How countries nurture CONTINUITY Human Capital Sustained efforts across political cycles WHO WHOLE OF CO GOVE G RN RNM NME OVERN NT EN CE OR EN D IN ID AT EV Continuity across political cycles IO is fundamental to human capital N transformation. Country experiences across diverse contexts have shown that consistent prioritization of human capital issues is both possible and effective. ABOUT THIS SERIES This four-part series explores the strategies Bangladesh: sustained efforts governments have deployed to overcome the myriad barriers to effectively invest to reduce fertility in human capital. It focuses on a whole Bangladesh was able to achieve a dramatic fertility of government approach that (i) sustains decline as the result of sustained effort over efforts across political cycles; (ii) coordinates several decades. In the mid-1970s, a Bangladeshi across government; and (iii) designs policies woman had more than six children on average; and programs that use and expand the by 2000, this number had declined significantly evidence base. to 3.3, and by 2011 it had dropped to 2.3 and was on track to achieve replacement levels. A major While adopting any one of these strategies family planning program that combined supply- can help build human capital, countries side and demand-side initiatives helped make this that have implemented all three in tandem transformation possible.1 are often among those that have made major strides in improving human capital The program depended on a large cadre of female outcomes. In this series, we examine the outreach workers going door-to-door to provide information, motivate clients, and offer contraceptive various dimensions of this approach using supplies. It used mass media and other forms of country examples and conclude with social and behavior change communication to a look at how success across all three stimulate a change in attitudes about family size and strategies has led to meaningful gains and demand for contraception. This involved not only lasting benefits. academics and researchers who generated and built an evidence base around these efforts but also religious and community leaders who supported behavior change. The program both contributed to and benefited from improvements in women’s status in Bangladesh over the past 40 years, including improvements in girls’ educational attainment and the economic empowerment of women. The program is estimated to have cost $100 million to $150 million worldbank.org/humancapital per year, with about one-half to two-thirds of the The parallel addition of an investment line to the funding coming from external donors (depending national budget—and its growth over time, from on the year). Cost-effectiveness estimates suggest US$0.3 million in 2002 to US$5.7 million annually a value of $13 to $18 per birth averted (a standard in 2015—further demonstrates the administration’s measure for family planning programs).2 commitment to nutrition through institutionalizing “funding for nutrition beyond the life of any Senegal: prioritizing nutrition single project or administration”.3 beyond a single administration As a result, between 1992 and 2017, Senegal reduced the prevalence of child stunting from Since the country’s independence in 1960, 34 percent to 17 percent, the lowest in continental nutrition has always been recognized as a Sub-Saharan Africa and in contrast with several priority for the government of Senegal. The neighboring countries which experienced either country’s Quadrennial Economic and Social a stagnation or deterioration in child nutrition Development Plans, as early as the 1960s, indicators. Though still high, child anemia also prioritized the development of institutions saw some improvement, with a reduction from dedicated to food and nutrition and made maternal 82.6 percent in 2005 to 66.3 percent in 2015. and infant protection a national priority. The institutionalization of nutrition in the 1990s, the Senegal is now at a critical stage of ramping up shift toward the prevention of malnutrition using a key nutrition interventions to scale and embarking community-based and preventive approach, and on a new Multisectoral Strategic Nutrition Plan. the subsequent creation of the Prime Minister’s Due to varying nutrition profiles across the country, Nutrition Coordination Unit in 2001 to coordinate the government recognizes interventions should the large-scale implementation of these activities be regionally tailored to strengthen community across pertinent sectors, all contributed to the and household resilience against malnutrition. significant and rapid improvements in nutrition the country has seen to date. Vietnam: a persistent focus on education In Vietnam, the government’s unshakable commitment to improving people’s learning, together with regular monitoring of reforms and realignment between policy and implementation, has driven the continuous expansion and improvement of the country’s education system.4 In 1945, the newly independent government of Vietnam immediately began offering literacy classes to all of its citizens. Literacy has been a national priority for every administration ever since. In 2006, to achieve national school standards, the Ministry of Education and Training implemented the Primary Education for Disadvantaged Children (PEDC) Project. The objective of the project was to improve access to primary school and the quality of education for disadvantaged girls and boys. PEDC introduced the concept of Fundamental School Quality Levels, which defined the minimum package of inputs—physical facilities, school organization and management, teaching materials and teacher support, and school-parent linkages— necessary for providing a quality education at a A primary school student, Soc Trang province, Vietnam Photo: Chau Doan / World Bank school, and the basic outcomes that are expected of schools.5 Over time, it was used to create an Sustained prioritization of input index, which serves not only to monitor human capital issues is both progress but to assess whether inputs actually lead to learning.6 possible and effective. Vietnam’s long-term investment in education is reaping rewards. The country has achieved both SENEGAL: universal preschool education for five-year-old children and primary education and is working prioritized nutrition as early towards achieving universal lower secondary as the 1960s education. In 2012, the country’s 15-year-olds participated for the first time in the Program for International Student Assessment (PISA) and institutionalized funding ranked 17th in mathematics, 8th in science, and beyond the life of any single 19th in reading among 65 participating nations, project or administration placing Vietnam above the OECD average. Almost 17 percent of Vietnam’s poorest 15-year- old students were among the 25 percent top- reduced child stunting from performing students in PISA tests, far above the 34% to 17% (1992-2017) 6 percent average across OECD countries. More recently, Vietnam was also among the top 10 lowest stunting rates in worldwide in science on the 2015 PISA.7 continental Sub-Saharan Africa Chile: institutionalizing investments in the early years preschools and the prevailing early life health In 2007, the government of Chile launched Chile gap between low-income and richer Chileans has Crece Contigo (ChCC) to provide health care to all been closed.8 The program now includes children children under-five and their families. The program up to the age of 9. offered a universal platform that brought together education, health, social and community services to support children throughout the course of their Philippines: expanding development—from conception until entry into protection of the most vulnerable preschool (age 4)—laying the foundations for their human capital and addressing issues of inequality In the Philippines, the ongoing Pantawid and poverty early in life. Pamilyang Pilipino Program (Pantawid Pamilya) plays a central role in the government’s strategy to Crece Contigo was institutionalized in Chilean address poverty and vulnerability among Filipinos. law, ensuring the program would transcend This national conditional cash transfer (CCT) program presidential terms of office. Sustainable funding provides health and education grants to poor was also codified in law, creating an official households based on an objective national targeting budget line for the Ministry of Social Development system. Piloted in 2007 with 6,000 household devoted to the program, along with specific beneficiaries, it was launched formally in 2008 funding for aspects of ChCC undertaken by the to cover 320,000 households. Since then, the Ministries of Health and Education. program has expanded to cover approximately Impact studies of this program have shown 20 percent of the population (20 million Filipinos) positive effects on child development—with and 100 percent of all poor households with significant impacts on the health and welfare of children, making Pantawid Pamilya the fourth low-income Chileans. The poorest 60 percent of largest CCT program in the world. households have free access to nurseries and APRIL 2019 no. 1 of 4 While the program started with a budget of PHP 4 million (US$100,000) in 2007, representing a tiny share of the country’s GDP and national budget, by 2014, it had grown to PHP 62.2 billion (US$1.5 billion), reaching 4.2 million household beneficiaries and representing 0.5 percent of the country’s GDP and 2.8 percent of the Government’s national budget. Impact evaluation studies show that the program is resulting in improved education and health outcomes among beneficiaries, including enhanced food security, community participation, and women’s empowerment. Specifically, it has helped reduce short-term poverty and food poverty at the national scale by up to 1.4 percentage points each—a substantial reduction given that pre-Pantawid rates were at 26.4 percent for total poverty and 12.5 percent for food poverty.9 Republic of Korea: long-term investments in health and education Starting in the early 1960s, the Republic of Korea underwent a massive demographic and economic transition resulting from simultaneous and sustained investments in health and education by successive governments. Investments in family planning policies, health centers and field workers, led to a rapid decline in Korea’s fertility, which sank from 5.4 children per women in 1950 to 2.9 in 1975 and 1.2 by 2005. This demographic shift created a window of opportunity to accelerate economic growth, which Korea did through policy measures across several sectors. The government shifted its education and skills development strategy, which resulted in a higher skilled labor force. This ‘production-oriented education’ provided citizens with knowledge and skills needed for economic development. The government also introduced comprehensive economic plans that focused on investments in labor-intensive sectors, directed investments to infrastructure and rural construction programs, and created a favorable business environment that brought in foreign direct investments. These economic policies took advantage of the demographic dividend and led to average annual The Human Capital Project is a global growth of 6.7 percent over a 40-year period. effort to accelerate more and better investments in people for greater ENDNOTES equity and economic growth. The 1  Rob, U., Phillips, J. F., Chakraborty, J., Koenig, M. A. 1987. The use effec­ tiveness of the Project is helping create the political copper T-200 in Matlab; Gribble .J. and Voss .M., 2009. Family Planning and Economic Well-Being: New Evidence from Bangladesh, Policy Brief. space for national leaders to prioritize 2 Joshi, Shareen, and Shultz, Paul T . 2007. Family planning as an investment in develop­ transformational investments in health, ment: Evaluation of a program’s consequences in Matlab, Bangladesh. Yale University, Economic Growth Center Discussion Paper. education, and social protection. The 3 Ruel-Bergeron, Julie. 2018. Investment in Nutrition in Senegal: Analysis & Perspective: objective is rapid progress toward a 15 Years of Experience in the Development of Nutrition Policy in Senegal. 4 Birger, Fredriksen. and Tan, Jee Peng (eds.) World Bank. 2008. An African Exploration world in which all children are well- of the East Asian Education Experience. nourished and ready to learn, can attain Patrinos, Harry Anthony, Pham Vu Thang, Nguyen Duc Thanh. 2018. The Economic Case for 5  Education in Vietnam. Policy Research Working Paper No. 8679. Washington, DC: World Bank. real learning in the classroom, and can 6 World Bank. 2018. Growing Smarter: Learning and Equitable Development in East Asia enter the job market as healthy, skilled, and the Pacific. Washington, DC: World Bank. 7 Kataoka, Sachiko. 2019. Vietnam’s Human Capital: Remarkable Education Success and and productive adults. Future Challenges. World Bank. 8 Clarke, Damian, Cortes Mendez Gustavo, and Diego Vergara Sepulveda. 2017: Growing Together: Assessing Equity and Efficiency in an Early-Life Health Program in Chile. 9 Acosta, Pablo Ariel, and Velarde, Rashiel. 2015. Philippine Social Protection Note. FOR MORE INFORMATION VISIT: October 2015, No. 8. World Bank. worldbank.org/humancapital