Joy de Beyer

The role of the World Bank in international health: renewed commitment and partnership.

During the course of the past ten years, the World Bank has become the single largest external financier of health activities in low and middle income countries and an important voice in national and international debates on health policy. This article highlights the Banks new strategic direction in the health sector aimed at: improving health, nutrition, and population outcomes of the poor; enhancing the performance of health care systems; and securing sustainable health care financing. Millions of preventable deaths and treatable illnesses, together with health systems that are inefficient, inequitable and ineffective, have motivated expanded Bank support for the health sector in many of its client countries. The new policy directions and system-wide reforms observed in these countries are the result of both demand and supply factors. It is part of a general shift in the Banks approach to development assistance, which sees systemic reform as a way to improve the impact and sustainability of investments in health. On the demand side, the Bank is trying to adapt to ongoing political, technological, economic, demographic, epidemiological and social pressures. On the supply side, the Banks growing international experience and substantial financial resources are used to complement the development assistance provided by other organizations and the global effort to improve health and health systems in low and middle income countries.

The incidence and impact on earnings of formal training provided by enterprises in Kenya and Tanzania

Abstract Data collected in 1980 in Kenya and Tanzania in enterprise-based surveys are analyzed to examine the incidence of formal training provided by employers. The wage benefits are estimated using earnings functions, for subsamples of skilled manual workers. The small training coefficient in Kenya is shown to be more likely the result of weak specification than low returns to training; separate earnings functions for subsamples stratified by training have significantly different slopes and position. Trained workers begin at lower wages but have steeper earnings profiles which cross over those of untrained workers.