# EXECUTIVE SUMMARY

## _Overview olFY91 Sector Operations_

1. The volume of lending in the Povulation, Health and Nutrition (PHN) sector showed continued and significant growth in FY91. Lending to twenty-eight projects totaled $1567.6 million, compared with commitments of $933.4 to eighteen projects in FY90, which, in turn marked a substantial increase in both number of projects and lending volume over FY89. In fact, growth both in number of projects aind amount of lending has been a notable feature of the Bank's support to PHN since FY81, when the Bank first began lending for health (Figure 1).

Figure 1: Lending for the Population, Health and Nutrition Sector, FY80-91 2. Of the twenty-eight projects approved during the fiscal year, eighteen are "pure" PHN projects and ten are social development projects -- multisectoral operations encompassing the PHN and education sectors and, in some cases, other sectors, as well, s-ch as agriculture, water supply and sanitation, other basic infrastructure and income generation activites for the poor. The ten social development projects received $464.8 million of IBRD/IDA support (30 percent of overall PHN lending) of which an estimated $207.4 million wil support PHN components. Lending for "pure" PHN projects and for the PHN components of the social development projects amounts to $1.3 bitlion, or 83 percent of overall lending to the sector.

<!-- Start of picture text --> 30Number o Pojects<br>30 28<br>2 6<br>20E la<br>20 t8 g<br>1. 1*<br>10. 7 7<br>a<br>4 4 2 m E<br>o-<br>80 81 82 83 84 86 80 87 88 8e 90 91<br>Fs8cal Year<br>- PHN PROJECTS EMSOCIAL DEV. PROJECTS<br>1800 Mill lons of USS<br>1600 166<br>1400<br>1200<br>1000 934<br>800i<br>eoo- 420 660<br>400 244193 304<br>200 143 120 3<br>o- 0 36 I 8"<br>S0 8t 82 83 84 88 S0 87 88 89 90 es<br>Fiscal Year<br>_PHN PROJECT8 80CIAL OEV. PROJECTS<br><!-- End of picture text --> 3. The growth in PHN lending has surpassed targets set by the Bank's senior management on a number of occasions. In November 1989, President Conable, in an address to the Annual Meeting of the International Planned Parenthood Federation, pledged to increase PHN lending to $800 million annually during the period FY90-92; lending for the total PHN sector and for "pure" PHN reached $933.4 milion and $845.1, respectively, in FY90, and $1567.6 and $1,300.2 respectively in FY91. The Bank's 1990 "Review of World Bank Programs and FY91 Budgets' estimated that PHN lending would increase from an average of 3 percent of Bank lending in FY89-90 to 4 percent in FY91. The proportion of total Bank lending to the sector increased considerably -- trum 4.5 percent in FY90 to 6.9 percent in FY91, or from 4.1 percent to 5.8 percent, if lending to non-PHN components is excluded. More recently, on the occasion of the World Summit for Children in September 1990, President Conable expressed hBank's determination to provide greater support for primary health care and set a goal of increasing lending for primary. health care from about 3 percent to about 5 percent of total lending within the next three to four years. InFY91,some90percentof "pure" PHNallocations, or $1220 million, supported primary health care, accounting for 5.4 percent of total Bank lending.