The Bank has hosted various conferences to address issues of male involvement in reproductive health and gender-based violence, yet no projects in the World Bank's portfolio have directly addressed ...either topic.1 Recent gender-related work in the World Bank's health projects in Latin America has made evident the limited capacity of health personnel and communities to integrate men into family planning and reproductive health programs or to respond effectively to domestic violence cases.2 Midwives at women's birthing centers in Nicaragua, for example, have been challenged with trying to convince men who oppose family planning of the economic difficulties of raising large families.3 Moreover, sheer lack of knowledge and capacity prevents health providers from screening for and providing proper treatment to gender-based violence survivors. The Integral Health Project for Men and Women, or PROSALVAR as it is commonly known, was designed to help build a response to these apparent gaps in healthcare projects in the LCR through pilot activities in three Highly Indebted Poor Countries: Bolivia, Honduras and Nicaragua. Financed by the Bank-Netherlands Partnership Program, the project's main objectives were to build the capacity of staff in health care centers and hospitals to effectively screen for intra-family violence and refer victims to appropriate services, and to better educate and involve men in sexual and reproductive health. As a pilot project, PROSALVAR also sought to help the Bank better understand its operational role in preventing and responding to gender-based violence and in promoting the male involvement agenda.
This paper reviews 40 full poverty reduction strategy papers (PRSPs) with regard to whether these strategy papers (1) recognize under-nutrition as a development problem in the country, (2) whether ...they use nutrition information for poverty analysis, and (3) whether the PRSP includes specific nutrition activities (policies, strategies, and programs) to deal with the unique nutrition problems in each country. The review shows that three quarters of the PRSPs recognize that under-nutrition is a development problem that leads to loss of human capital and/or productivity. Also, many PRSPs, either explicitly or implicitly, include country nutrition profiles in their poverty analysis. Consequently, a majority of PRSPs include strategies and specific actions to mitigate the effects of malnutrition. However, there appears to be little prioritization or sequencing of proposed actions. More importantly, the strategies and actions included in PRSPs often do not reflect an appropriate response to the nature of the nutrition problem in the country. In a quarter of countries with macronutrient deficiencies and about 40% of countries with micronutrient deficiencies, the PRSPs fail to address these two problems. Moreover, tackling nutrition issues requires greater institutional capacity and budget allocations than currently seem to exist. Gross mismatches between the causes of malnutrition and responses to the nutrition problem inevitably lead to a lack of impact and a waste of resources, which will further contribute to the marginalization of nutrition in future PRSPs.
