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Presents the findings of a study of the functions performed by Central Finance Agencies, defined as government organisations that carry out financial management functions for the whole of government. Using a political economy approach to the analysis of CFAs in ten case studies of low-income countries, the report identifies the principal constraints on the capability of CFAs.

It has been over twenty years since the Brazilian Sistema Unico de Saude (Unified Health System or SUS) was formally established by the 1988 Constitution. The impetus for the SUS came in part from rising costs and a crisis in the social security system that preceded the reforms, but also from a broad-based political movement calling for democratization and improved social rights. Building on reforms that started in the 1980s, the SUS was based on three overarching principles: (i) universal access to health services, with health defined as a citizens right and an obligation of the state; (ii) equality of access to health care; and (iii) integrality (comprehensiveness) and continuity of care; along with several other guiding ideas, including decentralization, increased participation, and evidence-based prioritization. The SUS reform established health a fundamental right and duty of the state, and started a process of fundamentally transforming Brazils health system to achieve this goal. So, what has been achieved since the SUS was established? And what challenges remain in achieving the goals that were established in 1988? These questions are the focus of this report. Specifically, it seeks to assess whether the SUS reforms have managed to transform the health system as envisaged more than 20 years ago, and whether the reforms have led to improved outcomes in terms of access to services, financial protection, and health status.Any effort to assess the performance of a health system runs into a host of challenges concerning the definition of boundaries of the health system, the outcomes that the assessment should focus on, data sources and quality, and the role of policies and reforms in understanding how the performance of the health system has changed over time. Building on an extensive literature on health system assessment, this report is based on a simple framework that specifies a set of health system building blocks, which affect a number of intermediate outcomes such as access, quality and efficiency, which, in turn, contribute to final outcomes, including health status, financial protection, and satisfaction. Based on this framework, the report starts by looking at how key building blocks of Brazils health system have changed over time and then moves on to review performance in terms of intermediate and final outcomes."

Indonesia has begun to emerge into middle-income status, yet persistent poverty and stark inequalities continue to affect young childrens development. This book tells the story of Indonesias efforts to change the trajectory of development for poor children. Many countries have similar aims, but several aspects of what is reported here are especially valuable and perhaps unique.The study offers data on all aspects of health and development in a sample of rural young children, collected with internationally-validated measures, as well as household information, information about parenting practices including feeding patterns, parent questionnaires, and data on the prevalence and distribution of ECED services. The data reported in this book is based on a sample of more than 6,000 Indonesian children living in 310 poor villages, including two age cohorts (aged 1 and 4 years old when data were first collected on their development in 2009). From the start, the project aimed not only to support service provision but also to support the development of national standards, build national and district capacity, and encourage the establishment of a system of ECED quality assurance, efforts that are still in process. Few such analyses have been done with such a large sample and with multiple measures. These design features allow a high level of confidence in the results that are reported. The lessons from this book will help to inform not only this projects further implementation but ECED initiatives in Indonesia and around the world. Thus, the results presented in this book are of significance for researchers, policy-makers, and practitioners within and beyond Indonesia. The experiences and research results discussed here are especially relevant for: Researchers in early childhood development and program evaluation; Policymakers within and beyond Indonesia; Providers of early childhood services; Professional development providers; and Advocates for quality early childhood services.

Financial services are important for women who are starting and growing a business, but in Pakistan microfinance providers (MFPs) are not reaching Pakistans businesswomen. Only 59 percent of microfinance clients are women, yet the majority of these loans are passed on the male members of the household husbands, fathers, and sons. The practice of passing on loans to male household members is quite widespread; women may be bearing all the transaction costs and risks of accessing loans, but are not the final beneficiaries. Second, a very low proportion of female microfinance clients are entrepreneurs. The report explores why businesswomen in Pakistan may not be using microfinance products to meet their start-up and working capital requirements, in spite of identifying access to finance as a key constraint to their business operations. Against this backdrop, access to finance remains the biggest challenge for a woman who wants to start or grow a business. Yet less than a quarter of the entrepreneurs identified through business development service providers were currently borrowing from microfinance lenders. Even among those entrepreneurs that borrow, dissatisfaction is high. Why?Women borrower-entrepreneurs are not able to access individual loan products, but instead are consistently relegated to group lending. But group loans are very costly for a woman who is running a business, and the loans are too small to fulfill working capital needs. Businesswomen are rarely given the opportunity to access individual loan products, which are usually offered exclusively to male borrowers, and women are not given opportunities to graduate from group loans to individual loans over time. Lending practices often are discriminatory, requiring husbands permission, male guarantors, and unmarried women are rarely considered as potential clients. Although MFIs understand that womens inclusion is integral to the objectives of microfinance, the practice of passing on loans raises serious issues about consumer protection for women clients, and the best and most effective solutions to these challenges could and should come from the sector itself. Designing better products that reach the needs of emerging women entrepreneurs could prove to be good business, achieving double bottom-line objectives. Investing in financial literacy and education of both men and women borrowers can help curb the demand for pass-through loans and help lower risks associated with deceptive practices.

Compiles useful trends and insights on the state of STEM research in Africa, and presents novel and important empirical analysis of the growing STI sector.

The presence of turbulence in multiple areas of our society--food, fuel, and finances-being but three critical areas presently being impacted means that long-held assumptions are no longer true, that the past is not prologue, and that the future is not clear. And enter into this unstable present the discipline of evaluation-a discipline formed and shaped in the past fifty years of stability, little turbulence, and strong assumptions that everything will go according to plan. If things do not go well, it is because of either a poor theory of change on how to bring about positive outcomes, or weak efforts at implementation. It is not because of the stormy present upsetting our quiet past. As it is, conventional evaluation behavior and beliefs are ill suited for these times. The transformational nature of the 'Arab Spring' is just one arena in which it is clear that a business as usual approach to evaluation is entirely inappropriate.The papers in this volume are from the 2011 Global Assembly of the International Development Evaluation Association (IDEAS). Nearly 350 development evaluators from eighty-five countries came together in Amman, Jordan to discuss and analyze the consequences of turbulence on evaluation. The intent of these papers is to systematically assess what changes have come during this time of turbulence and how these changes are impacting the craft of development evaluation. To be clear: this book is not about how to assess the impacts of crises on development and on people's lives. It is about the meaning of a changed world and changed assumptions on the concepts and methods used in evaluation.

Bangladesh seeks to attain middle-income status by 2021, the 50th anniversary of its independence. To accelerate growth enough to do so, Bangladesh needs to build a competitive urban space that is innovative, connected and liveable. Bangladesh's urban areas have to take proactive measures to improve and sustain all three drivers of competitiveness - innovation, connectivity and liveability.

Tunisia in a Changing Climate: Assessment and Actions for Increased Resilience and Development ispart of the World Bank Studies series. These papers are published to communicate the resultsof the Banks ongoing research and to stimulate public discussion.This book provides an assessment of climate risks, as well as opportunities and possibleactions for addressing climate change, in Tunisia. It recognizes that the Tunisian revolution ofJanuary 14th, 2011, created significant change in the country, resulting in new challenges andopportunities for addressing further change. Following the revolution, improvements in access toinformation, institutional capacity, and accountability have enhanced the governance and transparencythat are essential for effective climate change responses. However, political uncertaintyhas affected both foreign direct investment and tourism, which have further impacted already highrates of poverty and unemployment.

Provides insights on how schools are managed in Uganda in terms of policy and practice.

This publication will assist countries in understanding the specific challenges and opportunities posed by climate change in the agricultural sector in order to increase climate resilience and adapt to climate change. The report presents local-level priorities, informed by stakeholder input, to build agricultural resilience.

Emphasises that developing countries need to transition to a low-carbon transport sector now to avoid locking themselves into an unsustainable and costly future. Furthermore, it argues that this transition can be affordable if countries combine policies to reduce greenhouse gas emissions with broader sector reforms aimed at reducing local air pollution, road safety risks, and congestion.

This study was undertaken as the third of a series of three economic analyses examining the global epidemics of HIV/AIDS in vulnerable populations. Informed by a critical review of epidemiological evidence and the most recent analyses of intervention efficacy, this work modelled the costs and impact of addressing the needs of people who inject drugs at scale in various epidemic contexts.

Presents an integrated epidemiologic, social, and economic analysis of the global epidemics of HIV among sex workers in low- and middle-income countries. The book provides a comprehensive review and synthesis of the available public health and social science data to characterise the nature, scope, and complexities of these epidemics.

Given the chronic power shortages faced by numerous developing countries, and the need everywhere to keep pace with demand, understanding the drivers of public private partnerships (PPPs) in energy is critical. While many private electricity projects have been delayed and financing costs have increased, the impact of the global financial crisis was less severe than that of previous crises that originated in developing countries. This resilience stems from developing countries need to expand generation capacity, electricity sector reforms and better regulatory frameworks, and short-term solutions (such as rental power plants). The study reports the evidence from statistical analysis and a sample of case studies selected based. It proposes a novel analytical approach to model PPPs, using a two-stage procedure based on Heckmans sample selection distinguishing between those factors that determine whether private investment in energy takes place, and those that influence the volume of investment. The results of the analysis provide the following conclusions: Both general governance and regulatory instrument primarily affect investors decisions to enter the various power sector markets, not the subsequent level of investment indicating that investors seem to be adequately protected against risks. Support mechanisms, like feed-in tariffs, are crucial for attracting investors in renewable generation, but they do not succeed in displacing fossil fuel investment and they could play a bigger role in affecting the level of investment in renewables. There is a significant trade-off between effectiveness and efficiency of alternative instruments for deploying renewables. Feed-in tariffs tended to be quite effective but to be set on the high side, reducing incentives to cut costs and posing significant strains on already stripped national budgets. Competitive auctions, on the other hand have tended to be efficient but initially low and not always the most effective instrument. Countries can scale up renewables following different paths. For Brazil, the move from feed-in tariffs to auctions enabled it to both reduce costs and deploy additional capacity. Peru followed in Brazils path, opting for auctions instead of introducing feed-in tariffs. On the other hand, Chinas move from competitive tenders to feed-in tariffs allowed for discovery effects to determine the right level of prices to attract private investment in renewables.