Title page
Contents
ABSTRACT 2
I. INTRODUCTION 5
II. EDUCATION 12
A. The learning crisis and its causes 12
Immediate causes of the learning crisis 14
Systemic causes of the learning crisis 15
B. Three policy responses 17
Assess learning 18
Make schools work for learners 19
Reform the system 21
III. HEALTH CARE 23
A. The challenges 23
B. Building a high-performing health system 26
Moving away from hospital-centric structures, by increasing the availability, effectiveness, and quality of primary care 27
Improving quality of care in treating both chronic and acute illness 28
Reforming mechanisms for paying health-care providers 29
Improving the price and availability of critical medical products 30
Accelerating technological transformation, while prioritizing among available interventions and technologies 31
C. Efficient, equitable financing 31
IV. REASONS FOR OPTIMISM: CASE STUDIES OF SUCCESSFUL REFORM 33
A. Overall human-capital development 33
B. Successes in education 35
C. Successes in health care 36
V. CONCLUSION 37
VI. REFERENCES 38
Figure 1. Human Capital and Income Within and Across Countries 7
Figure 2. Proportion of 10-19-Year-Old Children Who Attain Each Grade, by Wealth Quintile 8
Figure 3. Socioeconomic Gradient in Child-Survival Rates by Country Income Level 9
Figure 4. Socioeconomic Gradient in Non-Stunting Rates by Country Income Level 10
Figure 5. In several countries, the 75th percentile of test-takers performs below the 25th percentile of the OECD average (2015 PISA mathematics assessment) 13
Figure 6. Children from poor households in Africa typically learn much less 13
Figure 7. Relationship between childhood stunting and health expenditure 25