Contents -- Foreword -- Preface -- Acknowledgments -- Abbreviations -- Executive Summary -- 1 Introduction and Overview -- The Importance of HNP in Socioeconomic Development -- Significant HNP Gains but Large, Persisting Challenges -- The Bank Role in HNP Improvements in the Past Decade -- Opportunities and Challenges: The New International Environment and DAH -- A Well-Organized and Sustainable Health System: Essential to Achieve HNP Results on the Ground -- A Shift in the Driver of the Bank-Country Relationship toward High-Quality Policy Advice and Strategic Focus of Bank Lending on Structural HNP Issues -- How to Best Serve Client Countries in This New Scenario? -- Strategic Objectives: What HNP Results? -- Strategic Directions: How to Support Country Efforts to Achieve Results? -- Implementing the Bank HNP Strategy -- A Window of Opportunity for Redoubled Support for Countries' HNP Results -- 2 Opportunities and Challenges in the New International Environment in Health -- A New International Environment -- The New Architecture for Development Assistance for Health -- 3 Bank Contribution and Challenges in Implementing the 1997 HNP Strategy -- Bank Contribution to the New DAH Architecture -- Taking Stock of the 1997 HNP Strategy -- Lending Trends since 1997 -- Need to Rapidly Improve Quality Performance of HNP Portfolio -- Need for Sharper Focus of Analytic and Advisory Activities -- Imbalance in HNP Staff Trends -- 4 How Can the Bank Better Serve Client Countries in the New Environment? Bank Comparative Advantages for HNP Results -- Bank Comparative Advantages -- Knowledge and Policy Advice on Public Policy to Improve Public-Private Synergies for HNP Results -- Providing Advice and Financing to Strengthen Health Systems for HNP Results -- Intersectoral Approach for Better HNP Results -- 5 New Bank Strategic Objectives: What HNP Results?.

Strategic Objective 1: Improve the Level and Distribution of Key HNP Outcomes, Outputs, and System Performance at Country and Global Levels to Improve Living Conditions, Particularly for the Poor and the Vulnerable -- Strategic Objective 2: Prevent Poverty Due to Illness (by Improving Financial Protection) -- Strategic Objective 3: Improve Financial Sustainability in the HNP Sector and Its Contribution to Sound Macroeconomic and Fiscal Policy and Country Competitiveness -- Strategic Objective 4: Improve Governance, Accountability, and Transparency in the Health Sector -- 6 New Bank Strategic Directions: How Should the Bank Support Client-Country Efforts? -- Strategic Direction 1: Renew Bank Focus on HNP Results -- Strategic Direction 2: Increase the Bank Contribution to Client-Country Efforts to Strengthen Health Systems for HNP Results -- Strategic Direction 3: Ensure Synergy between Health System Strengthening and Priority-Disease Interventions, Particularly in LICs -- Strategic Direction 4: Strengthen Bank Capacity to Advise Client Countries on an Intersectoral Approach to HNP Results -- Strategic Direction 5: Increase Selectivity, Improve Strategic Engagement, and Reach Agreement with Global Partners on Collaborative Division of Labor for the Benefit of Client Countries -- 7 Implications for Priority Health, Nutrition, and Population Programs and Interventions -- A Strong Commitment to Population, Sexual and Reproductive Health, and Maternal and Child Policy -- Opportunities for Sustaining, and Challenges to Improving, HNP Contributions to Combating HIV/AIDS -- Repositioning Nutrition to a Central Place in Development -- 8 Implementing New Bank HNP Strategic Directions -- Action Plan for Implementing Strategic Directions -- HNP Hub Mission and Organizational Changes -- Rebalancing Staff Skill-Mix.

Preliminary Estimates of Strategy Implementation Costs -- Annexes -- A HNP Hub Action Plan and Regional Action Plans -- HNP Hub Action Plan -- Regional Action Plans -- Africa Region -- East Asia and Pacific Region -- Eastern Europe and Central Asia Region -- Latin America and the Caribbean Region -- Middle East and North Africa Region -- South Asia Region -- B Acknowledgments -- C The New Global Health Architecture -- Emergence of a New Global Health Architecture: Trends Since the Mid-1990s -- Taking Stock of HNP Financing in the World -- Challenges in the New Global Health Architecture -- From Consensus on the Problems to Coordinated Action at Country Level -- D The World Bank HNP Results Framework -- E Multisectoral Constraints Assessment for Health Outcomes -- Rationale I (for Countries and Country Directors) -- Rationale II (for the HNP Family) -- Objectives of the Multisectoral Constraints Assessment -- F What Is a Health System? -- A Complex System in Constant Flux -- Health System Functions -- "Systems" Thinking -- G World Bank Partners in Health, Nutrition, and Population -- Global Health Partnerships and Initiatives -- Process/Programs without Financial Participation -- Global Institutional Partners -- Bilaterals/Partners -- Foundations -- H HNP Contributions to Combating HIV/AIDS: Background Paper to the World Bank HNP Strategy -- The Relationship between Health System Strengthening and Priority-Disease Approaches -- Overcoming Health Systems Constraints -- Vision for HNP Contributions to Combating AIDS -- The Bank's Contribution to HIV/AIDS through Health Systems -- Notes -- Bibliography -- Index -- Boxes -- ES.1 Healthy Development-The World Bank Strategy for Health, Nutrition, & Population Results -- ES.2 Key Next Steps for Implementation -- 1.1 Could Elizabeth Have Been Saved? Why Health Systems Matter.

5.1 What Are Governance and Corruption in the Health Sector -- 6.1 Promising New Mechanism Linked to Results: Loan Buy-Downs for Polio Eradication Results in Pakistan -- 6.2 Argentina Plan Nacer-Health System Strengthening Built into Results-Based Lending for MCH -- 7.1 The World Bank Commitment to Reproductive Rights and Reproductive Health -- A.1 HNP and the MIC Agenda -- Figures -- 1.1 Development Assistance for Health by Source, 2000 and 2005 -- 1.2 Total Global and World Bank Commitments for HIV/AIDS, 2000, 2002, and 2004 -- 2.1 Treatment of Diarrhea -- 2.2 Who Uses Public or Private Health Facilities for Acute Respiratory Infections? -- 3.1 All HNP Total Commitments, Disbursements, and New Lending, FY1997-FY2006 -- 3.2 Trends in IDA/IBRD Total New Lending for HNP, All Sector Boards Managed, FY1997-FY2006 -- 3.3 Project Outcomes, by Sector Board, FY2001-FY2006 -- 3.4 Trends in Portfolio Riskiness, HNP Sector Board versus Bank Overall, FY1997-FY2006 -- 3.5 Trends in HNP Mapped Staff, FY1997-FY2006 -- 3.6 Health Staff Composition, by Specialty, FY1997 -- 3.7 Health Staff Composition, by Specialty, FY2006 -- 3.8 New HNP Hires, Average Age -- 3.9 Staff Trends for HNP Hub, by Category, FY1999-FY2006 -- 4.1 Health System Functions and Other Determinants of Good System Performance -- 4.2 Multisectoral Determinants of Global Burden of Disease -- 5.1 Trends in Infant Mortality, by World Bank Region, 1980, 1990, 2004 -- 5.2 Most Frequent Shocks Causing Household Financial Stress, Peru -- 5.3 People Fall into Poverty due to Health Expenses -- 5.4 External Expenditures on Health, Selected Countries, 1999-2003 -- 5.5 External Expenditures on Health, Selected Countries, 1999-2003 -- 5.6 Creating Accountability in Health -- 7.1 Fertility Trends, by Geographic Region, 1950-2005 -- 7.2 Fertility Trends, Selected High-Fertility Countries, 1950-2005.

7.3 Population Activities Expenditures as Share of Total Population Assistance, 1995-2004 -- A.1 Results Framework: An Innovations Agenda -- C.1 Development Assistance for Health, by Source, 2000-2005 -- C.2 Net ODA as a Percent of GNI in DAC Donor Countries, 1990-2005, and Projected, 2006-2010 -- C.3 Volatility in Aid for Health, Selected Countries, 1999-2003 -- Tables -- 4.1 IBRD Net Staff By Sector Mapping, June 30, 2006 -- 5.1 Time Series Trends in Health Expenditures, Low-Income Countries, FY1999-FY2003 -- 5.2 Time Series Trends in External Expenditures for Health as Percent of Total Health Expenditures, FY1997-FY2003 -- 5.3 Time Series Trends in External Expenditures for Health as Percent of Fiscal Health Expenditures, FY1997-FY2003 -- 7.1 Some Characteristics of Countries According to Fertility Levels -- 7.2 Nutrition Provision Rated a Top Investment by Copenhagen Consensus -- 7.3 Progress toward Nonincome Poverty Target -- 8.1 Five-Year Action Plan-Renewing Focus on Results -- 8.2 Five-Year Action Plan-Strengthening Health Systems and Ensuring Synergy between Health System Strengthening and Priority-Disease Interventions -- 8.3 Five-Year Action Plan-Strengthening Bank Intersectoral Advisory Capacity -- 8.4 Five-Year Action Plan-Increasing Selectivity, Strategic Engagement, and Collaborative Division of Labor -- A.1 Health Indicators in the Africa Region -- A.2 Health Indicators in East Asia and Pacific Region -- A.3 Health Indicators in the Eastern Europe and Central Asia Region -- A.4 Health Indicators in the Latin America and the Caribbean Region -- A.5 Health Indicators in the Middle East and North Africa Region -- A.6 Health Indicators in the South Asia Region -- C.1 Composition of Health Expenditures in World Bank Regions and Income Categories, 2004.

H.1 Incentives Environment and Constraints for Health Systems in Low- and Middle-Income Countries.