Contacts: In Washington: Rachel McColgan-Arnold rmccolgan@worldbank.org In Bujumbura: Marie-Claire Nzeyimana mnzeyimana@worldbank.org WASHINGTON, June 09, 2009 – The World Bank’s Board of Executive Directors today approved a $25 million International Development Association (IDA) grant for the Health Sector Development Support Project in Burundi, to help the Government in its efforts to strengthen outcomes in the health sector, particularly among expectant mothers and children under 5. The project will also finance activities that tackle the incidence of malaria and HIV/AIDS transmission in those target groups. Burundi has one of the lowest per capita GDPs in the world (US$110 in 2007) and despite limited growth and recent stability, basic social indicators remain among the lowest in Africa. A 2005 survey found infant and child mortality to be 109 and 181 per 1,000 live births respectively and estimates for maternal mortality rates have remained stagnant at roughly 1,100 per 100,000 live births for the last several years. Deficits in the health system are further compounded by other factors including services that are not used (due to cost barriers) and scare and poorly motivated staff working in the sector. In spite of these challenges and reflecting the 2006-2011 Poverty Reduction Strategy Paper--which identified Human Development as one of four pillars--the Government has doubled public expenditure on human development. According to the Bank’s Task Team Leader, Ms. Montserrat Meiro-Lorenzo, “The challenge is to make that expenditure more efficient and equitable, building on the success to date of the Free Package of Service (FPS)s and the successful experiences with results-based financing (RBF).” The project has two components: The first ($20 million) seeks to increase the use of the FPS, targeted mostly, although not exclusively, at pregnant women and children under the age of 5, stimulating both the supply of and demand for cost-effective health service. The second component ($5 million) seeks to strengthen the capacity of the Ministry of Public Health (MSP) and other entities involved in results-based financing, by providing technical assistance, operational costs, training, and hardware to strengthen the capacity of the General Directorate of Resources (DGR) of the MSP. Ms. Meiro-Lorenzo pointed to the government’s use of the Health Sector Strategy (the PNDS) and RBF to move toward a sector-wide approach (SWAP): “This project is part of the ongoing SWAP process in that it focuses on the PNDS and works very closely with the government and its development partners to settle on a common set of indicators of success, a coordinated monitoring and evaluation system, a common implementation mechanism at the national level, harmonized financing so that it avoids gaps in funding and duplication, and a consensus on how to implement RBF nationwide. The dialogue between the MSP and its partners on the development of a pooled financing mechanism will continue throughout project implementation.” The project is aligned with the Bank’s Country Assistance Strategy (CAS) of August 2008 and with the government’s priorities as set out in the Burundi PRSP. The objectives for the health sector laid out in the CAS include the promotion of maternal and child health by deploying additional health personnel to rural areas as well as by establishing performance contracts with health facilities to give them an incentive to deliver the FPS. The proposed project is fully consistent with the CAS in that it increases the resources available for the FPS, and helps to build the MSP’s capacity to purchase services on the basis of performance, to attract health personnel to rural areas, to plan and manage resources, and to increase its monitoring and evaluation capacity. According to John M. McIntire, Country Director for Burundi, “The proposed IDA financing will be critical to help close the gap in health system investments and the World Bank’s experience in other countries around the globe indicates that employing the RBF approach can be extremely effective in increasing the use of cost-effective health interventions.” For more information on the World Bank’s work in sub-Saharan Africa visit: www.worldbank.org/afr For more information on the World Bank’s work in Burundi visit: www.worldbank.org/burundi For more information about the project visit: Burundi Health Sector Development Support Project |
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