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This book analyzes the objectives and content of the World Bank's assistance program during the period 1994-2003, the economic and social development outcomes in Pakistan, and the contributions of the Bank to development outcomes.

Background Cash-based transfer programmes are an emerging strategy in the prevention of wasting in children, especially targeted at vulnerable households during periods of food insecurity or during emergencies. However, the evidence surrounding the use of either cash or voucher transfer programmes in the humanitarian context and on nutritional outcomes is elusive. More evidence is needed not only to inform the global community of practice on best practices in humanitarian settings, but also to help strengthen national mitigation responses. Methods/Design The Research for Food Assistance on Nutrition Impact Pakistan study (REFANI-P) sets out to evaluate the impact of three cash-based interventions on nutritional outcomes in children aged less than five years from poor and very poor households in Dadu District. This four-arm parallel cluster randomised controlled trial is set among Action Against Hunger (ACF) programme villages in Dadu District, Sindh Province. Mothers are the target recipients of either seasonal unconditional cash transfers or fresh food vouchers. A comparison group receives ‘standard care’ provided by the ACF programme to which all groups have the same access. The primary outcomes are prevalence of wasting and mean weight-for-height Z-score (WHZ) in children. Impact will be assessed at 6 months and at 1 year from baseline. Using a theory-based approach we will determine ‘how’ the different interventions work by looking at the processes involved and the impact pathways following the theory of change developed for this context. Quantitative and qualitative data are collected on morbidity, health seeking, hygiene and nutrition behaviours, dietary diversity, haemoglobin concentration, women’s empowerment, household food security and expenditures and social capital. The direct and indirect costs of each intervention borne by the implementing organisation and their partners as well as by beneficiaries and their communities are also assessed. Discussion The results of this trial will provide robust evidence to help increase knowledge about the predictability of how different modalities of cash-based transfer work best to reduce the risk of child wasting during a season where food insecurity is at its highest. Evidence on costing and cost-effectiveness will further aid decisions on choice of modality in terms of effectiveness and sustainability. Trial registration Current Controlled Trials ISRCTN10761532 . Registered 26 March 2015.

In Nepal, India, Bangladesh and Pakistan, policy focused on improving access to maternity services has led to measures to reduce cost barriers impeding women's access to care. Specifically, these include cash transfer or voucher schemes designed to stimulate demand for services, including antenatal, delivery and post-partum care. In spite of their popularity, however, little is known about the impact or effectiveness of these schemes. This paper provides an overview of five major interventions: the Aama (Mothers') Programme (cash transfer element) in Nepal; the Janani Suraksha Yojana (Safe Motherhood Scheme) in India; the Chiranjeevi Yojana (Scheme for Long Life) in India; the Maternal Health Voucher Scheme in Bangladesh and the Sehat (Health) Voucher Scheme in Pakistan. It reviews the aims, rationale, implementation challenges, known outcomes, potential and limitations of each scheme based on current available data. Increased use of maternal health services has been reported since the schemes began, though evidence of improvements in maternal health outcomes has not been established due to a lack of controlled studies. Areas for improvement in these schemes, identified in this review, include the need for more efficient operational management, clear guidelines, financial transparency, plans for sustainability, evidence of equity and, above all, proven impact on quality of care and maternal mortality and morbidity. Au Népal, en Inde, au Bangladesh et au Pakistan, la politique centrée sur l'élargissement de l'accès aux services de maternité a débouché sur des mesures de réduction des obstacles financiers qui empêchent les femmes d'avoir accès aux soins, plus précisément des transferts de fonds ou des chèques conçus pour stimuler la demande, notamment de soins prénatals, obstétricaux et du post-partum. Pourtant, en dépit de leur popularité, on sait peu de choses de l'impact de ces programmes. L'article décrit cinq interventions majeures : le programme Aama (des mères) (élément de transfert de fonds) au Népal, le Janani Suraksha Yojana (plan de maternité sans risque) en Inde, le Chiranjeevi Yojana (plan pour une longue vie) en Inde, le projet de chèques de santé maternelle au Bangladesh et le système de chèques Sehat (santé) au Pakistan. Il examine les objectifs, les justificatifs, les obstacles à l'application, les résultats connus, le potentiel et les limites de chaque projet, avec les données disponibles. Un recours accru aux services de santé maternelle a été enregistré depuis le début des projets, mais sans qu'il soit possible de déterminer les améliorations de la santé maternelle, faute d'études contrôlées. L'étude recense les domaines d'amélioration des projets qui ont besoin d'une gestion opérationnelle plus efficace, de directives claires, de transparence financière, de plans de viabilité, de preuves d'équité et, surtout, de confirmer leur impact sur la qualité des soins, et la mortalité et morbidité maternelles. En Nepal, India, Bangladesh y Pakistán, debido a políticas centradas en mejorar el acceso a los servicios de maternidad, se ha intentado reducir las barreras de costo que impiden el acceso de las mujeres a los servicios: específicamente, transferencias de dinero o programas de cupones diseñados para estimular la demanda de los servicios, incluida la atención antes, durante y después del parto. Pese a su popularidad, no se sabe mucho acerca de su impacto o eficacia. En este artículo se resumen cinco intervenciones importantes: el Programa de Madres (transferencias de dinero) en Nepal; el Plan por una Maternidad sin Riesgos y el Plan por una Vida Larga, ambos en India; el Programa de Cupones para Servicios de Salud Materna en Bangladesh; y el Programa de Cupones para servicios de salud, en Pakistán. Se analizan los objetivos, la justificación y los retos de la implementación, los resultados, el potencial y las limitaciones de cada plan según los datos. Desde el inicio de estos planes, ha aumentado el uso de los servicios de salud materna, aunque por falta de estudios controlados no hay evidencia de mejoras en los resultados. Entre las áreas a mejorar figuran: la eficiencia de la administración operativa, directrices claras, transparencia financiera, planes de sostenibilidad, evidencia de equidad y, sobre todo, un impacto comprobado en la calidad de la atención y en las tasas de mortalidad y morbilidad maternas.

Assesses the successes and failures of foreign aid programs, with an overview and examination of joint aid strategies, information systems, and lessons learned by experts from Brookings Institution and World Bank, with case studies from scholars and practitioners who reside in the recipient countries (Indonesia, Cambodia, Ethiopia, Kenya, Pakistan, Tajikistan).

Foreign aid has been contributory towards fostering broad-based development and complementing national development initiatives in the recipient countries. This paper analyses the question of aid effectiveness towards the achievement of goals in the special context of a set of social outcomes in Pakistan. More specifically, the paper focuses the core question that 'how' and 'how far' foreign aid has affected the 'health', 'education', and overall 'human development index' in Pakistan. Our result shows that there is feedback Granger causality between GI and ODA. That is, Economic growth induces ODA and ODA Granger cause economic growth. As far as Education index, Human development index and life expectancy index concerned, there are only unidirectional Granger causality from ODA to Education index, Human development index and life expectancy index. This is consistent with other literature that ODA contribute to human development.

We used the rationale of Human Development Index to rank six regimes of Pakistan from 1979 to 2004 by designing a new index termed as Regime Performance Index (RPI). Our estimations are performed after converting all the growth rates of 13 selected socioeconomic indicators into standardised values. Rankings of the six regimes under RPI show that Nawaz Sharif s first era was relatively the best performance era in Pakistan to address social issues, followed by the Zia era and Benazir Bhutto's first era. Nawaz Sharif s second era is placed at the bottom of the rankings.

The objective of this study is twofold: (i) to estimate the equilibrium real exchange rate (RER) from a long-run perspective and calculate the degree of overvaluation for the period 1972-2007, and (ii) to test the Dutch Disease hypothesis concerning the effect of capital flows on the RER in Pakistan. Based on various macroeconomic fundamentals suggested in economic literature by Edwards (1988, 1989, 1994), Elbadawi (1994), and Montiel (1997), the equilibrium RER is estimated as a function of the terms of trade, government spending, degree of openness, workers' remittances, foreign direct investment (FDI) flows, and foreign economic assistance. In view of this study's long-term focus, all unsustainable and temporary flows are filtered out to obtain an accurate misalignment index. Estimation results are in line with theoretical postulations: an increase in capital flows, government spending on nontradable goods and terms of trade improvement are consistent with an appreciation of the RER, while an increase in the degree of openness is expected to depreciate the RER. Findings suggest that the RER suffers from chronic overvaluation in Pakistan. In spite of filtering out unsustainable and temporary flows, overvaluation increased from 0.75% in 2001 to 22.9% in 2007. A sharp rise in FDI flows (between 2005 and 2007) and an increase in remittances (between 2002 and 2007) are among the main factors that have contributed to this persistent overvaluation. Results also suggest that the Dutch Disease hypothesis holds in the case of Pakistan. [PUBLICATION ABSTRACT]

This paper has a two-fold objective: first, to examine the terms on which Pakistan receives aid and whether its debt situation is sustainable, and second, to examine the impact of aid and debt on economic growth. It is found that there is little encouraging that can be said about how the terms on which Pakistan has received aid over time have changed, and its current debt situation is not sustainable. Also reported is the analysis done elsewhere which shows that aid has a negative (Granger) causal impact on GDP, and aid has a robust negative impact on economic growth after controlling for supplyside shocks. We provide various reasons for this negative association.

This paper examines the gender component of the Urban Poverty Alleviation Project (UPAP), initiated by the National Rural Support Programme (NRSP) in Rawalpindi and Islamabad in 1996. UPAP gives loans to self-constituted groups of women who would be considered uncreditworthy by normal banking standards. Beyond the feasibility of project objectives with respect to the socioeconomic conditions of the context in which a programme is to be implemented, the aim of the paper is to highlight the mismatch between the product design and its conception and implementation by the staff of the given organisation. The examination of the impact on the status of the borrowers, within and outside the home, reveals that although loans are given to women, as per product design, the manner in which the programme is implemented and the vision that guides its future direction tend to miss the mark insofar as exploiting its potential or striking at the essence of poverty are concerned. Concentrating on the poorer members of a poor household and ameliorating their lot consequently loses primacy. So long as the UPAP thrust is not in agreement with the product design, sensitisation to the issue of women's empowerment also does not become a mandatory component of the programme. The opportunity for generating awareness of and sensitivity towards the plight of the most disadvantaged section of the population, and making efforts to overcome that disadvantage, is thereby lost. The potential for the need to improve the skills of women, in order to improve their welfare, also remains underutilised.

The fifth Population Census of Pakistan was conducted during 2-18 March, 1998. The population reported in this census was 130.58 million, with an average rate of growth of 2.61 percent per annum for the intercensal period of 1981-1998. The fifth census was due in March 1991 but was held during March 1998 due to the tendency of over-reporting among provinces at the time of housing census, which was undertaken as a preparatory step to the main population census. Several attempts were made between March 1991 and March 1998 and each time the census had to be postponed for the same reason. After all, the housing and population censuses were held with the assistance of military personnel who were checking the validity of members of each household independently. This dual approach not only helped preventing over-enumeration but also ensured maximum accuracy. This one hundred percent check eliminated the need for a post-enumeration check through a post-enumeration sample survey, which has its own limitations, aside from the time lag and sampling errors. The results of the census showed that its estimates of population for the country and its provinces/areas were very close to the estimates made in the projections by national experts in 1986. Based on the history of the Population Welfare Programme and other developments, an attempt has been made to estimate the rate of growth and population size for the years 1977 to 1997. Major developments in family planning have been achieved during the Seventh and the Eighth Five-Year Plans, from 1988-98, and there had a significant effect in lowering the rate of growth.