. Even where land has been transferred, it appears to have had minimal impact on the livelihoods of beneficiaries, largely because of inappropriate project design, a lack of necessary support services and shortages of working capital, leading to widespread underutilization of land. There is no evidence to suggest that land reform has led to improvements in agricultural efficiency, income, employment or economic growth. Therefore, the current approach, based on acquisition of land through the open market, minimal support to new farmers, and bureaucratic imposition of production models loosely based on existing commercial operators, is unlikely to transform the rural economy and lift people out of poverty. The paper argues that there are two important missing aspects in the land reform program. First, there is an absence of any viable small-farmer path to development, which could enable the millions of households residing in the communal areas and on commercial farms to expand their own production and accumulate wealth and resources in an incremental manner. Making this happen would require radical restructuring of existing farm units to create family-size farms, more realistic farm planning, appropriate support from a much-reformed state agricultural service, and a much greater role for beneficiaries in the design and implementation of their own projects. Second, what is clearly missing from the governance tradition is the sustained focus on implementation, resource mobilization, and timely policy adjustment. Much more will be required for land reform program to contribute significantly to economic growth and to the redistribution of wealth and opportunities to the majority of the population.

Water, as a resource, is integral to human activities of all kinds. The water sector, as a society's means of ensuring individuals have sufficient water is fundamental to recovery and development. While designing and implementing water supply operations in any societal context is a complicated endeavor, doing so in contexts affected by conflict, fragility and violence is inherently associated with compounded challenges. The objective of this study is to summarize operational lessons from task teams to inform effective water supply and access operations in conflict-affected and fragile situations. This paper defines common operational challenges and describes actions that task teams have taken in Bank projects in order to address those challenges. Further, the paper explores ways to ensure that water supply projects in fragile and conflict-affected situations (FCS) contexts, in addition to achieving technical objectives, can also address perpetual causes of conflict and fragility. The risks of escalating violence and decreasing stability are exacerbated in situations where access to water resources and services is poor, constrained, inequitable, and unsustainable. This knowledge product summarizes lessons from World Bank task teams that have prepared and implemented water supply projects in locations affected by conflict, fragility and violence. The findings intend to support operational problem-solving during water operations that are conducted in these situations. The study engaged task team members and surveyed project documentation, consolidating data on contextual and operational challenges and responsive methods that staff recommend. The findings of this study show that clear priorities in process and organizational capacity, with a focus on access, are needed to ensure that water supply operations in FCS contexts are conflict-sensitive.

Jamaica is a Caribbean country that has initiated comprehensive programs to address Non-Communicable Diseases (NCDs). The government created the National Health Fund (NHF) to reduce the cost of treatment of NCDs and finance some prevention programs. The main objective of this study is to learn from Jamaica's experience in tackling major NCDs and related risk factors, to provide policy options for Jamaica to improve its NCD programs and to share with other countries the lessons learned from its experience. The study attempts to answer three questions: a) whether the NHF and its drug subsidy program have reduced out-of-pocket spending on NCDs; b) whether access to treatment of NCDs has improved; and c) what the economic burden on NCD patients and their families is. The report presents an overall picture of the epidemiological and demographic transitions in Jamaica, its current burden of NCDs, and the change in the trend of NCDs in the past decade, using publicly available data, particularly data from the Jamaica living condition household surveys. It assesses the risk factors and analyzes Jamaica's response to NCDs with emphasis on the impact of the NHF on people's lives. Estimates of the economic burden of NCDs are provided and policy options to improve Jamaica's NCD programs are suggested. This study focuses on Jamaica's experience in addressing major NCDs and their related risk factors with the objective of learning from Jamaica and providing policy options to Jamaica to improve its programs.

In the wake of the revolution, Tunisian society is currently undergoing a significant transformation. In late 2011, the country's first representative government in more than three decades was formed, as the Constituent Assembly was seated. Hundreds of legitimate candidates ran in an election that was free, fair, and enjoyed nearly 90 percent participation by eligible voters. 'Tunisia: from revolutions to institutions,' published one year after the exile of Ben Ali, seeks to describe the factors driving this transformation, examining how specific elements of society have changed, or not changed, in the post-revolutionary period. Information and communication technologies (ICTs), which played a central role in the lead-up to the revolution as well as the revolution itself, have continued to influence rapid changes in the past year. This report charts the application of these technologies by citizens, civil society, entrepreneurs, and government stakeholders. It also identifies openings to capitalize on technology's ability to improve governance, expand economic opportunity, and encourage social cohesion.

In Colombia, the beginning of a new century has brought with it a palpable feeling of optimism. Colombians will need new and better skills to apply to new challenges and prospects. The past underperformance of Colombia's education system is both a cause and an effect of a system unable to provide high quality education to all. An "education revolution" has begun and progress is being made. Basic and secondary enrolment, quality and learning outcomes are trending upward. The government's main policy goals at the tertiary level focus on the key challenges: expanding enrolment and improving equity, increasing quality and relevance, and making governance and finance more responsive. To achieve these goals, policy makers and stakeholders must find ways to reach consensus, work together and overcome inertia. Colombia has drifted away from focusing exclusively on the needs of students, the graduates they become, and the society in which they live and work. Restoring the focus on how tertiary education can serve these needs is a good organizing principle for reform. The government developed a proposed reform of Law 30 - the main statute governing tertiary education - and vigorous national debate accompanied its dissemination. Opposition to for-profit education dominated the headlines, but, in the review team's view, other aspects of the proposed reform were and are more important. The dramatic increase in tertiary enrolment witnessed during the last decade has also resulted in a more equitable distribution of access to tertiary education. The goal of enrolling 50% of the age cohort is appropriate and achievable, but it implies new challenges for access and student finance policies. The tertiary system covers the full range of the Colombian economy's needs for skilled manpower, if not necessarily to an equal extent. The government has clear and well-founded plans and aspirations for future tertiary growth and development. The Colombian government and people are well aware that they need not only more, but also better and fairer, tertiary provision - growth in coverage must be accompanied by quality, relevance and equitable access. The Colombian system of propaedeutic cycles is a good step towards allowing students to progress up through the tertiary levels. Colombian tertiary institutions have considerable autonomy, which is valuable in many ways though limiting in others.

The significance of secondary education emerges from its critical role in promoting economic growth by determining the quality of those who enter labor market after schooling as well as those who pursue higher education. Secondary education is also important due to the positive externalities on promoting health, social cohesion and sustainable livelihood. Secondary education is undeniably the crucial stage in any education system, as it is in this stage that the elementary school graduates get their basic skills cemented and gain competencies that prepare them to enter either into higher education or into labor market. This analytical report presents the status of secondary education participation the participation in India using National Sample Survey (NSS) 64th round (2007-08). The specific objectives of this policy note are: a) the participation rates of adolescents in secondary education, disaggregated by gender, social and religious groups, household economic quintiles and different locations (rural or urban as well as across states) in India using NSS 64th round (2007-08); b) the transition patterns from elementary to secondary stage and dropouts in between, disaggregated; and c) the proportion of population who had secondary education; and participation in secondary education by type of management of schools. This policy note is organized in the following way. In the first section, a brief account of the secondary education scenario in the country is provided. In the second section, overall secondary education participation is analyzed. In section three, an analysis of gender and social or religious gaps in secondary education participation is taken up.

Since the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak, health care in China has become a leading national concern. Often highlighted by the popular phrase, kan-bing-nan, kan-bing-gui (seeking care is difficult and expensive), healthcare costs can be devastating. Prior to 2007, there were two formal insurance programs: the Urban Employee Basic Medical Insurance (UEBMI) for the urban employed population, and the New Rural Cooperative Medical Insurance (NRCMI) for rural residents. A third major group-urban resident without formal employment-was essentially left out of the state health security system. In July 2007, the State Council initiated a pilot experiment in 79 cities-the Urban Resident Basic Medical Insurance (URBMI). The plan targeted urban residents without formal employment, especially the elderly and children (State Council 2007). The present health policy note provides an updated review of healthcare settings and policy reforms, focusing primarily on urban health financing. It discusses urban insurance in the context of universal coverage and how to harmonize insurance schemes across urban and rural areas. This discussion is placed in the context of global experience and emerging principles of best practices.

Nicaragua, a largely urban country (56 percent of the population lives in urban areas), is one of the least populous (5.53 million) and poorest countries in CentralAmerica. Following reforms in the 1980s, Nicaragua made remarkable progress in gender equity in education and the labor force, while the wide availability of primary health care initiated in the 1970's, including family planning services, led to improvements in infant and child mortality rates. Several lessons emerge from Nicaragua's success at reducing fertility. The government was committed to gender equity and female empowerment through educating girls and women and recruiting women into the labor force. Family planning services were provided within a well functioning primary health care system, including an extensive, efficient contraceptive distribution network that works with international donors, and international and national Non-Governmental Organizations (NGOs) to offer women a good mix of options. Demand must be created through a timely public education campaign. Success requires civic engagement with stakeholders, which may initially mean avoiding unnecessary confrontation and publicity of services for addressing the concerns of more conservative stakeholders.

This report provides a gender review of a decade and a half of World Bank infrastructure lending for 1,246 projects. The objective of this review is to assess the status of and trends in gender integration in the World Bank infrastructure portfolio, and to establish a baseline for monitoring and enhancing gender integration in line with commitments made for the 2006 gender action plan. The portfolio review reveals important progress on gender integration in infrastructure operations. While an average of 14 percent of infrastructure projects in 1995 applied some attention to gender concerns in 1995, this climbed to 36 percent by 2009. The global average, moreover, hides large strides made over time in four regions. In 2009, East Asia and the Pacific, Middle East and North Africa, South Asia, and Africa all included gender concerns in the design of at least 50 percent of their infrastructure projects. Hard work remains in consolidating and extending the gains in gender coverage across the infrastructure portfolio. This will require stronger management commitment, concerted efforts, a plan with targets to achieve sustainable results, resources, specialist staffing, and capacity enhancement of staff. The portfolio review repeatedly found that supporting gender equality and women's empowerment in infrastructure operations have large benefits for the communities; the actions not only increased women's opportunities but also enhanced project effectiveness, efficiency, and sustainability.

The operations policy on Development Policy Lending (DPL), approved by the Board in August 2004, requires that the Bank systematically analyze whether specific country policies supported by an operation are likely to have "significant effects" on the country's environment, forests, and other natural resources. The implicit objective behind this requirement is to ensure that there is adequate capacity in the country to deal with adverse effects on the environment, forests, and other natural resources that the policies could trigger, even at the program design stage. DPL operations are associated with a whole array of policies such as macro policy reforms, fiscal policies, and specific sectoral policies, particularly in key sectors such as agriculture, health and education, energy, etc. In some cases, the operation may deal directly with reforms in certain environmentally sensitive sectors such as energy, transport, water and sanitation, agriculture, and forestry. In these cases, there is an obvious need for careful analysis of environmental, natural resource, and forestry impacts. In other cases, such as public sector reform and governance, there is less potential for likely significant impacts on the natural environment and natural resources. The toolkit is designed to be concise and user-friendly. It consists of three specific modules. The first module identifies relevant transmission channels through which the proposed reform would have a likely effect on the identified environmental, forest, and other natural resource priorities. The second module provides assistance in identifying key environmental issues in the country, regions, or sectors likely to be influenced by the DPL program. The third module presents different tools and methodologies for rapid assessment of the likely significant effects of each reform.

Mounting evidence suggests that excessive job protection reduces employment and labor market flows, hinders technological innovations, pushes workers into the informal sector, and hurts vulnerable groups by depriving them of job opportunities. Flexible labor markets stimulate job creation, investment, and growth, but they create job insecurity and displace some workers. How can the costs of such insecurity and displacements be minimized while ensuring that the labor market remains flexible? Each of the main unemployment income support systems (unemployment insurance, unemployment assistance, unemployment insurance savings accounts, severance pay, and public works) has strengths and weaknesses. Country-specific conditions, chief among them labor market and other institutions, the capacity to administer each type of system, and the size of the informal sector, determine which system is best suited to developing and transition countries.

Resumo OBJETIVO: analisar a utilização e a percepção sobre medicamentos genéricos pela população com diabetes e hipertensão na cidade de São Paulo, considerando-se a Política de Medicamentos Genéricos no Brasil. MÉTODOS: estudo transversal com dados do Inquérito de Saúde do Município de São Paulo (ISA-Capital), coletados em 2003; foi analisado o conhecimento sobre medicamentos genéricos e a associação entre utilização desses medicamentos e características sociodemográficas e socioeconômicas. RESULTADOS: foram incluídos 603 participantes; entre hipertensos e diabéticos, foi encontrada baixa utilização de medicamento genérico (33,3% e 26,3%, respectivamente) e a principal vantagem atribuída ao medicamento genérico foi o baixo custo (71,0% e 71,1%, respectivamente); não houve diferença estatisticamente significativa entre uso de medicamento genérico e idade, sexo ou escolaridade. CONCLUSÃO: o baixo custo e não haver diferença entre uso do genérico e escolaridade reforçam a importância do medicamento genérico para a promoção da equidade e do acesso universal a medicamentos. Resumen OBJETIVO: analizar el uso de medicamentos genéricos en la población con diabetes e hipertensión en São Paulo, Brasil, considerando la política de medicamentos genéricos en Brasil. MÉTODOS: estudio transversal con datos de la Encuesta en Salud del municipio de São Paulo (ISA-Capital), colectados en 2003; se analizó el conocimiento sobre medicamentos genéricos y la asociación entre el uso de estos y las características sociodemográficas y socioeconómicas de la población. RESULTADOS: incluimos 603 participantes, entre hipertensos y diabéticos se encontró un uso escaso de genéricos (33,3% y 26,3%, respectivamente) y la principal ventaja atribuida al medicamento genérico fue el bajo costo (71,0% y 71,1%, respectivamente); no hubo diferencia entre el uso de medicación genérica y la edad, sexo o educación. CONCLUSIÓN: el bajo costo y ninguna diferencia entre el uso de genérico y educación refuerza la importancia de los genéricos para la promoción de la equidad y el acceso universal a los medicamentos. Abstract OBJECTIVE: to analyze the use and perception of generic drugs by people with diabetes and hypertension in São Paulo City, Brazil, considering the Brazilian Generic Drug Policy. METHODS: this was a cross-sectional study using data from a household health survey (ISA-Capital) in 2003; analysis was performed on knowledge regarding generic drugs and on the association between their use and sociodemographic and socio-economic characteristics. RESULTS: 603 people with hypertension and diabetes were included in the study, low use of generic drugs was found (33.3% and 26.3, respectively) and low cost was the major reported advantage of generic drugs (71.0% and 71.1%, respectively); there was no statistically significant difference between the use of generic medication and age, sex or schooling. CONCLUSION: low cost and there being no difference between generic drug use and education level strengthen the importance of generic drugs for promoting equity and universal access to medication.