World Bank Funding and Health Care Sector Performance in Central and Eastern Europe

Abstract

This article looks at the impact of World Bank funding on health care sector performance in Central and Eastern European countries. The World Bank has been one of few organizations involved in health care sector assistance in these nations during the transition period, mainly through funds disbursement. This article tests hypotheses that those countries that perform better economically, that are more favorably evaluated by the World Bank, and that have more effective institutions are also more likely to benefi t from World Bank assistance, through improvements in the performance of their health care sectors.

The World Bank’s social assistance recommendations for developing and transition countries: Containment of political unrest and mobilization of political support

“…While the literature on the pre-1980 welfare systems thus emphasized both structural and political factors, most students of recent welfare system transformations have solely emphasized structural factors, such as ageing, labour informalization, unemployment, globalization, deindustrialization, the rise of poverty and the rise of the service sector (Brooks and Manza, 2006; Pierson, 2001; see also Hall, 2007; Radin, 2008; Ruger, 2005; Tungodden et al, 2004). This literature has thereby largely under-examined the possibility that contemporary welfare system changes have also been affected by political concerns of national and supranational institutions.…”

“…The World Bank has facilitated and shaped this expansion through social assistance policy recommendations to national governments. Several scholars have illustrated that national governments have taken these recommendations into serious consideration in designing and redesigning welfare systems (Brooks, 2004; Deacon and Hulse, 1997; Radin, 2008). According to Weaver (2008: 1), ‘not only the Bank’s financial lending, but also what it says about development, shapes other multilateral, bi-lateral, and national development strategies and defines the conventional wisdom on global development’.…”

The Washington Consensus and Social Policy: World Bank Projects and Health Sector Reform in Costa Rica

“…The term Post‐Washington Consensus emerged in the late 1990s and emphasizes the need to move beyond the Washington Consensus by considering seriously the importance of governance institutions in any reform effort (Burki & Perry, ; Clift, ; Öniş & Şenses, ; Radin, ; Stiglitz, , ). Some have also argued that, contrary to the Washington Consensus, the Post‐Washington Consensus framework promotes investment in human capital as an end rather than only as a means to economic development.…”

Has Anyone Seen It?

“…54 Others attribute this to the lack of a clear blueprint for a successful health care system. 55 However, these two approaches only consider exogenous factors as explanatory variables and do not consider the role of domestic politics.…”

“…One explanation for the Central and eastern european countries' choice of economic restructuring reforms over that of welfare, education, and health is the influence of international organizations' agendas that were imposed on the countries that sough development loans, through mechanisms such as the World Bank's conditionality agreements, and other sector adjustment loans with prerequisites attached to them. 54 Others attribute this to the lack of a clear blueprint for a successful health care system. 55 However, these two approaches only consider exogenous factors as explanatory variables and do not consider the role of domestic politics.…”