Evaluating health projects : lessons from the literature
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This report reviews the literature on the causes of observed changes in health and fertility levels, the evaluation of policies, and programs designed to accelerate these changes; and presents the findings of earlier assessments of the World Bank's work in the Health, Nutrition, and Population (HNP) subsectors. A framework outlining the relationships between Bank activities in the sector, the characteristics of the health care system, household behavior, and changes in health outcomes is presented; and four evaluative criteria for assessing the performance of health care systems are identified. Broadly, the approach anticipates that Bank activities are more successful, as measured by their influence on system performance, when they achieve an appropriate fit between the institutional incentives, which determine the supply of health goods and services, the nature of those goods and services, and consumer demand. This report ends by describing a strategy for assessing the development effectiveness of the Bank's work in the HNP sectors. [Publisher's abstract]