The humanitarian group, Save the Children, has issued a new report sharply critical of World Bank nutrition programs. It says the Bank’s large-scale programs in Uganda, Ethiopia and Bangladesh have failed.
In its report, called “Thin on the Ground,” Save the children says, “it has been unable to find any evidence that these multi-million dollar projects are improving children's nutrition.”
Anna Taylor is a nutrition advisor for the group and author of the report. After examining the World Bank programs, she says, “there’s very little analysis in the early stages to actually understand the real causes of malnutrition.”
Ms. Taylor says, for example, in Ethiopia “a significant proportion of the project budget is spent on advising mothers on how to improve the growth of their children.”
She says, "Now our understanding of the causes of malnutrition in Ethiopia shows that advice isn’t going to be good enough. It’s no good advising a mother to wash her hands before preparing food when, for example, she might not be able to afford soap. She may only be able to afford soap two or three times a year. You know, another example in Ethiopia is that the health facilities are often a very, very long way away and people can’t afford to visit them. On average, Ethiopians visit health facilities once every four years. And yet they’re sick about eight times a year on average. So you can see that the issue of just giving mothers advice and not linking that to other forms of support could be very problematic in that sort of situation."
World Bank nutrition adviser, Milla McLachlan, is quoted in the South African Mail & Guardian newspaper as rejecting the criticism. While she says it is valuable to have constructive dialogue on the Bank’s work, “it is quite clear that the project has had very positive outcomes regarding behavior.” The World Bank official is also quoted as saying the lending agency does not operate nutrition programs in isolation – but also funds projects to improve sanitation, water, health and hygiene.
Anna Taylor of Save the Children responds.
"I mean, of course that’s true, the World Bank invests in all kinds of areas. But what we’ve observed in the specifics of these three projects is that the nutrition components are effectively done in isolation. So, it’s quite possible a mother will be counseled by a community worker, told that her child is severely malnourished, for example. And yet there’s no mechanism for referring that child for treatment in a health center. So, the actual reality for a mother experiencing this project is that there aren’t connected links between these kinds of investments. So, the experience of the mother is otherwise."
Save the Children says the World Bank is too quick to approve new loans to developing countries – putting them deeper in debt.
She says, "We’re really recommending something quite simple and that’s that the World Bank takes into account evaluation findings before proceeding with big loans which indebt poor countries. We’re asking them to do that in all three countries. In Ethiopia, where the project’s at an early stage, we’re asking them to start as a pilot (project) and not proceed with a large project until we can really evaluate the pilot stage. And so, it’s quite a simple request. But what we seem to be observing is that the World Bank doesn’t really have adequate systems in place to ensure that decisions about multi-million dollar loans are based on evidence."
At a World Bank meeting in June, Bank president James Wolfensohn expressed the need for development programs to be comprehensive. He said, “These plans should encompass education, health, infrastructure and environment – and the protection of culture and values.”