**Policy, Research, and External Affairs**

# **Population, Health, and Nutrition**

This paper - a product of the Population, icalth, and Nutrition Division, Population **and** IHUI;11;rn Resources Department - is part of a larger clffort in PRE to promote policy and rcsource commiiticnlt to **IhC** Safe Motherhood Initiative. Copics are availabic frec from the World Bank, 1818 11 Strect N\V, Washington DC 20433. Plcasc contalct Sonia Ainsworth, room S6-065, extension 31091 ( 16 pages . 1 figurcs).

_Financial trends for safe_ **_motherhood_** _initiatives._ Problems of definition and accounting methiods preclude an accuratc analysis of Financial trends among donors. Global support for specific safe motherhood activities is limitcd. For the 17 major bilateral sources, funding for selccted activities which contributc to safe motherhood is estimatcd to have increased (in currenlt dollars) from $691.5 million in 1986 to $818.8 million in 1988. About half this amount was lor so-called core* activities, including family planniilg scrvices. The magnitude of support lor preventionr of the complicatioris of pregnancy is less certain. Gcneral health, population, and nilIr-iion sector flows increased substantially over thc same period. These treneds wcre positivc fbr 13 sourccs, unchanged for **itrece,** and **ncat ivc** for year's total. This is due primarily to substantial increases in general loaIs for **health,** population. and nutrition. New specific safl motlherhood activities **are** beginning to emergc in **the** fornn ol care for thc complications of pregnancy, better secondary and tertiary facilities, training, and promotionail workshops.

The magnitude **and** elfectivencss ol donor firlancing will require nmore attention to two special problems:

* Strengthening recipicnt counLtrics' ability to articulate project demnd -- providing specific training, technicazl advisorv assistancce and operational guidelines for mobiliz.ing financial resources.

Of the six major multi lateral soUirces, totaIls for selected safc moithcrhood activities \Acre estimated to be $477.7 millioni in 1988. ai 41.7 percerit increase over 1987 and **a** 17 pcrcent increase over 1986, rclcctingt dilffercnces in thlc annual volume of' World Bank loan approvals. I lalf of this went for core scrvices. primaril **_\_ Ifaily** il planning.

Improving the data otn safe' motherhood financial tend(is -- establishing a conSCnsus on1 de finitions: seek ino a consenisus on fi nanc,all measurable programr or project catoornies ol s;f. mothlierhood; dcininig methods for tlhe s\stematic collection of donor and recipicent countrv data ont financial trncids.

**For tihC** full sectionI **onl** Interview **Noics \ ili** dilfI'crent financing sources, see WPS 413.

E.stirn ated World Bank saflc motherhood expenditurcs in 1989 are triplec the prcvious At the I ) X7 ConerenSceonic* SafeNl M'Ihc rho< si nl **Nair** hi **.1** I e rz andJ Mea sh en recoi ni emrr dd a coeTr program i'r safe n oitherhr sd th t 1rit I h **reduLinIg the nurinherof pregnancics** through **iadnI I\** p niang educ ation, pronotion, arld CoTilntunity -hased scr\ ices; reduc inIg the rAik **s to prct** an tchildhirih; pro\iding prcnatial care, lupcr\ ed deliscrit s, **screcinig,** and referral for highr-sk mothers; arid pros idirg coiITrLiricir **i :ti!Jii,** transjwuiation for complicated dcliscrie.

> The **P RE** Working Paper Series disset Iti.Ite the findIinis Of **'Aork** undcrr **\Xa\** in **tIie** Bank's Po ic ResearchI. inid Extcti.i

> Affairs Corimple An ohjecti% e of the series is tn get these findings out quicCkh. even if restentations _are_ **less** thlan full polished. The findiings, interpretations. aid uotlcusions in these palpwrs dlo not necessarily represent official Bank potlic>

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