Impact of Economic Crises on Health Outcomes & Health Financing

During past crises the Bank has supported operations that attempted to protect public "pro-poor" expenditures through conditions in SALs, DPLs and other programmatic operations. The experience is mixed: • Conditions • Some conditions aimed at protecting expenditures for the whole sector as a proportion of Government Expenditures. • Some conditions target budgetary commitments which may be quite different from actual government expenditures in health. • Some conditions protected expenditures without evaluating whether the expenditures were pro-poor to start with. • Good practices • In the good practices, the project supported the financing of the initiation or expansion of a sustainable safety net that tied essential health services to identified financing on a per capita basis with an appropriate system of monitoring and evaluation • The good projects avoided conditions in short term instruments (DPL) that involved long term institutional reforms (which require an investment or technical assistance instrument).download