Nepal | World Bank

World Bank Group Directs US$6.6 billion to Help South Asia Overcome Poverty, Boost Growth amid Global Crisis

Thu, 02 Jul 2009 21:12:14 GMT

Contact:

World Bank: Dale Lautenbach

(202) 473-3405

WASHINGTON, DC, July 2, 2009 – The World Bank Group committed US$6.6 billion in fiscal year 2009 (July 1, 2008 – June 30, 2009) to South Asia, focusing especially on reviving growth and protecting the poor amid the global economic crisis. This is an increase of US$1.1 billion over the previous year.

The Bank Group invested in 89 projects to promote economic growth, fight poverty, and assist private businesses, including nearly US$2 billion in infrastructure financing, a critical sector to provide the foundation for rapid recovery from the crisis and job creation.

Much of the Bank’s support focused on helping South Asian countries cope with the impact of the global economic crisis. For example, the Bank provided US$500 million to support the Government of Pakistan’s program to regain and maintain economic stability and steer the economy back onto a higher growth path. In India, a US$400 million loan was extended to improve access to finance for India’s Small and Medium Enterprises (SMEs) which face serious challenges in accessing adequate and timely financing on competitive terms.

“South Asian countries have been hard hit by a series of crises—food, then the fuel crisis, followed by the global financial crisis,” said Isabel M. Guerrero, World Bank Vice President for South Asia. “In response to the impact of these successive crises much of our work has been refocused to provide rapid financial assistance and policy advice to reverse the slowdown in growth and investment and to protect the poor and most vulnerable people.”

Globally, the World Bank Group committed US$58.8 billion in fiscal year 2009, up 54 percent from fiscal year 2008. Commitments from the International Bank for Reconstruction and Development (IBRD)—which provides financing, risk management products, and other financial services to countries—rose sharply in FY09 to $32.9 billion for 126 operations, from US$13.5 billion the previous year. Commitments from the International Development Association (IDA), which provides interest-free loans and grants to the world’s 79 poorest countries, totaled a record US$14 billion in FY09, up 25 percent from US$11.2 billion in FY08.

“Requests for assistance from the World Bank Group rose sharply this year, and we expect this to continue well into 2010, as the pace of recovery is far from certain,” said World Bank Group President Robert B. Zoellick. “Millions of people are still suffering, and we must continue to help countries safeguard priority expenditures, including on essential infrastructure, investment in human capital, and social safety nets, or we will further jeopardize hard-fought gains over recent years in overcoming poverty.”

Within South Asia, India was the largest borrower from IBRD and IDA, accounting for US$2,242 billion. Pakistan was the second largest borrower with US$1,609 million (IDA), followed by Bangladesh at US$1,096 million (IDA).

IBRD and IDA Lending in South Asia (Amounts in millions of US dollars)
	IBRD	IDA	IBRD/IDA
Afghanistan		197	197
Bangladesh		1,096	1,096
Bhutan		20	20
India	1,286	956	2,242
Maldives		3	3
Nepal		139	139
Pakistan		1,609	1,609
Sri Lanka		122	122
Total	1,286	4,142	5,428

Key to the Bank’s strategy in South Asia is scaling up existing programs that are delivering results. For example, in fiscal year 2009 the Bank approved US$250 million for the Pakistan Poverty Alleviation Fund (PPAF), a program the institution has supported since 2000. During this time, PPAF has facilitated the formation of 80,000 community organizations and provided 1.9 million micro-credit loans and 16,000 community infrastructure schemes. Similarly in Afghanistan, the Bank committed US$75 million to Afghanistan’s National Solidarity Program, a rural development initiative that has reached over 22,000 villages—about 68 percent of the rural population.

The International Finance Corporation (IFC), which makes equity investments, and provides loans, guarantees, and advisory services to private-sector business, committed close to US$1.2 billion in 47 projects in FY09 in South Asia. A third of the commitments this year were in infrastructure to support the acute financing needs of the sector in the region. A quarter of the program focused on the financial sector and the balance in manufacturing, agribusiness, health, and education sectors. In response to the scarcity of trade financing after the global economic slowdown, the region committed US$100 million in trade finance facilities to support local enterprises. As many as 15 projects in the region have a climate change component.

Paolo M. Martelli, Regional Director for IFC South Asia, said, “IFC's priority has always been to stand by our clients in the private sector. In difficult times, our role becomes even more critical. This year, IFC focused on the region's needs in infrastructure, on renewable, and clean production projects with significant development impacts."

IFC’s strategy in the South Asia region supports inclusive growth by increasing access to infrastructure and finance, focusing on low-income, rural, and fragile regions and making climate change central to its work, targeting areas where IFC can make the biggest difference. Through its advisory work, IFC addresses critical areas such as business environment reform, sustainable supply chains, access to finance, infrastructure, energy efficiency, and clean production.

The Multilateral Investment Guarantee Agency (MIGA), the Bank Group’s political risk insurance agency, is also supporting development in South Asia. In Pakistan, MIGA guarantees totaling US$1.74 million supported the establishment of Kashf Microfinance Bank (KMB) to make financial services available to the majority of unbanked population. Over the next five years, KMB will reach 1 million small depositors and 350,000 entrepreneurs through a network of over 100 branches across Pakistan. The network will be supplemented by 300 service posts closer to low income communities.

“As the leading international institution promoting foreign direct investment in emerging and transition economies, MIGA can help investors mitigate risks in these uncertain times and play an important role in helping countries attract FDI,” said Izumi Kobayashi, MIGA’s Executive Vice President. “MIGA can act as a stabilizing influence in the market.”

For more information about the World Bank’s work in South Asia, visit http://www.worldbank.org/sar

For more information about IFC’s work in South Asia, visit http://www.ifc.org/southasia/

For more information about MIGA, visit www.miga.org

World Bank Provides More Support to Power Development in Nepal

Thu, 18 Jun 2009 19:59:43 GMT

Contacts:

In Kathmandu:

Rajib Upadhya

(9771) 4226792/3

rupadhya@worldbank.org

In Washington:

Erik Nora

(202) 4584735

enora@worldbank.org

Washington, D.C., June 18, 2009 – The World Bank today approved US$ 89.2 million to support the Government of Nepal implement its Energy Crisis Management Action Plan.

Nepal is experiencing an energy crisis of unprecedented severity, caused by years of under-investment and sharp growth in electricity demand. This long-term problem was exacerbated in the last year by drought in part of the country and the loss, through flooding, of a transmission line that was used to import electricity from India.

As a result, by January 2009, grid-based consumers were being supplied with electricity for only 8 hours per day. This has had a highly negative impact on all aspects of the economy and has imposed a heavy burden on Nepalis. While recent rains have brought some relief to the power supply crisis, the shortage of storage capacity in the system means that the power supply deficit will continue to be severe for winters to come.

The Government of Nepal has declared a “national energy crisis” and its immediate priorities are to identify and implement quick investments to prevent a repeat in coming winters of crises of similar magnitude, while implementing medium-to-long term development plans on a parallel basis. The Government also intends to ensure the continued expansion of its successful micro-hydro rural electrification program.

“Increasing access to electricity is one of the major human and economic development challenges facing Nepal,” says Susan Goldmark, World Bank Country Director for Nepal. “While it is clear that chronic power shortages will continue to be a defining feature of life in Nepal for several years to come, the Bank is stepping up its assistance to help Nepal minimize economic impacts and hardships in the short term as well as to implement medium to long term development plans. 36,000 rural households will benefit from the expansion of Nepal’s micro-hydro program.”

The additional financing for the Nepal Power Development Project, which was approved on May 22, 2003, will include investments in rehabilitation of the Kali Gandaki ‘A’ Hydro Electric Plant (HEP), the largest plant in Nepal’s power system, as well as of two existing thermal plants in Duhabi and Hetauda. It will also finance construction of the Bharatpur-Bardaghat transmission line, strengthen the old and severely overloaded distribution network in Kathmandu Valley, and expand the Government’s off-grid micro-hydro rural electrification program.

These investments are intended to strengthen Nepal’s power system by increasing energy production through reduction of down-time at the Kali Gandaki ‘A’ HEP, making available an estimated 22 MW of capacity at the existing thermal plants. It will also improve the reliability of the Kathmandu Valley distribution network by adding 500 MW transmission capacity to relay power from existing and expected future projects. An additional 4.25 MW is expected to be installed through the micro-hydro program.

Nepal’s total grid-connected generation capacity amounts to a meager 683 MW, and the actual available capacity at any point in time is generally considerably lower. “Load-shedding”, or rotating outages, has long been a facet of the hydro-dependent power system in Nepal, where protracted conflict, and weak institutions and finances have hampered the addition of power generation capacity. Electricity supply is worse in the dry season (October to May) when river flows are lower.

“In the absence of a concerted scale-up of grid-supplied power, Nepal will continue to be burdened by a heavy reliance on costly, and often polluting, alternative means for meeting the demand for electricity", said Michael Haney, Senior Energy Specialist at the World Bank. “While some cite the high costs of hydropower development as an argument against developing Nepal’s great potential in this area, the cost to the economy of doing without electricity or relying on the alternatives is enormous.”

The additional financing is a blend of credit (US$73.7 million) and grant (US$15.5 million) from the International Development Association, the World Bank’s concessionary lending arm. The credit has 40 years to maturity with a 10-year grace period.

For more information on the Bank’s work in Nepal, please visit http://www.worldbank.org.np

For project information, please visit http://www.worldbank.org.np/external/projects/main?pagePK=64283627&piPK=73230&theSitePK=223555&menuPK=286969&Projectid=P116190

Nepal: Power Development Project

Thu, 18 Jun 2009 19:44:29 GMT

WASHINGTON, June 18, 2009 - The World Bank’s Board of Executive Directors today approved the following project:

Nepal: Power Development Project

IDA Grant: US$15.5 million equivalent

IDA Credit: US$73.7 million equivalent
Terms: Maturity = 40 years; Grace period = 10 years

Project ID: P043311

Project Description: The objective of the Power Development Project in Nepal will help build capacity to manage the development of Nepal's hydro power potential in a prudent and sustainable manner, increase access to electricity services in rural areas, and improve the supply of electricity.

Media Contact:

Erik Nora

(202) 458-4735

enora@worldbank.org

For more project information, please visit:

http://www-wds.worldbank.org/external/default/main?pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&theSitePK=523679&entityID=000160016_20030505152933&searchMenuPK=64187283&theSitePK=523679

Nepal: Agriculture Commercialization

Thu, 04 Jun 2009 21:22:12 GMT

WASHINGTON, June 4, 2009 - The World Bank’s Board of Executive Directors today approved the following project:

IDA Credit: SDR 7.2 million (US$10.7 million equivalent)

Terms: Maturity = 40 years; Grace period = 10 years

IDA Grant: SDR 6.3 million (US$9.3 million equivalent)

Project Description: The project will improve the competitiveness of smallholder farmers and the agribusiness sector in selected commodity value chains in 25 districts. This will be achieved by: (i) helping farmer groups and cooperatives engage in profitable market-oriented production and improving access to markets through the provision of technology and information services and critical public infrastructure and linkages to agribusiness; (ii) creating and strengthening industry-wide partnerships along the value chain, thus forging linkages between producers, traders, processors, and other stakeholders; and (iii) reducing existing obstacles to agriculture and food trade, thereby increasing the ability of farmers and agribusiness to respond to sanitary and phytosanitary and food-quality standards to meet domestic and international market requirements.

Media Contact:

Jan Erik Nora

(202) 458 4735

enora@worldbank.org

For more project information, please visit:
http://web.worldbank.org/external/projects/main?pagePK=64283627&piPK=73230&theSitePK=40941&menuPK=228424&Projectid=P087140

Flexibility, Conflict Sensitivity and Demonstrated Strengths Underpin New World Bank Strategy for Nepal

Thu, 04 Jun 2009 20:34:48 GMT

Contacts:

In Kathmandu: Rajib Upadhya (9771) 4226792/3

rupadhya@worldbank.org

In Washington: Erik Nora (202) 4584735

enora@worldbank.org

Washington D.C., June 4, 2009 – Nepal’s determination to build a robust peace through development and poverty reduction found strong support here today when the World Bank’s Board of Directors discussed the new country interim assistance strategy for the next two years.

Welcoming the many significant milestones achieved since the signing of the Comprehensive Peace Agreement in November 2006, the Bank’s strategy document supports the promotion of consensus and unity to address key elements of the peace process, including the foundations for state building, growth, and improved basic service delivery for Nepal’s poor.

Nepal is undertaking several difficult transitions at the same time. Despite the very real challenges, these transitions present an opportunity to move to the goal of a “new Nepal” which is stable and peaceful, inclusive of all its citizens, prosperous and accountable to its people, observes the Interim Strategy Note (ISN).

Given the transitional nature of Nepal’s current situation, with a new constitution being drafted and elections expected in 2011, the Bank Group has prepared an Interim Strategy Note covering fiscal years 2010 and 2011.

“Nepalis have shown remarkable resilience throughout their history. Thus, this is a period not only of risk but also enormous opportunity,” says Susan Goldmark, World Bank Country Director for Nepal. “While many of the transitions will not be completed in a two-year period, during this time the country can continue to establish a sound basis for peace and economic development.”

The strategy reflects considerable continuity, emphasizing the areas of strength but suggesting more flexibility to respond to opportunities. It builds on the areas which have shown to be robust and to modalities of implementation tailored to local conditions and what has worked in the past. By adopting a “peace filter”, the strategy also intends to improve sensitivity in Bank financed projects to the root causes of the conflict and social tensions.

Supporting the overarching goal of promoting peace and development, the strategy is organized around three themes that emerged during consultations within the Bank Group and with the Government, donor partners and civil society. These are also consistent with priorities of the Government of Nepal.

The first theme addresses the cluster of challenges facing the state in adapting and constructing the systems, institutions, and capacities needed for the new Nepal. The second focuses on overcoming constraints faced by the productive sector, especially in terms of productivity, connectivity and sustainability. The third theme concentrates on expanding and honing programs and activities that can increase opportunities and well-being, especially for the poor and excluded. Social inclusion runs across all of these themes as one of the foundations for the new Nepal. Within each of these themes, the strategy identifies specific areas where the Bank Group can make a difference.

Over the next two years Nepal can potentially benefit from an allocation of about US$ 782 million from the International Development Association (IDA), the Bank Group’s concessionary lending arm. These funds could finance about four to five new operations per year. The International Finance Corporation (IFC), the Bank’s Group’s private sector arm, can potentially commit US$15-20 million on average annually, depending on the availability of viable investments and improvements in the business climate.

The Board also approved a Project for Agriculture Commercialization and Trade. The project aims to improve the competitiveness of smallholder farmers and agribusiness in selected commodity value chains in 25 districts and is aligned with the third theme of the ISN.

The project is designed to help farmer groups and cooperatives engage in profitable market-oriented production and improve access to markets through technology and information services, critical public infrastructure and linkages to agribusiness. It intends to create and strengthen industry-wide partnerships along the value chain, forging linkages between producers, traders, processors, and other stakeholders. The project will also help reduce existing obstacles to agriculture and food trade, increasing the ability of farmers and agribusiness to respond to sanitary and phyto-sanitary and food-quality standards to meet domestic and international market requirements.

The US$20 million project will be financed with a credit of US$10.7 million and a grant of US$ 9.3 million.

Nepal - Power Development Project : additional financing

Mon, 18 May 2009 04:00:00 GMT

The project development objective of the Power Development Project for Nepal has been revised to better reflect the focus and scale of project activities following the restructuring of the project in 2008 and in light of the project scale-up, and is,"to increase access to electricity in rural areas; and improve the quantum and efficiency of electricity supply."The additional funding will help finance the costs associated with: (i) rehabilitation of existing assets and new investments required to support the response of the Government of Nepal to the energy crisis in the country; (ii) scaling up of the Government's successful off-grid rural electrification program; and (iii) additional technical assistance to benefit the Nepal Electricity Authority and the Alternative Energy Promotion Center, two implementing agencies. The closing date of the additional financing is December 31, 2012.

Nepal - Power Additional Financing Project

Thu, 14 May 2009 04:00:00 GMT

Nepal - Power Additional Financing Project

Wed, 06 May 2009 04:00:00 GMT

Nepal - Agricultural Commercialization and Trade Project

Tue, 05 May 2009 04:00:00 GMT

The development objective of the Agricultural Commercialization and Trade Project for Nepal is to improve the competitiveness of smallholder farmers and the agribusiness sector in selected commodity value chains in 25 districts supported by the project. There are three components to the project. The first component of the project is agriculture and rural business development, this component will finance demand-based sub-projects proposed by farmer groups, cooperatives, agribusinesses and other value chain participants to build strategic linkages with a view to increase competitiveness, productivity, quality, and market access. The second component of the project is support for sanitary and phyto-sanitary facilities and food quality management, this component will finance activities to strengthen the efficiency and effectiveness of sanitary and phyto-sanitary services in order to reduce existing obstacles to agricultural and food trade. It will also support the private sector's efforts to gain market advantage through improved food quality management. The third component of the project is project management, monitoring and evaluation, this component will finance overall project management, monitoring and evaluation and reporting.

Nepal - Agricultural Commercialization and Trade Project : resettlement and rehabilitation policy framework

Wed, 29 Apr 2009 04:00:00 GMT

The development objective of the Agricultural Commercialization and Trade Project is to assist the Government of Nepal in improving the competitiveness of smallholder farmers and the agribusiness sector in selected commodity value chains in 25 districts (in all development regions of the country except the eastern development region) supported by the project. Negative impacts include: loss of agricultural land; loss of agricultural crops, trees (perennial/annual crops); loss of house or other property; loss of community building/structure (irrigation, drinking water, schools, temples, etc); and business/commercial establishment (shops, water mills, and others). Mitigation measures include: 1) provision of land for those who become landless; 2) compensation as settled by agreement between users'organization and rehabilitation support to non titleholders; 3) resettlement assistance to those most vulnerable groups to restore pre-displacement level livelihoods; 4) re-establish or re-construct lost community resources, facilities like religious and cultural structures or provide alternatives in consultation with affected communities; 5) compensation for reestablishment/transition allowance in consultation with affected families; and 6) cash compensation/transition allowance to the affected people.

Nepal - Agricultural Commercialization and Trade Project : framework for indigenous people development plan

Wed, 29 Apr 2009 04:00:00 GMT

The objective of the Agricultural Commercialization and Trade Project is to assist the Government of Nepal in improving the competitiveness of smallholder farmers and the agribusiness sector in selected commodity value chains in 25 districts (in all development regions of the country except the eastern development region) supported by the project. Negative measures include: Nepalese agricultural sector is based on the production of basic staple grains. About 82 percent of cultivated land is planted with cereal crops, but basic staple grains contribute only about 30 percent of agricultural Gross Domestic product (GDP), while export crops contribute about 50 percent. Since the share of high-value crops in total cultivated area is still small, the desired process of agricultural diversification is hardly noticeable at the aggregate level. Therefore, the rural areas suffer from slow growth, rising poverty, food insecurity, and subsistence-level agriculture. Trade often occurs in local markets that are subject to gluts and price crashes. Storage and transport facilities are poorly developed; and quality and value enhancement through grading and processing is rare. Mitigation measures include: (i) providing pre-investment and advisory support to enable farmer organizations (FOs) and value chain participants to prepare subproject proposals and business plans for grant funding under the project; (ii) direct financing of approved subproject proposals in technology and information support and market infrastructure; and (iii) agribusiness development through partial financing of demand-driven investment proposals by agro enterprises, commodity associations and cooperatives that are actively engaged in the development of commodity value chains.

Nepal - Agricultural Commercialization and Trade Project

Tue, 28 Apr 2009 04:00:00 GMT

Nepal - Agricultural Commercialization and Trade Project

Mon, 06 Apr 2009 04:00:00 GMT

Nepal - Additional Financing of the Power Development Project : operational manual of environmental social impact assessment

Wed, 01 Apr 2009 04:00:00 GMT

The objective of the Additional Financing for Power Development Project for Nepal is to increase access to electricity in rural areas and improve the quantum and efficiency of electricity supply. Negative measures include: forests, road sector, mining sector, waste management, and industrial sector. Mitigation measures include: a) establishment of crude sugar or sugar industries with a production capacity of 3000 metric tons per day; b) establishment of industries producing lubricant by the process of blending reprocessing or reclamation; c) excavation of construction oriented minerals materials in small scale; d) improvement of the standard, rehabilitation and reconstruction of national highways, and feeder roads; and e) selecting, picking, disposing, and recycling waste through chemical, mechanical, or biological techniques in an area of not more than two hectares.

World Bank Maps Local and Global Economic Geography, Calls For Greater Integration

Mon, 16 Mar 2009 12:45:00 GMT

Contacts:
In Kathmandu: Rajib Upadhya (9771) 4226792/3
rupadhya@worldbank.org
In Washington: Erik Nora (202) 458 4735
enora@worldbank.org

KATHMANDU, March 16, 2009 – History shows that severe crises can cause nations to become inward-looking, sometimes with negative consequences. The World Development Report 2009: Reshaping Economic Geography, released today, argues that the most effective policies for promoting long-term growth are those that facilitate geographic concentration and economic integration, both within and across countries.

“The world’s most geographically disadvantaged people know all too well that growth does not come to every place at once,” said Indermit S. Gill, Director of the World Development Report (WDR) and Chief Economist, Europe and Central Asia. “Markets favor some places over others. To fight this concentration is tantamount to fighting prosperity. Governments should facilitate the geographic concentration of production. But they must also institute policies that make the provision of basic needs—of schools, security, streets, and sanitation—more universal.”

The new World Development Report challenges the assumption that economic activities must be spread geographically to benefit the world’s most poor and vulnerable. Trying to spread out economic activity can hinder growth and does little to fight poverty. For rapid, shared growth, governments must promote economic integration which, at its core, is about the mobility of people, products, and ideas.

“Throughout history, mobility has helped people escape the tyranny of poor geography or poor governance,” said Gill. “The report sees this as part of a vital process of economic integration, since mobile people and products form the cornerstone of inclusive, sustainable globalization.”

Integration should be the pivotal concept in the policy discussions involving the location of production, people and poverty—in particular, the debates on urbanization, regional development, and globalization. Instead, all three overemphasize place-based interventions.

“The ideas that the report bring to the table are highly relevant to the transitions that Nepal is currently undertaking,” said Susan Goldmark, the World Bank Country Director for Nepal. “Economic planners and policy makers in Nepal are discussing many of the same issues in the preparation of the Government’s National Development Strategy and the ideas presented in the report should be useful as the country embarks on the path of redefining institutions to support a peaceful, inclusive and prospering New Nepal.”

The WDR reframes the policy debates to include all the instruments of integration—common institutions, connective infrastructure, and targeted interventions. By common institutions, the report means regulations affecting land, labor and commerce, and social services such as education and health financed through taxes and transfers. Infrastructure refers to roads, railways, ports, airports, and communications systems. Interventions include slum clearance programs, special tax incentives to firms, and preferential trade access for poor countries.

Geography matters greatly in deciding what is needed, what is unnecessary, and what will fail, argues the report. By calibrating the blend of these policies, developing nations can reshape their economic geography, much as today’s high income economies did in the past. If they do this well, the report concludes, their growth will still be unbalanced, but their development will be inclusive.

Today’s event was co-hosted by the World Bank Nepal Office and the Management Association of Nepal. Vice Chairman of the National Planning Commission Dr. Guna Nidhi Sharma chaired the event. Finance Secretary Mr. Rameshore Prasad Khanal also shared Nepal’s experiences in planning and implementing development. Dr. Bimal Prasad Koirala, head of the Management Development Center of the Management Association of Nepal moderated the discussion.

For more information about the World Bank’s in Nepal, please visit
http://www.worldbank.org/np

To access this report on line, please visit
http://go.worldbank.org/K2CBHVB7H0

Nepal - Power Additional Financing Project

Thu, 12 Mar 2009 04:00:00 GMT

Urgent Action Needed to Address Reproductive Health Needs of Nepali Women

Fri, 06 Mar 2009 05:00:37 GMT

Contacts:
In Kathmandu: Rajib Upadhya (9771) 4226792/3
rupadhya@worldbank.org
In Washington: Erik Nora (202) 458 4735
enora@worldbank.org

Kathmandu March 5, 2009 – Nepal faces an uphill task in meeting its Millennium Development Goals (MDG) related to improving the reproductive health of its women, according to a new World Bank report launched today. Among its suggestions, the report calls for integration of reproductive health services, decentralized and action oriented planning, targeting poor geographic areas and finding innovative ways of financing reproductive health.

The report, Sparing Lives: Better Reproductive Health for Poor Women in South Asia, analyses the current state of reproductive health in five countries in the region – Bangladesh, India, Nepal, Pakistan and Sri Lanka – and highlights the major risks faced by poor women. The report calls for urgent action in reducing Nepal’s maternal mortality, scaling up skilled birth attendants, maternal and child nutrition, and increasing the use of contraceptives.

The report underlines the need for countries in the region to pay more attention to poor women’s reproductive health if MDGs related to maternal and child health is to be achieved. It points out that an average South Asian woman faces a hundred times greater risk of dying during childbirth (1 in 43) than a woman in an industrialized country (1 in 4,000).

Today, Nepal’s Maternal Mortality Ratio (MMR) is two times higher than its MDG goal of a two-thirds reduction. Nepal’s target is to reduce MMR to 134 by 2015 from the current official estimate of 281 (per hundred thousand live births). The lifetime risk of dying during pregnancy for a woman in Nepal is 1 in 42. It lags far behind Sri Lanka (1 in 430); Bangladesh (1 in 59); and India (1 in 48) and is only slightly better than in Pakistan (1 in 31). Sri Lanka has the highest child immunization coverage (94 percent) in the region, followed by Nepal (83 percent), Pakistan (77 percent), Bangladesh (65 percent) and India (44 percent).

“This report highlights the enormous challenges that the region faces in addressing the reproductive health needs of poor women,” said Ms. Susan Goldmark, the World Bank Country Director for Nepal. “At the same time, there are lessons in the report that countries can learn from each other. For Nepal, given the diversity and disparities between the rich and the poor, the challenges are even more significant. We stand ready to support Nepal in its commitment to overcoming the challenges of achieving better reproductive health outcomes for women,” she said.

The report acknowledges the positive strides Nepal has made in the area of fertility. Between 1995-96 and 2005-06, fertility declined from 4.6 to 3.1 births per woman. The greatest change occurred among the adolescent group of 15-19 year-olds, which is a positive trend. Most urban areas have achieved replacement level fertility.

The disparities in Nepal’s
reproductive health services

Nepal’s rural poor and Dalit, Janjati women receive far lower levels of maternal health service coverage than other women.
84 percent of the wealthiest Nepali women receive antenatal care. Only 18 percent of the poorest do.
• Only 5 percent of poor women receive the services of trained birth attendants. 58 percent of wealthiest women do. Trained attendance at delivery is the single most important intervention to increase the chances of neonatal and maternal survival.
Only the wealthiest women are most likely to deliver at a health facility. The poorest women nearly universally deliver at home. Compare this to Sri Lanka where antenatal care and institutional delivery are nearly universal.

The challenges ahead: The widening gap between the rich and the poor

The report advocates the need to reduce disparities between the rich and the poor in accessing health services. For example in Nepal the number of poor women having access to antenatal care is 25 % that of the rich.

“Women’s low education and poverty are consistently associated with low use of reproductive health services,” said Meera Chatterjee, Senior Social Development Specialist at the World Bank and lead author of the report. “If we want to break the cycle of poverty we cannot ignore reproductive health because poor reproductive health undermines the well-being and survival of individuals and represents significant losses to the community, resulting in transmission of poverty from one generation to the next,” she said.

Poor nutrition
Poor nutrition is another major challenge, according to the report. An estimated 50 million children in India suffer from under-nutrition today. In fact, two-fifths of all children under five in the region are malnourished. In Bangladesh, India and Nepal, 40-50 percent of all children are under-nourished.

The disparities between the rich and the poor are also very stark. Compared to the richest quintile of urban women in Nepal, the poorest urban quintile is 4.8 times more likely to be under-nourished, and the poorest rural quintile, 5.6 times more likely.

Contraceptive use
To reduce fertility, the report calls for Nepal to accelerate availability and use of temporary methods. “In 2005-06, 48 percent of Nepali couples were using modern methods of contraception. However, only one-fifth of them were using temporary methods. While the availability of spacing contraceptives has increased in the past decade, the continued emphasis on terminal methods (i.e., sterilization) means that many couples do not contraceptive and continue to have more children than they really want, says the report.

The report makes the following recommendations to help improve reproductive health in the region:

Single window for complete package of essential reproductive health services: Poor women often do not have the time, money, or the power to approach providers for health care, family planning, and childbirth. They, therefore, need to be provided a continuum of care through a ‘single window’.
Antenatal care and skilled birth attendance need to be stepped up: Institutional delivery or the presence of a skilled birth attendant can make a critical difference to the survival of mothers and their babies. It is only in Sri Lanka that almost all births take place in institutions; in India and Pakistan it is less than 40 percent and in Nepal it is only 21 percent.
Decentralized and action oriented planning is needed: The focus should be on action planning which involves poor women themselves, their institutions, local governments and health staff. This will increase relevance and accountability.
Disseminating ‘know-how’: Good practices that have worked within the developed world and in the region need to be shared and is an important central function that must be stepped up.
Efficient financing: The report calls for innovative financing to the reproductive health sub-sector to ensure the inputs for additional and better services. Increasing allocations to in-patient maternal and child health services over current low levels in most areas could substantially increase the use of needed health care by the poor.
Innovative financing: Vouchers, reimbursement, insurance and social marketing are some feasible approaches that will reduce heavy out-of-pocket expenditures by the poor on reproductive health care. For example, Bangladesh has a good voucher system which is being used to increase the availability of services and improve equity, the report adds.

For more information about the World Bank’s in Nepal, please visit
http://www.worldbank.org/np

Nepal - Power Additional Financing Project

Thu, 05 Mar 2009 05:00:00 GMT

HIV and AIDS Pose Serious Risk to Economic and Social Development in South Asia, Despite Low Infection Rates

Fri, 27 Feb 2009 15:00:00 GMT

Media Contact:
In Washington: Erik Nora (202) 458 4735
enora@worldbank.org

WASHINGTON, DC, February 27, 2009 ─ HIV and AIDS can pose a serious economic and social development risk to countries in South Asia unless prevention programs, targeting vulnerable groups at high risk of infection, are scaled up, says a World Bank report released today.

The report, titled “HIV and AIDS in South Asia: An Economic Development Risk,” argues that, even if the overall prevalence rate is low (up to 0.5 percent), there is high and rising HIV prevalence among vulnerable groups at high risk for HIV infection, including sex workers and their clients, and injecting drug users and their partners. Without increasing prevention interventions among those at highest risk, these concentrated epidemics can further escalate.

Overall, the number of people living with HIV and AIDS in South Asia is about 2.6 million, of whom the lion’s share is in India. AIDS accounts for 1.5 percent of all deaths in South Asia and about 2 percent of all deaths in India. These numbers of deaths are comparable to the numbers from diabetes, tuberculosis, and measles.

The report finds the impacts of HIV and AIDS in South Asia on the aggregate level of economic activity to be small. For India, the effect on GDP (0.16 percent) corresponds to a one-off loss of about 1.5 weeks of GDP growth. However, the direct welfare costs of increased mortality and lower life expectancy are more substantial, accounting for 3 percent to 4 percent of GDP in India and Nepal, respectively

“Even in the low HIV prevalence countries of South Asia, there cannot be any room for complacency,” said Mariam Claeson, World Bank HIV and AIDS Coordinator for South Asia. “While the impact of HIV and AIDS on economic growth is small in South Asia, the welfare cost on households is by no means negligible. HIV and AIDS also have an enormous disproportionate impact on vulnerable and often marginalized people at highest risk of infection, and on poor households with less access to information, preventive services and treatment.”

The economic impact on individual households affected by the disease is substantial, the report says. In a household study on India, 36 percent of people living with HIV and AIDS who were able to retain their employment nevertheless reported an income loss, which averaged about 9 percent. Among those who lost their employment (about 9 percent), the income loss was severe, at about 66 percent.

Many of the adverse development impacts of HIV and AIDS arise from its uneven impact on different population groups. Access to prevention and treatment, for example, is strongly linked to socioeconomic factors such as gender, education, and wealth. And, people’s ability to cope with the financial effects of HIV and AIDS differs strongly. For example, the report finds that HIV and AIDS have a disproportionate economic impact on HIV-positive widows who face the double burden of living with HIV and AIDS and the low socioeconomic status of women.

“This analysis shows that failure to contain the epidemic at low levels may have serious economic consequences,” said Sadiq Ahmed, World Bank's Acting Chief Economist for the South Asia Region.

Access to antiretroviral treatment (ART) is low in South Asian countries, even compared to countries in other regions with much higher infections rates. The report says the fiscal cost of treatment could be very high if South Asian countries fail to contain the epidemic.

Access to effective treatment is vitally important to mitigate the health and economic impacts of HIV and AIDS, the report says. At the same time, the medical costs of treatment can put a substantial proportion of the population living with HIV and AIDS at risk of poverty, especially in a region where most health services are paid for out of pocket. This underscores the crucial role of effective prevention.

With the exception of Sri Lanka, three-quarters or more of health expenditures in South Asia are financed privately and little are covered by third-party payers like insurance agencies. With the limited ability of many households to pay catastrophic health expenses associated with HIV and AIDS, and the negative externalities associated with poor adherence, the report argues for a large and critical role for the public sector in the provision of ART.

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To read the report, visit http://go.worldbank.org/YHRC95J2J0

For more about the World Bank’s work in HIV and AIDS in South Asia, visit
http://www.worldbank.org/saraids

World Bank Seeks Innovative Ideas to Improve Nutrition in South Asia

Thu, 12 Feb 2009 05:06:31 GMT

Contacts:
In Kathmandu: Rajib Upadhya (9771) 4226792/3
rupadhya@worldbank.org
In Washington: Erik Nora (202) 458 4735
enora@worldbank.org

KATHMANDU, February 12, 2009 ─ The World Bank today launched a competitive Development Marketplace for Nutrition aimed at finding and funding innovative ideas that will change the lives of thousands of pregnant women, infants, and young children in South Asia.

Titled “Family and Community Approaches to Improving Infant and Young Child Nutrition,” the Development Marketplace is looking for entrepreneurial organizations across South Asia to submit proposals for local, small-scale projects which have the potential to be scaled up and replicated. The winners will be selected by an international jury of development and nutrition experts at the Development Marketplace event in August, 2009 in Dhaka, Bangladesh and will receive funding to implement their proposals.

“Malnutrition affects the lives of millions of infants and young children in South Asia,” said Isabel Guerrero, World Bank Vice President for the South Asia region. “It saps a child's growth potential, delays enrollment in school, limits school achievements, and lowers lifetime earnings. This competition offers a unique opportunity to channel small grants directly to community organizations and NGOs who present innovative ways to address this devastating problem.”

Malnutrition is the single biggest contributor to child mortality in the world. In no place is this problem more serious than in South Asia, where child malnutrition rates are among the highest in the world. Both child underweight and stunting rates in the region are nearly double those in Africa. In Nepal, Malnutrition remains a big problem, evidenced by the fact that nearly half of all children below the age of 5 suffer from stunted growth. Nutrition “stuck” with one in two children under age 5 years is anemic, and 39% of them are underweight.

“Recent evidence clearly shows that there are proven effective interventions to improve nutrition,” said Andrea Vermehren, World Bank team leader for the Development Marketplace. “However, effectively implementing these interventions - and implementing them at scale is a major challenge. We believe this effort will help find new ways of providing innovative solutions to malnutrition.”

The South Asia Regional Development Marketplace is implemented in partnership with the Deutsche Gesellschaft fur Technische Zusammenarbeit (GTZ), Micronutrient Initiative, UNICEF, and the World Food Program. The competition is open to civil society groups, social entrepreneurs, youth organizations, private foundations, academia, and private sector corporations in Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka. The maximum award will be US$40,000 per proposal. Proposals will be accepted until March 31, 2009.

For eligibility criteria, details on the competition and to submit proposals online, please visit the South Asia Regional Development Marketplace website – www.worldbank.org/nutritiondm2009.

The Development Marketplace global competition has awarded nearly US$46 million to small-scale projects over the last eight years. Using this funding as a launching pad, projects often go on to scale up or replicate elsewhere, winning prestigious awards within the sphere of social entrepreneurship.

For more information about the World Bank’s work in South Asia, please visit http://www.worldbank.org/sar

For more information about the World Bank’s in Nepal, please visit http://www.worldbank.org/np