The Health Benefits of Transport Projects : A Review of the World Bank Transport Sector Lending Portfolio

This paper reviews the contribution of the World Bank's transport lending portfolio to health outcomes, as background for the Independent Evaluation Group's (IEG) evaluation of the Bank's support for health, nutrition and population (HNP). Over the past decade (FY97-06), the World Bank committed nearly $28 billion to 229 new transport projects managed by the Transport Sector Board (TSB). Specifically, the paper reviews the extent to which these projects: cite potential health benefits or risks in design documents; include specific objectives with respect to improving health outcomes or mitigating health risks; propose environmental improvements that are likely to provide health benefits; target transport services, and both health and behavioral outcomes to the poor; and plans to collect evidence on changes in health outcomes as a result of transport interventions. For completed projects, it assesses the extent to which expected health benefits or objectives have been achieved. This review of health benefits in the transport lending portfolio over the past decade shows that in the majority of the cases the focus has been on improvements in road safety, as measured by a reduction in the fatality or injury rates. Among the 55 projects with health related objectives, 82 percent had objectives to improve road safety, while only 7 percent had objectives to improve safety of other modes of transport and only 2 percent each had HIV/AIDS prevention or air quality improvement objectives.