**Policy, Research, and External Atfairs**

**Population, Health, and Nutrition**

This paper --- a prodiuct of the Population, lcailth, an(l Nuirition GJIViSiOll, Po1ulatiOn and1(1 ILlmlal Resources Depaitment --- is part oki ; larger efiort in I iRF to promlote policy and re **soLIu rce** Coini0 t InCit to the Safc Motherhoo(i Initiafive Copies are availahle f'ree from the World( Bank, 1818 **II** StrCet NW, Washington DC 2(433. Plealse contact Sonia Ainswonhti, room S6-065, extension 31091 (50 pag°res w ith figures and tables).

_Financial trendsfor safr motherhood initiatit'es._ Problems of definition and accouunting metilods precludc an acchraite analysis of financial trcnds among donors. Global support lor speci1ic safe mothcrhcod activities is limited. For thc 17 major bilateral sources, funding, for selectedi activities which contribute to safc motherlhood is estimated to have increased (in curretit dollars) from $691.5 million in 1986 to $8 18.8 **iX** illioin in 1988. About half this amount was for so-callc(i corc* activities, including family planning **scrvices.** The magnitude of support for prveention of the complications **ol** pregnanc\ is less certain. Gcncral health, population, and nutrition sector flows increased subsantlialIv ovcr the same period. Th,ese tireinds % crc lxpsitivC lor 13 sources, unchanged flor tlhree, and negative for one.

Of tIC six maMjor- i ul tilatera;l **soCcsL.-,** totlIs tor sclccted safe inoinerhioodt actiities . cre estimated to be $477.7 miillion in 1(8S, a 41.7 percent increase over 1987 and a 1 _7_ percent increase over 1986, reilectingt dilltrenccs in the annual volunmc of- World 13Bank loan approval . Half of this went for corc services, prim an iv familny planning Estimated World Bank sale **mothicr** ood expenditures in 19S9 arc triple telC previous year's total. This is due priailyril tO substIa;Stiali incrcascs in gencral lozans Ior lzalthl, populat ion, and nutrition. New specific safe miotliherhioodi activitics are beginning to emerge in thic lomit **of** care tor tthe corn plications of pregnancy, **_hcbtcr_** seconldary and tertiary 'facilities, training, and promotional workshops.

> Thc maignitudc anid effectiveness of tdonor financing will requirc more attention to 1' 0 special problcIs:

* Strengthening recipient coltriesis a ilit k aItiCflcalatC projecltCt _dIeanHid_ providim : spL cili1 irainino. techlnical advisory assistince, aiid oI)crationaiil gUid(II ine 01fo' **nIOI** ili i ine 'iiinIL i II resourc.es.

* Improvintg ttih data on salc nmotliclilood 1inancial trends - establishing a consensus o n definitions: seeking a conscnSuIs on Ii nain i aill mecasuirable prograLin or project caiect orics ol sacI motherhood: (eifiilltitn methio(ds for1 t11h. s%SterC atic collection of donor and rccipit countill data oi i finan1.cial trend,,.

At thc I1987 Cuntfercrntc otn **5.,iu** NlihclLrli,d- inl .l.,l !ir, arl \ic1\.msr.m rt < ,riiarcii., .m 1 i~rc tnr.gr. ir r di. nih. r,\ )' i ! :l 11l.:i. x **reducing the numLbrol pregtritL.** I **Shrouh** ! .uu 1 p!rnuTg w LjdwIk, **a rrIsio r** nn t iond otmniunt L **haitd s** yr. **c.s** rc ,ur L ig thSc i . _I_ I o pf i'i and chtldhi nh; pyrou dirrg prcnAL.n.sl ..prc 1 rx .cJ h .: **cr1,.,.** rc cruuTg, m,ld **rctc1rral fXr tuh -ri.k nrrhcr'.** ;ui urn, ,,nuTgk 1iiliil ., :.,! **tranportnation fur conipiiciatcd** dcl '. criuc The PRE **Vv(rk1Irg L)a1spr** S cWr c. **III** .u1 .i vii **I!L** _1Vt_ 'm.k **LITrtdr** d .r I **t** ic ati.k s 1)t 1<sup>ht</sup> I R l i . i, ;'. **Affairs ('omplex. AnL** hjccti **tic 'r. . .** ,ci 't h it **i** tiid **S0Ut 4 cqI kk** . **(-%en** ilt r,:Ath.t.. I,c. ku- **Txplished. ihc** findings. **icrtirtt.rtair t. .in,! . i** inn **in i,, rs,rk'rs** iitn1 **rr1ccs.sri1I** rcprc<cTt mitci. Bui tv .. **,** P<sup>m</sup> rntiLILcc **, ttsL' IRE:** D)issCtIirrsntio0T C'CTltcr