59 PHN 1991 Sector Review

## _Haiti - Economic and Social FAnd Project_

The objectives of the project would be to: (i) establish an effective<sup>mechanism, the Economic and</sup> Social Fund (ESF), as a means of responding flexibly and efficiently to the<sup>basic needs of the poor through</sup> NGOs, cooperatives, community associations and other grass roots organizations;<sup>(ii) assist the GOH to</sup> improve health, nutrition and education services and provide physical<sup>infrastructure, and employment</sup> opportunities to the poor; (iii) provide an effective channel for critically required<sup>donor financing and</sup> coordinate domestic efforts that are currently fragmented; and, (iv) strengthen<sup>the capacity of community</sup> groups, cooperatives and other grass roots organizations in preparing and implementing<sup>projects. The</sup> proposed operation would consist of a project component and an institutional<sup>development component.</sup> The project component (US$10 million, IDA contribution) would address<sup>the needs of the poor in health</sup> and nutrition, education and physical infrastructure. Financing would<sup>be provided for. (i) health and</sup> nutrition projects primarily for children, pregnant and lactating mothers, rehabilitation<sup>and construction of</sup> primary health care facilities, essential drugs, immunization, construction of small water<sup>supply systems,</sup> small-scale sewerage systems and latrines (US$6.4 million); (ii) rehabilitation<sup>and construction of pre-</sup> school centers and primary schools, provision of school furniture and pedagogic<sup>material, literacy and</sup> vocational training programs (US$2.5 million); and (iii) rural market and<sup>social service access roads and</sup> related drainage works (US$1.0 million); and advisory services to participating<sup>organizations (US$0.1</sup> million). The institutional development component (US$1.3 million)<sup>would finance administrative and</sup> technical assistance to the ESF, including salaries for selected ESF staff,<sup>equipment (vehicles and</sup> computers), consultant services and operating costs.

## _Honduras - Social Investment Fund Project_

The objectives of the proposed project are to: (i) mitigate the social<sup>costs of adjustment and allow</sup> economic reform measures to be put into place rapidly with the necessary support<sup>of the population, (ii)</sup> lay the basis for a decentralized program of direct support for the poor and<sup>malnourished to buy food, and</sup> (iii) support the improvement of service delivery In the social ministries. The<sup>project would have four</sup> components: (i) the financing of the FHIS (more than 95% of total project cost),<sup>(i) sutpport to a pilot</sup> targeted nutrition assistance program (the executing agency would be the<sup>Family Assistance Program), (iii)</sup> technical assistance to help design a program to improve the efficiency<sup>and equity of the services of MOH</sup> nd MOE, and (iv) the setting up of a monitoring and evaluation system of the government's<sup>social policy</sup> interventions through the use of a Living Standards Measurement Study<sup>(the coordinator of this program</sup> would be the Ministry of Planning).

# _Mexico - Basic Health Care Project_

The project would: (a) strengthen and extend basic health care<sup>services and targeted nutrition</sup> assistance to about 13 million uninsured poor in 47 health jurisdictions<sup>in Oaxaca, Chiapas, Hidalgo, and</sup> Guerrero and in the Federal District (Project States); (b) support<sup>institutional improvements to strengthen</sup> management capability to enhance the efficiency and effectiveness<sup>of the health care system; and (c)</sup> strengthen the implementation of sectoral reforms to decentralize<sup>budgetary, management, and operational</sup> responsibilities from the federal level to the states. Attainment of<sup>these objectives would support a</sup> broader government policy for poverty alleviation and contribute to<sup>improved health and nutritional status</sup> of low-income residents in Mexico's poorest states.

The project consists of two major components: (a) Health Services Component<sup>(89 percent of total</sup> project cost including contingencies), which would focus on improving<sup>and extending delivery of basic</sup> health care and nutrition assistance (PASSPA program) for 13<sup>million uninsured people. Specific actions</sup>