Resources for

Fighting Poverty in Africa

Five World Bank projects improving the lives of the poor

A health, population, and rural water project in Mali helped build several hundred community health centers. With the help of a pilot female literacy project, the Senegalese government is on track toward its goal of more than halving female illiteracy by 2005. These are two examples of how World Bank-financed projects help improve the lives of the poor in Africa.

The following feature is the fifth of a six-part series on how the World Bank attacks poverty in the field.

Mali Improves Access to Rural Health Services

Too few community health centers in the countryside, expensive drugs, and a poorly coordinated health care system have long plagued Mali's health sector. To address these shortcomings, the World Bank together with other donors in 1991 launched a Second Health, Population, and Rural Water Project (PSPHR).






	Lack of knowledge, poor feeding practices, food scarcity, and sheer poverty all figure in the tragedy of hunger. But in Madagascar, one of the world's most impoverished countries, an alliance of Malgaches and donors has begun to show how malnutrition can be vanquished. SEECALINE is a highly successful Malgache response to the hardships of food insecurity and malnutrition. It is supported by the World Bank and six bilateral and multilateral assistance agencies



	Social Funds responding to demand-driven community-based projects often end up inadvertently leaving out some of the most vulnerable groups that they were created to include. Responding to this challenge, the Malawi Social Action Fund (MASAF) has made it one of its primary goals to help these groups organize themselves

Spurred by a productive partnership between the Bank and UNICEF and the involvement of local communities, the project met its objectives. By 1998, nearly 300 new community health centers had been built, one-third of which were directly financed by PSPHR. The percentage of the population living within 15 kilometers of a health facility more than doubled from 17 percent in 1995 to 39 percent in 1998.

The community clinics have been largely successful in improving service coverage and client satisfaction. In addition, community management committees were established for some government clinics, although staff continue to be employed by the government. Generic prescription drugs are now widely available, and prices are low enough for community health enters to cover recurrent costs from drug sales.

Senegal Teaches Women to Read and Write

In the Senegalese countryside, the majority of women aged 15-39--peak years of productivity, childbearing and motherhood--cannot read or write. The World Bank recognizes that educating women is the single most effective way to reduce poverty. Not surprisingly, children of illiterate mothers in Senegal are more likely to die young and less likely to attend school.

The main objective of the Senegal Pilot Female Literacy project is to develop a approach for NGOs to expand their programs with the aim of lowering the illiteracy rate to about 40 percent overall and to 47 percent for women. The project targets 135,000 adults, three-quarters of whom are women, training teachers and providing teaching materials.

Since the project's beginning in 1996, the number of literacy programs has almost doubled. Almost 1,000 new classes have started, serving 30,500 students. Women make up about 90 percent of all participants, and the drop out rate is below 10 percent. Helped by the pilot project, the government is on track toward its goal of more than halving the female illiteracy rate from 66 percent to 30 percent between 1995 and 2005.

Madagascar Reduces Malnutrition

Lack of knowledge, poor feeding practices, food scarcity, and sheer poverty all figure in the tragedy of hunger. But in Madagascar, one of the world's most impoverished countries, an alliance of Malgaches and donors has begun to show how malnutrition can be vanquished. SEECALINE is a highly successful Malgache response to the hardships of food insecurity and malnutrition. It is supported by the World Bank and six bilateral and multilateral assistance agencies.

Project I, 1993-99. The Food Security and Nutrition Project was the first in Madagascar of its scope and size to work with communities and NGOs. The project focused on two provinces suffering from extreme food scarcities, Antananarivo and Toliary, training mothers, monitoring and promoting the growth of almost half a million children, and giving food supplements where needed. The project also conducted a national campaign for iodized salt. The results were encouraging: For example, the introduction of iodized salt helped reduce the presence of goiter in pregnant women and schoolchildren from 45 percent in 1992 to 15 percent in 1998. The project, which achieved a high level of government ownership and was carried out almost entirely by Malagasy, contributed to a 48-58 percent reduction in malnutrition in areas near community nutrition centers

Project II, 1998-2003. Although Project I was highly successful in the targeted provinces, only the iodized salt campaign had national impact. If anything, due to economic stagnation, hunger in Madagascar was worse in 1997 than in 1993. Thus, an expanded program was sorely needed. The second project, which covers the entire country, targets almost a million children under three, 2.5 million up to 14 years, and more than 700,000 pregnant or lactating women. Most live in rural areas.

Malawi Social Action Fund Reaches out to the Most
Vulnerable Groups

Social Funds responding to demand-driven community-based projects often end up inadvertently leaving out some of the most vulnerable groups that they were created to include. Responding to this challenge, the Malawi Social Action Fund (MASAF) has made it one of its primary goals to help these groups organize themselves.

Launched in 1996 with a World Bank-loan, the MASAF under its Sponsored Sub-Project (SSP) finances self-help community projects and transfer cash through safety-net activities. The fund is targeting poor communities, individual households, and vulnerable and disadvantaged social groups. The SSP has eliminated many layers of government involvement. Project-selection and monitoring is done by advisory committees, now set up in each region of Malawi to be closer to the projects being evaluated. The advisory committees are made up of NGO representatives, MASAF staff, government officials and beneficiaries.

So far six Sponsored Sub-Projects are being implemented. One example is a program run by Friends of Orphans Community Care Center (FOCCC), a community-based NGO outside the city of Blantyre. This NGO is now active in 27 villages with MASAF supporting their work in ten of these, helping 1,230 orphans. Beside running an orphanage, one of the most important functions of FOCCC is to train caregivers in how to tend to and raise an orphan, so he or she can stay in the community. In other areas, MASAF has since 1996 built approximately 2000 class rooms, sunk 2000 boreholes, constructed a number of health stations and postal stations, and built a modern market place.

Africa Improves Structural Adjustment

Reforming African economies successfully through so-called structural adjustment programs has long proved a challenge. With only 60 percent of adjustment operations achieving satisfactory outcomes, the World Bank in 1995 introduced Higher Impact Adjustment Lending (HIAL) in the Africa Region.

HIAL is aimed at improving results by focussing support on countries most likely to use assistance effectively. The program also seeks to enhance the design of such operations to help match transfers to needs and to the pace of reforms, smoothing resource flows while giving governments more freedom in timing reforms and greater ownership.

An initial 1999 evaluation shows that HIAL has been effective. With the number of conditions cut in half (compared with 1980-93) on average, HIAL produced improved development outcomes: HIAL countries performed better than other poor countries in fiscal adjustment, exchange and interest rate policy, and structural reforms. Better results were also achieved in economic growth, inflation, the current account, foreign exchange reserves and debt sustainability. There were also more poverty-focussed operations in the HIAL group.

Helpful links: Click here for more on the World Bank's work in the Africa region. For more on World Bank efforts to alleviate poverty, go to the Prague Briefing Center.