Background

The world is more diverse today in terms of demographic and epidemiological conditions than it was 30 years ago when the development community began working on population issues. While many countries have succeeded in slowing population growth, others still face large absolute and relative increases in numbers which threaten to undermine their efforts at economic and social development. One legacy of high population growth rates in the past is the young age distribution and high dependency rates in many poor countries. Another is the wide differential in birth and death rates as the fertility and health transitions proceed at different speeds within the same country. Both legacies contribute to inequity by social class, gender and geographical area that effective human development policies must address.

The World Bank, borrower countries, and the donor community have begun to work to implement agreements made at the 1994 International Conference on Population and Development (ICPD) to broaden the scope of population policies and programs to address a wider range of reproductive health and human development goals. While many countries and donors have made policy commitments to the ICPD Program of Action, all face major obstacles in implementation. A key barrier is the limited knowledge and technical expertise both for (1) addressing the changing demographic and epidemiological conditions in poor countries, and (2) designing and delivering comprehensive packages of reproductive health services. Poor countries face severe financial and organizational constraints in all the social sectors, including health. In the past, donor support emphasized the importance of technical and managerial skills for the promotion of per capita income growth. With the new focus on human development, many are addressing these constraints through health reform strategies such as instituting new organizational and financing arrangements for health care, changing public and private roles, and improving overall quality and accountability in the health system. Often, in the course of these reforms in the health sector in particular, reproductive health issues are neglected despite the firm worldwide commitment to their promotion.

To this end, the World Bank Institute (WBI) is developing an intensive, innovative learning program as a service to client countries. WBI is relying strongly on collaboration with donors and regional partner institutes to identify and develop appropriate learning materials, to identify expert resource persons and trainers, and to help co-finance its programs. The Adapting to Change Team is mobilizing its expertise to provide training in best practices and lessons learned about the "what" and the "how" to implement more efficient, equitable and financially sustainable population and reproductive health programs.

The Bank’s comparative advantage in this area is believed to lie in its strong inter-sectoral approach to development, its involvement in program design as well as implementation in many countries of the world, its access to finance and planning officials as well as those from the health ministries and other related sectors (education, women’s affairs, social security, and so on), its expertise in the area of costing, sustainable financing, and public-private collaboration, and its strong motivation to work effectively with other multilateral and bilateral donors in this field. With its dual mandate in training for staff and clients alike, WBI is well situated to deliver this comprehensive program whereby client and task manager, together with other key actors in the field (NGOs, donors, etc.) may work side-by-side to understand the crucial issues and translate them into effective and sustainable action.

Target Audiences

The target audiences for the learning program include public and private sector professionals involved in the financing, planning, implementation and evaluation of reproductive health and family planning services in Bank client countries. It will also be offered to staff members from the Bank and other donor agencies who are working with countries to implement the reproductive health approach called for in the ICPD Program of Action. Joint training of participants from client countries and the Bank and other donor agencies’ staff is expected to contribute to shared learning as well as a common language and understanding of the issues and options involved.

By undertaking joint training of participants from client countries, the Bank and other donor agencies, the course is expected to contribute to shared learning as well as development of a common language and understanding of the issues and options involved. Collaborative arrangements in the selection of the country teams will ensure that the teams are comprised of participants who are believed to be effective agents of change, well-placed to put their new knowledge and skills to practical use.

The objective of the program is to improve the population and reproductive health outcomes of populations in developing countries through: (1) providing participants with an understanding the changing national and international policy and program environment for their work in population and reproductive health; (2) equipping participants with the tools they will need to design and deliver an effective and affordable package of reproductive health services in their countries; and (3) informing participants working in national health systems about the pressures for reform, indicating ways in which key reform initiatives can be exploited to produce a policy environment in which more effective, comprehensive and affordable reproductive health services are provided to all.