empleo

Challenge As in most resource-limited settings, the health of the population depends on equity and efficiency and on overcoming access gaps in the provision of healthcare services. In 2010, Nicaragua was one of the poorest countries in Latin America and the Caribbean. Between 2005 and 2010, the country experienced a slight reduction in maternal and infant mortality, with better control of transmissible diseases and improved immunization coverage. However, the health system continued to respond poorly to other health challenges, including the spread of H1N1 and dengue and the rise in non-communicable diseases, creating a double burden of disease. Through the introduction of health reform in the early 2000s, Nicaragua created a new Community and Family Health Model focused on universal access to basic health and nutrition services; health promotion and prevention; access to health services for vulnerable populations of indigenous residents, women, children, and the elderly; and community participation. Approach The Improving Community and Health Care Services Project (and its additional financing) was designed to support the Community and Family Health Model, and it aligned with Nicaragua’s 2009–11 National Human Development Plan (NHDP) and the World Bank’s 2008–12 and 2013–17 Country Partnership Strategies (CPS). The project’s interventions included introduction of the results-based financing mechanism in 66 municipalities; establishment of social contracts for well-being between administrative levels; results-based budgets at the hospital level; development and implementation of the National Strategy for Sexual and Reproductive Health; strengthened knowledge and skills bases for health workers; improved Ministry of Health (MOH) operational capacity at the central, regional, and local levels, including rehabilitation of health centers; maintenance and repair of medical equipment; and activation of a public health emergencies component. The project also effectively supported several policy goals articulated in the NHDP and CPS, including reducing maternal and child mortality and progressing toward the Sustainable Development Goals. It narrowed gaps in health service coverage and quality for vulnerable groups, and it implemented strategies for the better use of existing financial funds and health infrastructure. 

Challenge With a GDP per person of US$673, Haiti is the poorest country in Latin America and the Caribbean and one of the poorest countries in the world. In the last several years, a series of external shocks have hit, including the 2010 earthquake, exacerbating the country’s fragility and reversing the poverty gains achieved since 2001. Haiti’s education sector faced tremendous challenges post-earthquake, including significantly diminished capacities for responding to them. The losses of schools, teachers, and staff from the Ministry of National Education and Professional Training (Ministère de l’Education Nationale et de la Formation Professionnelle, MENFP) compound the problems of a sector that already faced a shortage of schooling infrastructure, trained teachers, and effective governance mechanisms. On the supply-side, there were simply not enough spaces for children to enroll in free public schools, as four out of five primary schools in Haiti are private.  Tuition, even in the lowest-cost private schools, was prohibitive for poor families, especially for those living in rural areas characterized by poverty rates of 82 percent (77 percent living in extreme poverty). Although access to education has improved dramatically over the past twenty years, due to high demand from families and a proliferation of low-cost private schools, challenges still exist regarding late entry and school progression due to the cost burden on families and the relatively low quality of education. While 90 percent of children aged between 6 and 12 are enrolled in school, they start primary school on average two years later than national goals suggest, and once at school, only 50 percent of students successfully reach sixth grade on time. Approach The objective of Education for All Project for Haiti: Phase II is to support (i) enrollment of students in select non-public primary schools in disadvantaged areas; (ii) student attendance in select public and non-public primary schools in disadvantaged areas; and (iii) strengthened management of the Haiti’s primary education sector.  Project financing aims at (i) improving access to primary education through the tuition waiver program and provision of basic educational services in underserved rural communities; (ii) supporting teaching and learning through a school health and nutrition program, as well as through pre-service and in-service training for primary school teachers; and (iii) improving sector management by building the institutional and monitoring and evaluation capacity of the MENFP

Challenge The subsystems comprising Mexico’s upper secondary educational structure worked independently and without clearly defined national policies. Also lacking were adequate quality assurance mechanisms to guarantee the relevance of the education provided and to avoid excessive, ineffective, or inappropriate transfers of students between subsystems. These gaps in efficacy help explain the persistently high dropout rate (only about 60 percent of students enrolled in USE graduated) and the low levels of achievement and learning among Mexican students. In 2008 only 15.6 percent of the students in 12th grade scored at levels considered good or excellent on the mathematics portion of the census-based standardized test (ENLACE). Upper secondary education represented a major bottleneck in the education system: few students were graduating, leading to a lack of skilled workers. Preparing Mexico’s workforce for the knowledge economy required a different kind of education system — one that emphasized new competencies and analytical ability and responded to the demands of the productive sector. Approach Between 2010 and 2016, with the Series of Programmatic Development Policy Loans on Upper Secondary Education, the World Bank provided general budgetary support to back up reforms creating the institutional basis for the National Upper Secondary Education System (Sistema Nacional de Bachillerato, SNB).  The development policy loan (DPL) series supported key policy actions to improve the quality, relevance, and equity of upper secondary education in Mexico, and Bank engagement in the reforms proved essential to guaranteeing policy continuity through the changes in ruling party and administration in December 2012. In addition, the technical collaboration between the Bank and the government helped foster reforms based on evidence and international best practices. For instance, an impact evaluation provided information useful in better targeting scholarships to the poor. In addition, just-in-time technical assistance helped overcome some obstacles faced during reform implementation; for example, workshop recommendations on international best teaching practices led to critical design improvements in the Programa de Formación Docentes, the teacher-training program introduced with the reform. 

Challenge The conclusions of the Argentine Second National Communication (2008) to the United Nations Framework Convention on Climate Change (UNFCCC) identified core climate vulnerabilities through 2040, including increased water stress; intens…

Challenge Between early 2003 and May 2004, approximately 15 percent of the Dominican population (1.4 million people) became poor, and about 6.5 percent (600,000 people) fell into extreme poverty, due to an economic and financial crisis in 2003 that undermined real incomes. With a recently established Social Cabinet mandated to monitor and oversee all social assistance and protection programs, the Dominican government committed itself in early 2007 to important reforms of its social assistance programs. Central to this effort was locating and providing documentation to poor people who were excluded from social services because they lacked proper identification papers. Strengthening the targeting of social programs, particularly the cash transfer program, was another goal. The government identified approximately 400,000 poor individuals eligible for social assistance programs (subsidized health insurance, cash transfers, and others), but who had been excluded for lack of legal identity papers. Approach The objective of the Social Protection Investment Project was to improve the coverage, targeting, and effectiveness of social protection programs in the Dominican Republic. These programs combined preventive, promotional, and active measures with the goal of improving the education and health investment (that is, the human capital development) of the poorest Dominicans. The project used a multisectoral approach to document excluded individuals by financing an active search for poor undocumented Dominicans and then guiding them through the process of obtaining their identification documents. The active search included the coordinated participation of the Social Cabinet’s institutions, the Central Electoral Council, and the municipalities to ensure the services were delivered to beneficiaries. This component used output-based financing. In addition, the project facilitated the introduction of improvements in the cash transfer program by confirming conditionalities in education and health that had not formerly been verified. The project supported improvements in the monitoring capacities of the education and health ministries involved, and it supported the design of a pilot for a community-based social audit mechanism (Community Report Cards) that was successfully expanded nationally by 2015. Finally, the project supported institutional development and strengthened the monitoring and evaluation capacities of the Social Cabinet, leading to improved targeting, updating the poverty status of the families registered in the Unified Beneficiary Identification System, and consolidating social programs.  

Challenge With a GDP per person of US$673, Haiti is the poorest country in Latin America and the Caribbean and one of the poorest countries in the world. In the last several years, a series of external shocks have hit, including the 2010 earthquake, exacerbating the country’s fragility and reversing the poverty gains achieved since 2001. Haiti’s education sector faced tremendous challenges post-earthquake, including significantly diminished capacities for responding to them. The losses of schools, teachers, and staff from the Ministry of National Education and Professional Training (Ministère de l’Education Nationale et de la Formation Professionnelle, MENFP) compound the problems of a sector that already faced a shortage of schooling infrastructure, trained teachers, and effective governance mechanisms. On the supply-side, there were simply not enough spaces for children to enroll in free public schools, as four out of five primary schools in Haiti are private.  Tuition, even in the lowest-cost private schools, was prohibitive for poor families, especially for those living in rural areas characterized by poverty rates of 82 percent (77 percent living in extreme poverty). Although access to education has improved dramatically over the past twenty years, due to high demand from families and a proliferation of low-cost private schools, challenges still exist regarding late entry and school progression due to the cost burden on families and the relatively low quality of education. While 90 percent of children aged between 6 and 12 are enrolled in school, they start primary school on average two years later than national goals suggest, and once at school, only 50 percent of students successfully reach sixth grade on time. Approach The objective of Education for All Project for Haiti: Phase II is to support (i) enrollment of students in select non-public primary schools in disadvantaged areas; (ii) student attendance in select public and non-public primary schools in disadvantaged areas; and (iii) strengthened management of the Haiti’s primary education sector.  Project financing aims at (i) improving access to primary education through the tuition waiver program and provision of basic educational services in underserved rural communities; (ii) supporting teaching and learning through a school health and nutrition program, as well as through pre-service and in-service training for primary school teachers; and (iii) improving sector management by building the institutional and monitoring and evaluation capacity of the MENFP

Challenge Pernambuco, a poor, largely arid northeastern state, was characterized by low education attainment. The resulting poorly qualified labor pool was considered a bottleneck to growth and reduced the impact of state-planned investments. P…

Challenge The grasslands of the Pampa biome in Brazil’s Rio Grande do Sul State support high levels of biodiversity, and the area is considered one of the most globally significant for endemic birds. It occupies 176,496 square kilometers, 63 percent of the state’s total area (and 2.07 percent of Brazil’s total area). These natural grasslands provide forage for approximately 18 million animals, mainly cattle and sheep, and livestock production is a primary economic activity in the biome. In recent decades, the area has gone through a process of intense land use change and degradation as natural vegetation has been replaced by rice paddies, soybean fields, and forests of alien species. The Pampa consequently became the second most devastated biome in Brazil. In 2009, only 35.6 percent of its natural vegetation remained, leading to losses of both biodiversity and socioeconomic opportunities. Consequently, the Rio Grande do Sul government recognized the complex issue of the interaction between agriculture and biodiversity conservation to be a central development and conservation challenge. Approach The goal established for the Rio Grande do Sul Biodiversity Project was to contribute to the protection of natural habitats and biological diversity through the following activities: •  Strengthening state policies and the operational capacity of the institutions charged with environmental management and rural development. •  Strengthening the system of state protected areas. •   Promoting sustainable practices by rural producers in the cattle ranching and forestry sectors that, when integrated into agricultural activities, lead to reversion of marginal agricultural areas to forest. • Increasing knowledge about biodiversity conservation and sustainable rural production systems in the Pampa biome to provide a sound scientific basis for developing a strong regulatory framework for the control of invasive alien species and the restoration and conservation of relevant sites and indigenous species. Though this was a pilot project, the strategy intended to support a small number of landholdings and demonstration units as a basis for strong outreach and dissemination activities to educate potential beneficiaries on sustainable practices.

Challenge Despite advances in criminal procedural reform and more transparent processes, lack of access to justice was a fundamental challenge in Peru. The costs of accessing justice services was high, including formal costs such as attorneys’ and court fees and informal ones such as bribes paid and opportunity costs for time invested in the process. Another challenge was the limited technical capabilities and professionalization of staff at the judiciary and in the Attorney General’s Office, as no permanent system existed to select, evaluate, train, or remove judges and prosecutors. Related challenges to professional development were weak accountability mechanisms and inefficiencies in judicial processes. Finally, the gradual implementation of the new criminal procedural code (NCPC) required coordination and close cooperation among the central stakeholders, including the judiciary, the Ministry of Justice (MINJUS), the Attorney General’s Office, the Judicial Academy, and the National Judicial Council. Approach The World Bank’s 2007–11 Country Partnership Strategy for Peru identified as an essential pillar the modernization of state institutions, with special focus on improving justice and reducing corruption. Additionally, improving access to justice (understood as both having the opportunity to present claims before a competent authority and receiving a timely process) ­­was one of the government’s main priorities. The Justice Services Improvement II Project sought to improve the quality of service delivery of the institutions forming part of the Justice Service Administration System and to enhance access to justice services. Overall, project activities targeted improved justice services delivery, strengthened managerial capabilities of justice-sector institutions, and enhanced transparency and access to justice.   

Desafío Los subsistemas que conforman la estructura de la educación media superior en México funcionaban de manera independiente y sin políticas nacionales claramente definidas. También faltaban mecanismos de control de calidad adecuados para garantizar la relevancia de la educación impartida y evitar transferencias excesivas, ineficaces o inapropiadas de estudiantes entre subsistemas. Esta falta de eficacia ayuda a explicar la elevada y persistente tasa de abandono (apenas se graduaba alrededor del 60 por ciento de los alumnos inscriptos en la EMS) y el bajo nivel de rendimiento y aprendizaje de estudiantes mexicanos. En 2008 apenas el 15,6 por ciento de los alumnos de 12.o grado obtuvo una nota considerada buena o excelente en la parte de matemáticas de la prueba estandarizada basada en el censo (ENLACE). La educación media superior se erigía así en uno de los principales cuellos de botella del sistema educativo: pocos estudiantes se estaban graduando, resultando en una falta de trabajadores capacitados. Preparar a la fuerza laboral mexicana para la economía del conocimiento demandaba un sistema educativo diferente —uno que hiciera hincapié en nuevas habilidades y capacidades analíticas y que respondiese a la demanda del sector productivo—. Enfoque Entre 2010 y 2016, con la serie de Préstamos Programáticos para Políticas de Desarrollo para la Educación Media Superior, el Banco Mundial brindó apoyo presupuestario general para el respaldo de reformas, creando la base institucional para el Sistema Nacional de Bachillerato (SNB). Esta serie de préstamos para políticas de desarrollo (DPL, por sus siglas en inglés) apoyó varias políticas clave tendientes a mejorar la calidad, pertinencia y equidad de la educación media superior en México, mientras que la participación del Banco en las reformas se tornó esencial a la hora de garantizar la continuidad de las políticas tras el cambio de administración y partido gobernante en diciembre de 2012. Además, la colaboración técnica entre el Banco y el gobierno ayudó a propiciar reformas basadas en evidencia y mejores prácticas internacionales. Por ejemplo, una evaluación de impacto proporcionó información útil para mejorar la focalización de las becas en los pobres. Asimismo, la asistencia técnica “justo a tiempo” ayudó a superar algunos de los obstáculos enfrentados durante la implementación de la reforma; por ejemplo, las recomendaciones de los talleres sobre mejores prácticas internacionales de enseñanza derivaron en mejoras cruciales en el diseño del Programa de Formación Docente introducido con la reforma. 

Hubo un tiempo en que los guaraníes de la aldea Tekoa Marangatu, en el sur de Brasil, cazaban y recolectaban frutas para alimentarse. Hoy en día, la dieta es completamente diferente. La comida es comprada por los indígenas o donada por la población urbana. Frutas, verduras y carnes fueron sustituidos por enlatados, galletas y otros productos procesados. Pero este cambio en la dieta ha cobrado su precio. No hay estadísticas formales, pero líderes indígenas y los asistentes rurales y sociales que trabajan en la zona relatan casos de colesterol alto, diabetes, sobrepeso, problemas dentales y enfermedades de la piel. "Luego de tener contacto con las culturas no indígenas, empezamos a apreciar otros tipos de comidas", admite el cacique Ricardo Benete. "Queremos tratar de volver a ser como antes, comer lo que plantamos", continúa el líder guaraní mientras enseña los nuevos huertos y un pequeño colmenar cuidado por los indígenas. El nuevo emprendimiento del grupo es una panadería donde la comunidad horneará panes y pasteles sanos usando frutas, verduras y raíces (como la yuca y la batata) disponibles en la aldea. Los alimentos servirán inicialmente para el consumo de las 45 familias locales, tanto en los hogares como en la merienda de la escuela indígena. En el futuro, también quieren vender estos productos para obtener ingresos. Hoy en día, la principal fuente proviene de las artesanías vendidas en los pueblos cercanos, pero los recursos son insuficientes para satisfacer las necesidades de la comunidad. Esta historia muestra el estado de nutrición y salud de los indígenas luego del contacto con los blancos y también el impacto positivo que una iniciativa puede tener si nace en el grupo. La panadería se construyó con el apoyo del programa Santa Catarina Rural, del gobierno estatal, financiado por el Banco Mundial. La iniciativa beneficia a 40.000 pequeños agricultores, incluyendo más de 1.200 familias indígenas. “Fue importante incluir a las comunidades rurales indígenas en este trabajo por dos razones: porque ellas producen alimentos y porque la atención a las comunidades indígenas ahora se ofrece de manera integrada por el gobierno”, dijo Diego Arias, director del programa en el Banco Mundial. La iniciativa tiene otros resultados positivos, como en la tierra Xapecó, en Santa Catarina, donde la etnia Kaingang predomina entre las 1.350 familias. Desde 2008, los indígenas se han especializado en la crianza de ganado lechero. Setenta y nueve familias están en la actividad y han superado los prejuicios del mercado contra productos elaborados por los indígenas, de acuerdo con el informe del taller Pueblos Indígenas y Proyectos Productivos Rurales de América Latina.

Challenge As in most resource-limited settings, the health of the population depends on equity and efficiency and on overcoming access gaps in the provision of healthcare services. In 2010, Nicaragua was one of the poorest countries in Latin America and the Caribbean. Between 2005 and 2010, the country experienced a slight reduction in maternal and infant mortality, with better control of transmissible diseases and improved immunization coverage. However, the health system continued to respond poorly to other health challenges, including the spread of H1N1 and dengue and the rise in non-communicable diseases, creating a double burden of disease. Through the introduction of health reform in the early 2000s, Nicaragua created a new Community and Family Health Model focused on universal access to basic health and nutrition services; health promotion and prevention; access to health services for vulnerable populations of indigenous residents, women, children, and the elderly; and community participation. Approach The Improving Community and Health Care Services Project (and its additional financing) was designed to support the Community and Family Health Model, and it aligned with Nicaragua’s 2009–11 National Human Development Plan (NHDP) and the World Bank’s 2008–12 and 2013–17 Country Partnership Strategies (CPS). The project’s interventions included introduction of the results-based financing mechanism in 66 municipalities; establishment of social contracts for well-being between administrative levels; results-based budgets at the hospital level; development and implementation of the National Strategy for Sexual and Reproductive Health; strengthened knowledge and skills bases for health workers; improved Ministry of Health (MOH) operational capacity at the central, regional, and local levels, including rehabilitation of health centers; maintenance and repair of medical equipment; and activation of a public health emergencies component. The project also effectively supported several policy goals articulated in the NHDP and CPS, including reducing maternal and child mortality and progressing toward the Sustainable Development Goals. It narrowed gaps in health service coverage and quality for vulnerable groups, and it implemented strategies for the better use of existing financial funds and health infrastructure.