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# CHAPTER IV. THE PHN RESEARCH AND SPECLAL GRANTS PROGRAMS: A FOCUS ON ISSUES AND CHALLENGES IN PHN SECTORS

59. During FY90 PHRHN dedicated its resources to the research and support of many PHN sector issues raised in Chapter III. While Chapter IV will limit itself to the assessment of PHRHN's FY90 accomplishments, a more detailed description of PHRHN's work is presented in Annex 9 and a list of publications produced by PHRHN during FY90 is contained in Annex 10.

# POPULATION

60. lNo population research tasks will provide direction both to staff within the Bank, and to government officials on the development of appropriate policy and programs to facilitate an efficient reduction of fertility. The task entitled 'Impediments to Contraceptive Use and Fertility Decline" will build upon previous studies to explore both demand and supply impediments with a view to recommending more effective targetting and design of FP services. "Effective Family Planning Programs" seeks to: (a) demonstrate the effectiveness of property managed family planning programs at increasing contraceptive use; (b) provide a concise synthesis of the major factors that contribute to program effectiveness; and (c) recommend appropriate national policies and donor policies for strengthening family planning programs. The Safe Motherhood Initiative activities described below under the Health section, and in more detail in Annex 9, paras. 17-22, have sought to promote demand for and availability of family planning services in support of maternal health. Special Grant Programs, managed by PHRHN, support research on Population NGOs and on Human Reproduction.

# HEALTH

61. Three PHRHN research tasks aim at assisting in the establishment of national health sector priorities (target groups and cost-effective interventions) in the face of an evolving epidemiological profile and constrained resources: "Adult Health", "Disease Control Priorities in Developing Countries" and "Economic Impact of Adult Mortality in Sub-Saharan Africa". Safe Motherhood activities undertaken by the division have successfully promoted, inside and outside of the Bank, the importance of this issue and continue to explore and promote the most costeffective interventions in this regard.

62. The Africa Health Policy Study, targetted at government officials, Bank staff, and the donor community, will facilitate the development of appropriate health policy for Africa by Africans, by identifying the need for capacity building in this regard, assessing strengths and weaknesses of existing health policies in Africa, and encouraging donors to support the refinement of policy with more resources and greater flexibility. The International Health Policy Program, an initiative supported by two private American foundations, and undertaken in cooperation with the Bank and WHO, also supports the development of local capacity in health policy analysis.

63. The "Hospital Resource Use' study addresses both financing and management issues, exploring ways to increase hospital efficiency and cost-recovery efforts, which would permit reallocation of a significant amount of scarce resources for health away from hospitals to lower level facilities, whose services are suffering from lack of recurrent financing.