Reaching people at the periphery. Can the World Bank's population, health and nutrition operations do better?
Heaver, R.
Working Papers Policy, Planning and Research, World Bank 81: 50
1988
Document Number: 207872
Many of the World Bank's population, health, and nutrition (PHN) programmes are designed to elicit behaviourial changes in poor people living at the geographical and social peripheries. Few programmes specifically target the disadvantaged, however, and research about clients focuses mainly on routine statistics rather than on whether education and services do or will meet clients' needs. The health sector, in particular, has little understanding of what clients feel and why they behave as they do. Yet this is precisely what PHN programme designers must know to increase acceptance of public health services among clients most inclined toward early mortality and least likely to accept family planning. PHN programme design should be reoriented to: learn about clients' perceptions and behaviour; target the clients most in need of services; give public sector providers of service stronger financial and non-financial incentives to understand and reach out to clients; make more use of private or community-based systems that are responsive to client needs; and carry out more studies that evaluate programme responsiveness to clients.