Department of Anthropology and Sociology, Denison University, 100 West College Street, Knapp Hall 103-D, Granville, OH, 43023, USA.
Global Health. 2021 Jan 6;17(1):6. doi: 10.1186/s12992-020-00649-1.
The World Bank wields immense financial and normative power in health in the developing world. During the 1980s and 1990s, in the face of intense criticism of its structural adjustment policies, the World Bank purportedly turned its attention to "pro-growth and pro-poor" policies and new lending instruments. One focus has been an investment in maternal and infant health. My analysis uses a mixed methods approach to examine the relationship between traditional structural adjustment and health loans and projects and infant mortality in Latin America and the Caribbean from 2000 to 2015.
My answer to whether the World Bank's projects in Latin America worked "for the children" is: somewhat. The results are heartening in that quantitatively, health projects are associated with lower infant mortality rates, net of controls, whereas traditional structural adjustment loans do not appear to be negatively associated with infant mortality, though examined across a short time horizon. Qualitative data suggest that infants, children, and mothers are considered in World Bank loans and projects in the context of an economic logic: focusing on productivity, economic growth, and human capital, rather than human rights.
Taken together, my results suggest that the World Bank appears to, at least partially, have amended its approach and its recent work in the region is associated with reductions in infant mortality. However, the World Bank's economistic approach risks compartmentalizing healthcare and reducing people to their economic potential. As such, there remains work to do, in Latin America and beyond, if health interventions are to be effective at sustainably and holistically protecting vulnerable groups.
世界银行在发展中国家的卫生领域拥有巨大的财务和规范权力。在 20 世纪 80 年代和 90 年代，面对对其结构调整政策的强烈批评，世界银行据称将注意力转向“促进增长和扶贫”政策和新的贷款工具。一个重点是投资母婴健康。我的分析采用混合方法来检验传统结构调整与卫生贷款和项目以及 2000 年至 2015 年拉丁美洲和加勒比地区婴儿死亡率之间的关系。
我对世界银行在拉丁美洲的项目是否“为了孩子”的回答是：有些。结果令人鼓舞，因为从数量上看，卫生项目与较低的婴儿死亡率有关，控制后，而传统的结构调整贷款似乎与婴儿死亡率没有负相关，尽管在短时间内进行了检查。定性数据表明，在世界银行贷款和项目中，婴儿、儿童和母亲被视为一种经济逻辑的一部分：关注生产力、经济增长和人力资本，而不是人权。
综上所述，我的结果表明，世界银行似乎至少部分地修正了其方法，其最近在该地区的工作与婴儿死亡率的降低有关。然而，世界银行的经济主义方法有将医疗保健分割并将人们降低到其经济潜力的风险。因此，如果卫生干预措施要有效地可持续和全面地保护弱势群体，那么在拉丁美洲及其他地区仍有工作要做。
