UNLEASHING THE SOUTH ASIAN CENTURY THROUGH HUMAN CAPITAL FOR ALL 4i4HCA: A Framework for Human Capital Acceleration in South Asia #InvestInPeople South Asia Human Capital Plan OUTLINE Key Messages Context Challenges Strategic Priorities WB Partnership Deep Dive 1: 4i4HCA Strategic Priorities in South Asia Deep Dive 2: Main Drivers and Challenges for Human Capital Development in South Asia Sources of Data Acknowledgements #InvestInPeople South Asia Human Capital Plan 02 KEY MESSAGES CONTEXT Despite major progress across many human capital dimensions, South Asia faces large and persistent human capital deficits which limit current and future economic development • Given current quality, coverage, and effectiveness of human capital investments, on average, South Asian children born today can expect to attain only 48% of their full productive potential • COVID-19 risks wiping out some major gains, while slowing progress in other areas CHALLENGES Three key drivers limit human capital outcomes in South Asia • Poor quality and effectiveness of services undermine the impact of public investments • Multiple inequalities lead to large segments of the population being left behind • People face increasing vulnerability to a spectrum of shocks and risks STRATEGIC PRIORITIES Human Capital Acceleration in South Asia requires a 4-pronged framework for action: 4i4HCA • Invest smarter and with quality • Include and empower, especially adolescent girls and women • Insure and prepare for potential shocks and risks • Innovate through data, technology, and multi-sector action WB PARTNERSHIP The World Bank commits to support South Asia on Human Capital Acceleration via • Immediate and comprehensive support in the wake of the COVID-19 pandemic • A customized partnership based on data-driven country-specific analysis and priorities • Increased IDA/IBRD financing commitments for Human Capital (HD+critical non-HD investments) • Knowledge sharing across South Asia and across the globe • Mobilization of a Whole-of-World-Bank-Group approach to ensure multi-sectoral alignment and action #InvestInPeople South Asia Human Capital Plan 03 CONTEXT SOUTH ASIA’S AMBITION TO LEAD THE 21ST CENTURY AND IMPROVE QUALITY OF LIFE FOR ALL CITIZENS IS POSSIBLE ONLY WITH A STRONG FOCUS ON HUMAN CAPITAL DEVELOPMENT • Human capital is a critical input to economic growth, leading to better • Deepened and better Human Capital investments will be needed: skilled and more productive workers who live and work longer and help drive a dynamic economy • To get countries back on their feet economically, revive employment, and rebuild social cohesion--the building blocks for the region’s future • In South Asia boosting human capital will require addressing last mile service delivery, especially to include marginalized groups, improving • To build back stronger and more resilient health, education, and social quality, better prevention and protection against shocks, and innovations protection systems capable of responding to the challenges of the 21st century • Covid-19 has demonstrated the close links between a strong public health system; effective, scalable social protection system; flexible, • To drive reforms that could be game changers innovative education system; and the economic performance of a country • Investment in Human Capital – for all in South Asia – is not a luxury, • It is estimated that economies could take two years to recover, while but an economic necessity; the time for action is now! many families will permanently lose jobs, and many children will lose years in learning; the poor and vulnerable will be disproportionately affected, widening the gap in equality of opportunity #InvestInPeople South Asia Human Capital Plan 04 CONTEXT SOUTH ASIA HAS MADE MAJOR PROGRESS IN HUMAN CAPITAL DIMENSIONS Fastest declines in under-5 child mortality The share of population living on less than $1.90/day fell to 12% in 2015 DEATHS PER 1,000 LIVE BIRTHS 300 UNDER-FIVE MORTALITY RATE 1990-2019 SSA Each arrow represents a country or region’s progress on child mortality between 1990 and 2019 SAR POPULATION IN POVERTY 600 100% PERCENTAGE OF TOTAL 100 EAP MNA NUMBER IN POVERTY LAC 500 80% 50 ECA 400 SDG 2030 TARGET = 25 60% 25 300 40% (MILLIONS) 200 10 1990 100 20% 5 0 0% 2 1990 1993 1996 1999 2002 2005 2008 2011 2013 2015 2019 Source: UN Inter-agency Group for Child Mortality Estimation, 2020 Source: World Bank, "Poverty and Shared Prosperity", 2018 Most countries have achieved near-universal Highest rate of increase in life expectancy primary school enrollment SCHOOL ENROLLMENT AGE 6-11 Afghanistan LIFE EXPECTANCY AT BIRTH 1990-2018 SAR SCHOOL ENROLLMENT % 100 80 Bangladesh EAP 80 Bhutan MNA 70 YEARS India ECA 60 Maldives SAR = FASTEST GROWTH RATE SSA 40 Nepal 60 LAC 20 Pakistan Sri Lanka 50 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 1990 1995 2000 2005 2010 2015 2018 Source: World Bank, “Ready to Learn”, 2020 Source: United Nations Population Division, "World Population Prospects", 2019 #InvestInPeople South Asia Human Capital Plan 05 CONTEXT DESPITE THIS MOMENTUM, HUMAN CAPITAL DEFICITS ARE LARGE AND PERSISTENT, HUMAN CAPITAL INDEX (HCI) 2020 LIMITING ECONOMIC DEVELOPMENT SOUTH ASIA: 0.48 AVERAGE ALL REGIONS: 0.58 South Asia has the second-lowest level of human capital attainment: on average, children born today can expect to attain only 48% of their full potential GDP per worker could be 2.1 times higher in South Asia if the quantity and quality of human capital is improved Source: World Bank, Human Capital Project, 2020 SURVIVAL Children who don’t X SCHOOL Contribution of quality- X HEALTH Contribution of health (adult = HUMAN CAPITAL INDEX Productivity of a future worker survive don’t grow up to adjusted years of school to survival rate and stunting) to (relative to benchmark of complete become future workers productivity of future workers productivity of future workers education and full health) #InvestInPeople South Asia Human Capital Plan 06 CONTEXT AS IN THE REST OF THE WORLD, THE COVID-19 CRISIS IS ALREADY REVERSING VALUABLE HUMAN CAPITAL GAINS IN SOUTH ASIA RELATIVE INCREASE IN POVERTY (% INCREASE OVER BASELINE SCENARIO WITH NO COVID-19) 50% Social Protection and Jobs 40% • Employment and livelihoods have been lost due to government-imposed social distancing measures and resulting 30% declines in economic activity, with expected severe consequences in terms of increases in poverty throughout South Asia 20% • Most workers are informal (e.g. 90% in India, 80% in Pakistan) and have limited coping mechanisms to absorb shocks, 10% which can lead to disinvestments in human capital 0% Sri Lanka Bangladesh Afghanistan Health Source: World Bank Estimates, 2020 • Substantial health impacts are expected due to disruptions in routine health service delivery as well as reduced health-seeking levels due to lockdowns and fear of infection TB NOTIFICATIONS IN INDIA • For example, in India, TB case notifications were down 84% compared to the prior year, and 22 priority services 250,000 fell by a third 200,000 • In Afghanistan, government-supported health facilities have performed 23% fewer surgeries and 15% fewer tetanus 150,000 vaccinations during the COVID-19 pandemic 100,000 Education 50,000 0 • Due to school closures and the economic crisis related to lockdowns, learning-adjusted years of schooling in South Asia April 2018 April 2019 April 2020 are expected to fall by between 0.3 - 0.5 years, translating into an economic loss of US$1.0 -1.9 trillion in lost earnings Source: National TB Elimination Program, 2020 #InvestInPeople South Asia Human Capital Plan 07 CHALLENGES THE THREE MAIN DRIVERS OF POOR HUMAN CAPITAL IN SOUTH ASIA Credit: Shutterstock Credit: Shutterstock Credit: UN Women / Allison Joyce • Quality and effectiveness of • Inequality of opportunities: • South Asians are increasingly services are lacking in both large segments of the vulnerable to a spectrum of public and private arenas population are being left behind shocks and risk factors #InvestInPeople South Asia Human Capital Plan 08 CHALLENGES INVESTMENT IN HUMAN CAPITAL NEEDS TO BE SMARTER TO ACHIEVE FULL BENEFITS A LACK OF QUALITY AND REGULATION UNDERMINES THE IMPACT OF PUBLIC AND PRIVATE SECTOR SERVICE DELIVERY • South Asia’s public spending on human capital sectors • South Asia has increasing geo-spatial disparities, being (share of GDP) is the lowest in the world, limiting the home to the largest cluster of megacities while also facing effectiveness of the state to boost human capital outcomes left out/last mile areas: more than half of the urban populations in Afghanistan, Bangladesh and Nepal live in informal settlements or slums • Services often lack the quality even where coverage is good: South Asian SP benefits are often too small, while overall healthcare access and quality is 2nd lowest in the • Environmental factors in SAR are essential to human capital world wellbeing & development – air quality, water quality >134 million people do not have access to improved drinking water; 68-84% of sources are contaminated • Local governments are not sufficiently empowered or accountable for front-line services: in Bangladesh the central government collects and spends >95% of revenue; • Private and non-state actor performance need to be engaged in Sindh, Pakistan, on average 25-30% of teachers are in service delivery and regulated better in order to enhance absent from school quality and coverage in education and health services #InvestInPeople South Asia Human Capital Plan 09 CHALLENGES INEQUALITY OF OPPORTUNITIES: NEED URGENT REDRESS SO PEOPLE ARE NO LONGER LEFT BEHIND ONLY IF SOUTH ASIA CAN INCLUDE ALL OF SOCIETY – ESPECIALLY ADOLESCENT GIRLS AND WOMEN – BOOSTING AND HARNESSING THEIR POTENTIAL, CAN IT BOTH LEAP AHEAD AND SUSTAIN ITS PRODUCTIVITY GAINS • South Asia has the highest stunting levels in the world • Low empowerment of girls and women lead to inter-generational (33%): 56 million children <5 years face a lifetime of losses: children of adolescent mothers in India fared worse in physical and cognitive deficits mortality, nutrition, and cognitive outcomes than for older mothers • More than half of South Asian children (58%) suffer from • South Asia has the lowest rates for women’s labor force “learning poverty”, unable to read and understand a story participation in the world (23% in SAR vs 47% globally): a huge by age 10, and 35 million children are out-of-school missed opportunity or a huge potential for future gains • South Asia’s potentially large “demographic dividend” is • With the highest rates of Gender-Based Violence in the world, in peril: the vast majority of youth are un/under/informally insecurity and GBV are major barriers to economic participation of employed with precarious livelihoods (Sri Lanka: 66%, women and girls in South Asia Bangladesh: 91%) • Lack of official IDs makes it harder for the poor to access services, • Disparities across income, gender, ethnicity, etc. and for governments to target services: 300 million or 1 in 6 people constrain people’s access to services: the gap among in South Asia lack identification the poorest and richest 20% of households seeking health care persisted over time in South Asia #InvestInPeople South Asia Human Capital Plan 10 CHALLENGES BETTER PREPARDNESS AND PROTECTION CAN REDUCE VULNERABILITY TO A SPECTRUM OF SHOCKS AND RISK FACTORS COVID 19 SHOWS THAT SYSTEMS AND SERVICES WHICH PROMOTE HUMAN CAPITAL ARE NOT A LUXURY; THEY ARE A NECESSITY, CRITICAL TO PREVENTING TRAGIC REVERSALS OF HARD-WON HUMAN CAPITAL ACCUMULATION • South Asia’s vulnerability to climate change is massive: • South Asia has the lowest social protection coverage rate in the 800 million people at risk of lower incomes, 40 million at world; it also has the highest share of out of pocket health financing. risk of becoming climate refugees, living standards to 60 million people are impoverished annually as a result decline from 3-7% by 2050, increased risks of vector- borne and other infectious disease incidence and • NCDs are now the top health risks driving loss of productive life- transmission years across South Asia: >3.2 million deaths/year from NCDs • Environmental pollution - particularly air pollution - is a • Displacement is jeopardizing human capital accumulation, often leading risk factor for premature deaths: 1 out of every among the most vulnerable: of the Rohingya refugees in Cox’s 10 deaths in all countries but Sri Lanka and Maldives is Bazar, >60% of the adults have never attended school due to environmental risks #InvestInPeople South Asia Human Capital Plan 11 STRATEGIC PRIORITIES A 21ST CENTURY FRAMEWORK FOR PRODUCTIVITY IN SOUTH ASIA: 4 “i”s FOR HUMAN CAPITAL ACCELERATION (4i4HCA) WINDOW 1 WINDOW 2 WINDOW 3 WINDOW 4 The analysis of the key drivers of Human Capital outcomes in South Asia calls for a re-imagining of the framework for action: we term this new framework the 4i4HCA or the 4”i”s for Human Capital Acceleration in South Asia, built around 4 windows of opportunity INVEST INCLUDE INSURE INNOVATE SMARTER INNOVATE INNOVATE #InvestInPeople South Asia Human Capital Plan 12 STRATEGIC PRIORITIES 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 1: INVEST SMARTER More and better investments are critical to ensure quality services reach all South Asians so they can enhance their productivity • Focus squarely on raising the quality of services • Align share and efficiency of human capital spending with global benchmarks • Promote a strong regulatory environment in public and private sector delivery • Shine a light on institutional accountability and governance #InvestInPeople South Asia Human Credit: Capital Plan Shutterstock 13 STRATEGIC PRIORITIES 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 2: INCLUDE There is vast untapped economic potential in excluded and vulnerable groups that could be used to power South Asia’s growth • End the lifetime burden of stunting • Prioritize learning poverty to build strong foundations • Empower South Asia’s billion adolescent girls and women • Focus on 21st century skills and productive opportunities for youth • Identify the poor and vulnerable to target services #InvestInPeople South Asia Credit: Human Graham Capital Crouch / World 14 Plan Bank STRATEGIC PRIORITIES 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 3: INSURE Human capital gains can be easily and irreparably lost; environmental protection, insurance, strong public health systems, and investment in scalable safety nets can help protect those gains • Prioritize clean air and clean water • Reduce mortality and morbidity from the four major NCDs • Deepen preparedness of systems and resilience to shocks • Prepare societies for the extreme impacts of climate change • Safeguard displaced human capital #InvestInPeople South Asia Credit: UNHuman WomenCapital Plan Asia and 15 the Pacific STRATEGIC PRIORITIES 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 4: INNOVATE, INNOVATE, INNOVATE Human capital accumulation can be accelerated through digital and other emerging technologies, while ensuring that these technologies bridge inequalities and empower individuals and communities; at the same time, institutional innovations need to be pursued too • Build a tech framework for generating human capital outcomes • Leverage digital technologies to improve real-time delivery of services • Strengthen voice, agency, and empowerment • Deploy multi-sectoral strategies when and where needed #InvestInPeople South Asia Human Credit: Capital Plan Shutterstock 16 STRATEGIC PRIORITIES 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA Success will require country leadership and political will Common yet Evidence driven policy Multi-sectoral projects customized approach development & monitoring where needed Develop Country Human Capital Use COVID-19 as an opportunity to Provide strong, clear government Acceleration Plans collect data on what’s working and where leadership at all levels – central to improve to set-up prepared, scalable, and local Seek out and learn from best shock-adaptive service delivery practices throughout the region Institute a high-level multi-sector and the globe Establish a Human Capital Monitoring coordinating vehicle for project Framework for close monitoring of core development and monitoring of indicators to enable policy makers and long-term outcomes citizen groups to track progress and make course corrections #InvestInPeople South Asia Human Capital Plan 17 STRATEGIC PRIORITIES 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA Progress will require accountability for results These ambitious but achievable targets are Regional for South Asia; progress on any of them will depend on the decisions and actions of each country Outcome indicators (Regional averages) † Baseline (2020) § ** Target (2025) HUMAN CAPITAL INDEX 0.48 0.56 Invest smarter Index of government effectiveness (percentile rank) 36 44 Include Stunting (age 0-5 years) ‡ 30% 16% Child survival (age 0-5 years) ‡ 96.6% 98% Percent of 10-year-olds unable to read basic paragraph (learning poverty) 59% 49% Female labor force participation 40% 50% † Average of 8 countries; not population weighted Prevalence of modern contraception use among adolescent girls 18% 25% ‡ Component of the Human Capital Index Net enrolment rate in secondary school among girls 61% 80% Youth activation (share working among those who are not studying/training, age 15-24) 55% 60% § Data from 2020 or most recent year available; data sources for all indicators are provided on page 68 Insure PM 2.5 air pollution (mean annual exposure, micrograms per cubic meter) 53 40 * The four NCDs are: cardiovascular diseases, cancers, Adult survival (share of 15-year olds who survive to age 60) ‡ 84% 87% chronic respiratory diseases, and diabetes Number of deaths due to NCDs* (ages 30-70, total of all countries) 3.2 mn 2.3 mn ** The simple average of all country stunting rates is used Death rate due to road crashes (per 100,000) 15 10 here in order for the regional target to not be overly affected National disaster risk reduction and shock-responsive safety net score (out of 4) 0.7 1.4 by the numbers of highly-populated countries Social safety net coverage of the poorest quintile 33% 55% Note: All indicators to be disaggregated by sex, by Proportion of children under 5 years of age whose births have been registered with a civil authority 67% 82% socio-economic group, and by geographic area as relevant #InvestInPeople South Asia Human Capital Plan 18 STRATEGIC PRIORITIES 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA Countries have started the journey, with room to do even better Outcome indicators Current best performer † Current lowest ranked † HUMAN CAPITAL INDEX Sri Lanka (0.60) Afghanistan (0.40) Invest smarter Index of government effectiveness (percentile rank) Bhutan (67) Afghanistan (8) Include Stunting (age 0-5 years) ‡ Maldives (15%) Pakistan (38%) Child survival (age 0-5 years) ‡ Sri Lanka (99%) Pakistan (93%) Percent of 10-year-olds unable to read basic paragraph (learning poverty) Sri Lanka (15%) Afghanistan (93%) Female labor force participation Nepal (83%) India (21%) Prevalence of modern contraception use among adolescent girls Bangladesh (47%) Maldives (0%) † Best and lowest among countries with Net enrolment rate in secondary school among girls Sri Lanka (92%) Pakistan (34%) available data Youth activation (share working among those who are not studying/training, age 15-24) Nepal (68%) India (41%) ‡ Component of the Human Capital Index Insure PM 2.5 air pollution (mean annual exposure, micrograms per cubic meter) Maldives (8) Nepal (100) * The four NCDs are: cardiovascular Adult survival (share of 15-year olds who survive to age 60) ‡ Sri Lanka (90%) Afghanistan (79%) diseases, cancers, chronic respiratory Rate of deaths per 100,000 due to NCDs* (ages 30-70, total of all countries) Maldives (147) Afghanistan (557) diseases, and diabetes Death rate due to road crashes (per 100,000) Maldives (0.9) India (22.6) Note: (1) All indicators to be National disaster risk reduction and shock-responsive safety net score (out of 4) Sri Lanka (1.6) Afghanistan/Bhutan (0) disaggregated by sex, by socio-economic Social safety net coverage of the poorest quintile India (96%) Bhutan (4%) group, and by geographic area as relevant; (2) data sources for all indicators Proportion of children under 5 years of age whose births have been registered with a civil authority Bhutan (100%) Bangladesh (20%) are provided on page 68 #InvestInPeople South Asia Human Capital Plan 19 WB PARTNERSHIP 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA The WBG is fully committed to this agenda Common yet Evidence driven policy Multi-sectoral customized approach development & monitoring projects where needed Support the development of Country Include human capital index, components, and key Mobilize a whole of WBG approach, across Human Capital Acceleration Plans that drivers in core analytics sectors, to tackle human capital priorities factor in COVID-19 response and recovery Develop analytical basis to help formulate leading Promote a consistent and collaborative multi- The World Bank will utilize its Country and lagging indicators – both for the Bank and sectoral focus and convergence; leveraging Partnership Framework to support human Governments technology in a region that is a leader in doing so capital priorities; this will include doubling human capital commitments from 2019 to Facilitate evidence and knowledge generation and Utilize Human Capital-focused Development Policy 2025 and more analytical support transfers within the Region and across the world Financing to safeguard gains, foster reforms #InvestInPeople South Asia Human Capital Plan 20 WB PARTNERSHIP 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA Intermediate indicators to track WBG performance They focus on scaling up Bank financing, promoting a human capital focus in Human Development (HD) and critical non-HD programs, increasing cross-sectoral coordination, leveraging technology and innovation, and generating human capital advocacy and sharing knowledge • Volume (US$ M) of IBRD/IDA aggregate commitments for Human Capital (HD+critical non-HD investments**) • Share (%) of Development Policy Operations with prior actions related to Human Capital • Share (%) of country programs that include Advisory Services and Analytics with a Human Capital focus • # of South Asian countries with a prioritized Human Capital Plan under implementation • # of HD operations that include private sector/non-state actor activity in service delivery • # of knowledge-exchanges and/or outreach to civil society for cross-country learning on Human Capital issues • Share (%) of HD projects with sex-disaggregated indicators (to better monitor gender differentiated impact) • Climate Co-Benefits of new HD operations • Share (%) of new lending -- HD and non-HD -- that includes measures to prevent and/or mitigate against GBV • Share (%) of HD operations making use of technology to improve human capital outcomes Credit: Simone D. McCourtie / World Bank **To include, inter alia, investments in WASH, reductions in air pollution, energy solutions for schools and health facilities, road traffic crash reduction measures, etc. #InvestInPeople South Asia Human Capital Plan 21 WB PARTNERSHIP 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA Mobilizing to protect Human Capital: WBG COVID-19 response Social Protection and Jobs Health Education New SPJ projects planned in all South Asia On April 2, 2020, the World Bank’s Executive On April 2, 2020, the World Bank’s Executive countries for a total of at least US$1.9 billion, Board approved COVID-19 emergency Board approved COVID-19 emergency of which US$1.5 billion to be disbursed by response health projects in 5 South Asian response health projects in 5 South Asian end-June 2020 in Bangladesh, India, and countries, with the remaining 3 approved by countries, with the remaining 3 approved by Pakistan, with additional repurposing of end-April for a total of US$1.57 billion end-April for a total of US$1.57 billion resources to be done in Nepal, Maldives and Sri Lanka Projects cover short and medium-term Projects cover short and medium-term response activities including case response activities including case Project activities aim to: (1) Adjust cash identification, contact tracing, procurement of identification, contact tracing, procurement of transfer programs to ensure continuous (or medical supplies, infection prevention, medical supplies, infection prevention, increased) support to the poor and training for health personnel, community training for health personnel, community vulnerable; (2) Expand cash transfer engagement, and building systems for engagement, and building systems for programs to include newly vulnerable monitoring, evaluation, and research monitoring, evaluation, and research households and individuals; (3) Promote employment retention/restoration and Analytics underway on impacts on delivery of Analytics underway on impacts on delivery of support workers; and (4) Make social essential health services, health outcomes essential health services, health outcomes protection more responsive to shocks #InvestInPeople South Asia Human Capital Plan 22 WB PARTNERSHIP 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA A new focus on Technology for Human Capital Anchoring WBG support in our core values, squarely focused on tackling (digital) inequalities and targeting vulnerable groups • Act fast on 3-5 reform priorities; draw up actionable roadmaps, top down & bottom up • Build resilient public service infrastructure and mobilize decentralized delivery capacity Boosting technology awareness among countries and Bank teams • Engage clients in joint simulations and adaptive management in anticipation of future crises; build trust through co-design • Pivot global HD expertise and data to provide real time support to front line teams and expand collaboration with contributing GPs Redoubling HD’s Advisory Services to shape recovery for a better digital future post-COVID • Use public expenditure analysis to develop technology pathways and impact whole-of-government decisions • Engage on regulation & digital policy frameworks (data protection, dual use, innovation) Leveraging WBG’s convener and catalyst role to connect with stakeholders & HD eco-systems • Scale up knowledge exchange & rapid piloting with STI networks, public & private decision-makers (e.g., Nepal) • Focus country-level aid coordination on technology integration to reduce overlap and duplication • Finance provision of global public goods to address local needs Anticipating and mitigating technology risks • Avoid single-solution provider lock-ins; create feedback loops against bias • Pursue interoperability and open source standards; address bottlenecks in technology procurement • Take positions against misuse, cyber crime #InvestInPeople South Asia Human Capital Plan 23 WB PARTNERSHIP 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA For results, actions are required at both Regional and national levels, and across sectors: Examples DD + SPJ + FCI on financial inclusion and modern payment systems AGR + HNP on food safety, food fortification, and One-Health approach to disease control IFC + SPJ Developing innovative services for aging urban populations MTI + HNP on tobacco taxation to reduce NCD risk factors and boost domestic revenues TR + URL + SPJ on safer transport systems and public spaces for EEX + EDU on climate-adapted cooling/heating options for schools women and girls for an optimal learning environment EDU + HNP + SPJ Spearheading the dialogue on Empowerment of HNP + SPJ on health insurance for the poorest Adolescent Girls and Women SPJ + URL on developing shock-responsive safety net systems EDU + SPJ on skill development for youth and labor force through training/retraining opportunities REGIONALLY ALIGNED ACTIONS The WB is ramping up support to human capital areas such as labor migration, educational centers of excellence, and disease surveillance and pandemic preparedness where Regionally aligned actions are critical to achieve results COLLABORATE-CONVERGE-LEVERAGE-MEASURE: Requires a consistent and collaborative multi-sectoral focus; convergence of actions across sectors; leveraging of technology in a region that is relatively amenable to doing so; and facilitating evidence/knowledge generation and transfers across the region and the world World Bank Global Practice acronyms used above: AGR: Agriculture; DD: Digital Development; EDU: Education; EEX: Energy and Extractives; FCI: Finance, Competitiveness and Innovation; #InvestInPeople HNP: Health, Nutrition and Population; MTI: Macroeconomics, Trade and Investment; SPJ: Social Protection and Jobs; TR: Transport; URL: Urban, Disaster Risk Management, Resilience South Asia Human Capital Plan 24 and Land; IFC: International Finance Corporation of the World Bank Group 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA THANK YOU Building Human Capital is a long-term venture and requires focus, political will, and a whole-of-government approach across successive administrations Achieving such a strategic shift in the Human Capital narrative will be critical to enable South Asia to lead the 21st century for its citizens and for the people of the world #InvestInPeople South Asia Human Credit: Capital Adobe Plan Stock 25 DEEP DIVE 1 4i4HCA Strategic Priorities in South Asia SOUTH ASIA HUMAN CAPITAL ACCELERATION PLAN #InvestInPeople South Simone Credit: Asia Human Capital Plan D. McCourtie 26 / World Bank 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 1: INVEST SMARTER FOCUS SQUARELY ON RAISING THE QUALITY OF SERVICES Why? • Quality concerns in both public and private service delivery remains highly variable, especially those accessible to the poor; unless addressed, human capital outcomes will fall short What is being proposed? EDUCATION SAFETY NETS HEALTH JOBS • Teacher training, mentoring, • Targeting intended • Licensing of practitioners and • Comprehensive programs and materials beneficiaries facilities, public and private addressing all constraints • Well-equipped classrooms • Benefits are adequate • Strategic purchasing • Scale to address stock and flows • CCTs to encourage use of instruments basic services Improve service infrastructure: Functioning electricity, water, and sanitation Countries in the Region have introduced innovations: • Linkages between safety nets and use of services (Bhutan) • Measuring student learning gains and higher-order thinking skills among engineering students using internationally comparable assessments (India) • Health service quality monitoring through facility dashboards, citizen engagement via district and state assemblies (Tamil Nadu State, India) #InvestInPeople South Asia Human Capital Plan 27 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 1: INVEST SMARTER ALIGN SHARE AND EFFICIENCY OF HUMAN CAPITAL SPENDING WITH GLOBAL BENCHMARKS Why? • South Asian countries have some of the lowest social sector budget shares and low efficiency; need to spend more on these sectors but also spend better What is being proposed? • Improving revenue-generation efforts • Education: focusing more on early childhood education, job market skills focus • Health: integrating services across levels of care and across public/private provision, while also promoting use of strategic purchasing to improve efficiency and accountability • Social protection: ensuring full coverage of vulnerable groups by smart safety nets linked to human capital Countries in the Region have introduced innovations: • Increasing focus of social protection on the poorest households (Bangladesh) #InvestInPeople South Asia Human Capital Plan 28 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 1: INVEST SMARTER PROMOTE A STRONG REGULATORY ENVIRONMENT IN PUBLIC AND PRIVATE SECTOR DELIVERY Why? • Setting standards as well as even-handed enforcement is key to unlocking improved outcomes What is being proposed? • Regulate: set standards for both public and private service providers; ensure adequate environmental health and safety • Enforce standards: e.g. food safety; emissions; water management; road safety; workplace safety Countries in the Region have introduced innovations: • Investment in a biometric/photo system has allowed the removal of 6000 ghost teachers from payroll, this biometric identification-based solution was launched to address teacher absenteeism, missing facilities, and student attendance and enrollment allowing timely policy actions (Sindh Province, Pakistan) • Online system for fair and transparent teacher recruitment and transfer decisions (Karnataka State, India) #InvestInPeople South Asia Human Capital Plan 29 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 1: INVEST SMARTER SHINE A LIGHT ON INSTITUTIONAL ACCOUNTABILITY AND GOVERNANCE Why? • Improved accountability is essential for improved efficiency of spending, quality of services, and better human capital outcomes What is being proposed? • Instituting Balanced Scorecards, geo-monitoring, statistical analytics, corruption identification/response, participatory community oversight committees • Adopting merit-based recruitment, such as for school teachers • Performance-based contracting in service provision Countries in the Region have introduced innovations: • Strong government oversight of performance-based contracts with non-state actors in health (Afghanistan) #InvestInPeople South Asia Human Capital Plan 30 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 2: INCLUDE INVESTING IN ENDING THE LIFETIME BURDEN OF STUNTING Why? • Adequate nutrition and stimulation during conception through age 2 years profoundly impacts the cognitive and productive potential of a child for the entirety of their life • Mobile and Web-Based Applications in India’s National What is being proposed? Nutritional Mission (POSHAN Abhiyaan) • Focusing on the first 1000 days of the child’s life • Delaying motherhood beyond adolescence, ensuring maternal health and nutrition • Help deliver services more • Promoting exclusive breastfeeding, good infant and child feeding practices, early stimulation effectively • Addressing environmental factors, e.g. WASH, air pollution, food safety, food fortification • Facilitate better supervision and • Implementing programs at scale to have impact at scale use of data for decision-making • Improve beneficiary outreach Countries in the Region have introduced innovations: through direct system generated • 1.4 million women Anganwadi community workers are delivering nutrition services and early SMS alerts stimulation (India) #InvestInPeople South Asia Human Capital Plan 31 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 2: INCLUDE ELIMINATE LEARNING POVERTY TO BUILD STRONG FOUNDATIONS Why? • Without the ability to read, the child cannot make any further advances in learning outcomes In Punjab and Sindh, PPPs cover almost 15% of the system providing What is being proposed? free access to schools to the poorest. Impact evaluation shows: • Boosting learning through scale up of publicly supported early childhood stimulation and education • Following-through with the promise of free education for all, augmented by stipends/scholarships • In Sindh: PPP increased for the most vulnerable enrolment by 30 percentage • Ensure schools are a safe place to learn free of corporal punishment and gender-based violence points for all and increased • Provide local languages books and reading material for young readers at large scale in schools and learning outcomes by 0.67 through other facilities (libraries or make-shift libraries) Standard Deviations • Investing in well-trained teachers and supportive supervision plus decentralized community oversight • In Punjab: vouchers increased private school enrolment by 7.5 percentage points for girls, and Countries in the Region have introduced innovations: 4.2 percentage points for boys • Community outreach to provide early stimulation; scripted lesson plans and mentoring for teachers (Punjab Province, Pakistan) • Community based schools to increase access in FCV (Afghanistan) #InvestInPeople South Asia Human Capital Plan 32 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 2: INCLUDE EMPOWER SOUTH ASIA’S BILLION ADOLESCENT GIRLS AND WOMEN Why? • Poor nutrition and health, early marriage/childbearing, school drop-out and poor school-to-work transition of adolescent girls curtails human capital accumulation of two generations, perpetuates the intergenerational cycle of poverty, limits the opportunity to harness a demographic dividend; that is why the empowerment of adolescent girls and women is potentially one of the most important investments in galvanizing productivity growth in South Asia What is being proposed? • The next frontier in building the human capital of adolescent girls and women requires unified national programs at scale, with incentives linked to results, a platform for continuous learning and knowledge-sharing, and coordinated in a cross- sectoral framework to: “ENHANCE, ENABLE, AND EMPLOY” ENHANCE: delivery of health, nutrition, education ENABLE: people to make better decisions and social norms to change EMPLOY High quality nutrition and health services tailored to adolescent girls and boys Community-based programs to bring changes in social norms targeted to Increase # of female and subject matter teachers, so that STEM track can be adolescents, their families, their communities, typically including “safe spaces” for offered equally to girls, boys Enabling environment in schools to cut secondary school drop-outs for girls and girls, mentorship, life skills, income generation boys (e.g. separate functional toilets for girls, sanitary napkins in schools) Stimulate demand for women’s labor in 21st century fields, especially STEM jobs, Social and behavior change communication to change social norms, including green jobs; and support increased demand in sectors already female-dominated Supplementary education content on gender norms, toxic masculinity, life skills, direct outreach to men and boys with info to address risky behaviors, GBV, toxic (e.g. garments) self-image, and aspirations for both boys and girls masculinity Private sector partnerships, regulation, and incentives to make workplaces Female-friendly skilling program and support to improve entry/retention of women CCTs to nudge behaviors on use of health/nutrition services, completion of sec female-friendly in the workforce school, delaying marriage Strengthen participation of young women in self-help groups, especially to support Building coalitions with religious leaders on girls’ education and women’s health Safe spaces in cities and on transport, cross sectoral action to prevent violence, empowerment of married adolescents; increase child care support survivors #InvestInPeople South Asia Human Capital Plan 33 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 2: INCLUDE FOCUS ON 21ST CENTURY SKILLS AND PRODUCTIVE OPPORTUNITIES FOR YOUTH Why? • Improved access to skills for the 21st century’s changing job markets, and accelerated Percentage of firms that indicate creation of youth and female-friendly “good” jobs would enable millions more people to hiring was a challenge due to a lack move out of their current vulnerability in the informal sector and contribute more productively of required skills and face less insecurity 25 What is being proposed? 20 • Equipping youth (male and female) with socio-emotional competencies, labor-market relevant 15 skills, access to assets/finance, shifting work norms, support for child and elder care • Boosting creation of quality jobs via increased rural productivity, agribusiness, infrastructure, 10 good governance 5 • Promoting safe international economic migration and portability of social benefits for migrants 0 Countries in the Region have introduced innovations: Afghanistan 2008 Bangladesh 2007 • Scaled up comprehensive packages that address multiple constraints faced by youth (Nepal) Sri Lanka 2011 Pakistan 2007 Nepal 2009 • Improving employability of youth from low-income households (Bangladesh) India 2006 Source: Enterprise Surveys, multiple years #InvestInPeople South Asia Human Capital Plan 34 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 2: INCLUDE IDENTIFY THE POOR AND VULNERABLE TO TARGET SERVICES Integrated social registries are linked to all social protection programs and not only help Why? improve targeting and • Well-targeted safety nets with wide and deep coverage can boost capacity of poor identification, but also lead to a households, incentivize investments, link the poor to services, promote social capital, and more harmonized system that increase participation increases coordination among programs and reduces duplication What is being proposed? • Developing National Identification/Social Registries for use by social programs to better identify and target beneficiaries, as well as assure these households’ eligibility for programs If it covers a large part of the population, it can also save time Countries in the Region have introduced innovations: and resources needed to expand coverage in times of crisis • In Pakistan, the National and Socio Economic Registry (NSER) covers almost 80% of the population and is instrumental in identifying vulnerable groups. (Other examples: India, Sri Lanka) For example, Pakistan managed to provide relief to all the BISP • Cash transfers • Housing benefits beneficiaries (the national safety • Social pension and other allowances • Energy and other subsidies nets program) as well as to an • Health benefits • Education and training additional 7.5 million non-BISP • Social services • Labor and employment users by expanding the coverage • Emergency Assistance • Productive Inclusion using NSER • In-kind programs • Legal Services #InvestInPeople South Asia Human Capital Plan 35 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 3: INSURE PRIORITIZE CLEAN AIR AND CLEAN WATER India Clean Air Initiative Why? • South Asia can make major inroads into the high human capital costs it bears from the current level of environmental pollution (air and water), a leading risk factor for deaths, illness, stunting, and poorer learning outcomes What is being proposed? • Promoting an airshed-based management approach across boundaries • Tackling water contamination alongside air pollution • Power generation/industry—enforcing standards, promoting cleaner energy • Target of 20-30% reduction of PM2.5 and PM10 • Agriculture—reducing crop burning and promoting efficient fertilizer use concentrations by 2024 • Transport—using higher vehicle standards and promoting public transport (rather than private transport) • Action Plans for 122+ non- • Residential–-promoting LPG and clean cooking stoves attainment cities by • Making air quality and water quality data available in real time regulators • Sector initiatives expected to Countries in the Region have introduced innovations: yield air quality co-benefits • Flagship multi-sector initiative to dramatically improve air quality with national level targets (India) • 10 crores IR allocated to 28 • Import duty on improved cookstoves reduced by 10%, making cleaner cooking technologies more cities to implement Action Plans (2019) affordable (Bangladesh) • National Knowledge Network #InvestInPeople South Asia Human Capital Plan 36 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 3: INSURE REDUCE MORTALITY AND MORBIDITY FROM THE FOUR MAJOR NCDS* * Diabetes, cardiovascular disease, cancer, chronic respiratory diseases Why? • In every country in South Asia NCDs now represent a much higher share of healthy years lost than do communicable diseases; early detection and treatment of the primary risk factors for NCDs can save millions of lives, while also ensuring “healthy aging”, thereby enabling longer and more productive life years; finally, reduced co-morbidities from NCDs improve people’s ability to fight infectious diseases such as COVID-19 What is being proposed? • Prevent the onset of NCDs by promoting behavior change and reducing risky behaviors, e.g. tobacco and alcohol control; or dietary change, e.g. sugar and sodium reduction • Protecting the population through early, at scale detection via the primary health care system • Establishing health information systems capable of tracking and treating patients over prolonged periods • Regulating food production systems to make foods safer and healthier, e.g. transfat elimination • Innovating to devise affordable treatment models of chronic care for poor and middle-class households • Alongside NCDs, focusing on reducing road traffic injuries would save many lives at the peak of their productivity; this requires coordinated action to strengthen licensing, regulation, enforcement, trauma care Countries in the Region have introduced innovations: • Focus on prevention and pro-active screening for NCDs (Bhutan, India (Tamil Nadu State), Sri Lanka) • Income-differentiated pricing policy for dialysis services at Gonoshasthaya Kendra (Bangladesh) #InvestInPeople South Asia Human Capital Plan 37 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 3: INSURE DEEPEN PREPAREDNESS OF SYSTEMS AND RESILIENCE TO SHOCKS India’s Pradhan Mantri Jan Arogya Yojana (PMJAY) targets the bottom 40% of the Why? population (500 million+ people) in rural and urban areas, and is • As COVID-19 shows, the lack of adequate safety net or insurance mechanisms against shocks the world’s largest fully (e.g. droughts, floods, loss of livelihood, disease) results in millions of people suffering government-funded health catastrophic losses with knock-on effects in terms of losing human capital, often permanently insurance scheme What is being proposed? The objective is to reduce catastrophic and impoverishing • Protecting the population through universal health coverage and financing mechanisms to avoid impoverishing out-of-pocket expenses (OOP) costs at the point of service delivery due to hospitalization: 17% of • Implementing shock-responsive safety nets for rapid scale-up: early warning systems, triggers, contingent financing, Indian families (over 200 million coordination mechanisms, identification procedures, m-payment platforms people) incur catastrophic health • Ensuring academic continuity through flexible education systems using multiple modalities for teaching and learning expenditures or >10% of total spending each year due to • Improving health system capacity for pandemic preparedness and response by deploying One Health approaches, health OOP public health surveillance, improved diagnostics and infection prevention and control, and surge capacity for health workers and service delivery • Social pension mechanisms for the elderly Countries in the Region have introduced innovations: • Targeted Cash Transfer programs were rapidly scaled up to help cushion the economic impact of the COVID-19 related lockdowns on the poor (India, Pakistan, Sri Lanka) • DRM financing strategies that combine budget funds, contingency financing, insurance, etc. to lower the cost of timely response to shocks (The Maldives) #InvestInPeople South Asia Human Capital Plan 38 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 3: INSURE PREPARE SOCIETIES FOR THE EXTREME IMPACTS OF CLIMATE CHANGE India has used its response to COVID-19 as an opportunity to start planning medium and long- Why? term programs that can protect and build resilience of • Addressing population vulnerability to climate change is essential to safeguard human capital vulnerable households against future shocks Some of the ex-ante What is being proposed? interventions include setting up social insurance for life, health, • Strengthening early warning systems, social safety nets, and post disaster recovery and accidents; scale up existing • Promoting green buildings (e.g. schools, health facilities) safety nets and complement • Promoting climate resistant agriculture: diversifying sources of income, diversified and resilient crops these interventions with • Preparing communities for changing patterns of vector-borne and other infectious diseases provision of livelihoods and jobs Countries in the Region have introduced innovations: • Analysis of the public budget is being undertaken to identify options to build effective contingency reserves to mitigate climate impacts (Afghanistan) • Building resilience of households against future shocks (India) #InvestInPeople South Asia Human Capital Plan 39 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 3: INSURE SAFEGUARD DISPLACED HUMAN CAPITAL There are laws that regulate recruitment and placement of migrant workers from Why? Bangladesh, as well as a welfare fund that is used to • Forced displacements are on the rise, including internally-displaced persons (IDPs), and enhance language skills, refugees, driven by severe climatic shocks or conflicts; they need comprehensive support to introduce service desks at (re)build human capital and prevent inter-generational negative impacts; economic migrants airports, and to support workers also move within or outside the country for better opportunities and require protection of rights at their destinations through Bangladesh embassies and services In 2012, Bangladesh and What is being proposed? Malaysia signed a bilateral • Ensuring comprehensive support to displaced households including basic services, GBV, livelihoods agreement to better regulate • Building an inclusive approach and supporting host communities to reduce risk of local conflict and control economic migration • Ensuring a conducive regulatory environment (e.g. portable benefits, labor agreements) for safe and secure migration Countries in the Region have introduced innovations: • Emergency Recovery Project for Temporarily Displaced People to help rehabilitate IDPs (Pakistan) • Emergency Multi-Sector Rohingya Crisis Response Project, which provides community works and services, and prevents GBV (Bangladesh) • Bilateral agreements between governments to set up regulatory frameworks that protect the rights of migrant workers and ensure secure migration (All) #InvestInPeople South Asia Human Capital Plan 40 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 4: INNOVATE, INNOVATE, INNOVATE BUILD A TECH FRAMEWORK FOR GENERATING HUMAN CAPITAL OUTCOMES HD/Other sector technology Skills and knowledge Policies and institutions Technology for functions performed by key sectoral actors. Ability to adopt and utilize technology; to create jobs or Digital (industrial) policies and institutions Tend to be analogue, pre-/early-digital be employed (rather than displaced by automation) Data, security, analytics, management of Entrepreneurship; firm capabilities Government government platforms Market-relevant, employable skills; “digital skills” Intellectual property, competition Manage delivery system efficiently, effectively, accountably Ability to develop and adapt technology; access and Broader domains pertaining use of S&T for economy, Enable frontline; plan, monitor results and respond apply expertise to design and improve systems society, sustainability (inclusion, resilience) Frontline Service Delivery Manage local delivery chains & beneficiary touch points (Medical, pedagogical, poverty-reducing) Crisis preparedness / response mechanisms Deliver with quality research & innovation National and international science-policy advisory (teach, diagnose / cure, target and transfer) STEM teaching/learning (tertiary, postdoctoral) Citizen / Community Afford & improve lives; make & own decisions; acquire capabilities Protect members livelihood; influence the system Technology to transform (inter-)sectoral systems by shifting the dynamics among actors (also empowering). Tend to be advanced digital Ecosystem-building data systems, government-as-a-platform Credit: Shutterstock Building blocks e.g. connectivity, ID, payment #InvestInPeople South Asia Human Capital Plan 41 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 4: INNOVATE, INNOVATE, INNOVATE LEVERAGE DIGITAL TECHNOLOGIES TO IMPROVE REAL-TIME DELIVERY OF SERVICES Why? Improving Payment Systems • The full potential of digital technologies and explosion of data can be deployed to re- with Innovation and Technology design services with a focus on the end user, such that services can be delivered at scale with greater targeting and customization, in real-time G2P 3.0 Delivery over multiple channels and choice What is being proposed? G2P 2.0 • Electronic data capture for greater insight into program performance such as school Digital delivery over a single channel attendance, learning evaluations, communicable disease spread • Satellite monitoring of crop productivity in agriculture, population movements, G2P 1.0 Cash delivery extreme weather • Data-driven risk identification and triggering of response (early warning systems) for While most social protection programs floods, droughts, communicable disease spread tend to have a basic G2P system (cash • Dynamic social registries of vulnerable populations for better targeting or single channel), Bangladesh is • Build government capacities for leading digital transformation, setting policies, and making the leap to version 3 of G2P, implementing programs with use of multiple commercial channels, inter-operable with the National ID system for ID verification Countries in the Region have introduced innovations: and with Banks/Mobile Financial Service • Government to People (G2P) systems (Bangladesh) Providers for account verification and to exchange information on ID verification #InvestInPeople South Asia Human Capital Plan 42 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 4: INNOVATE, INNOVATE, INNOVATE STRENGTHEN VOICE, AGENCY, AND EMPOWERMENT The innovative SafeTiPin App leverages information and data – such as photos of public infrastructure – collected through their apps to create safe and inclusive Why? environments, especially for women • The convergence of information and communication technologies with biological and physical technologies, offers great potential for increasing human capital SafeTiPin has information on over 50 cities in India and globally. Impacts include the installation of improved lighting at over 5000 spots in Delhi as a What is being proposed? result of their safety mapping • Create/ expand ecosystems and platforms for innovation, focusing on real-life Human Capital challenges which empower communities and/or vulnerable groups and increase resilience • Create policy frameworks/ regulations for data collection, storage and use/ transparency and accountability, ensure privacy of and agency over individual data • Strengthen Science, Technology and Innovation capabilities, including through open data/science platforms Countries in the Region have introduced innovations: • In Sindh, a mobile app offering curriculum-aligned content, chat rooms for teachers and students, and basic assessments was launched as a resilient continuity measure during the pandemic (Pakistan) • Technology solutions to improve classroom instruction have been developed, piloted, and started to be scaled-up in various South Asian countries, eg the introduction of QR codes in textbooks is a prime example which provides a gateway to topic-specific dynamic online content for learners and teachers (India) #InvestInPeople South Asia Human Capital Plan 43 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA WINDOW 4: INNOVATE, INNOVATE, INNOVATE DEPLOY MULTI-SECTORAL STRATEGIES WHEN AND WHERE NEEDED Why? • Human capital outcomes often require concerted action across sectors and/or convergence approaches What is being proposed? • Convergence of spatially focused investment strategies across health, education, WASH, energy, roads, etc. for high-density, low-income urban areas • Coordinate actions across sectors: for example, incentives for use of services in safety nets; screening for GBV in health clinics; nutrition education in schools; climate-smart investments in public works • Use the revenue from a carbon tax to boost social assistance spending • Establish links between HD plans and local and national climate action plans and disaster management plans Countries in the Region have introduced innovations: • CAT-DDOs to promote multi-hazard disaster risk preparedness and rapid response, including for epidemics (The Maldives, Bhutan, Nepal) #InvestInPeople South Asia Human Capital Plan 44 DEEP DIVE 2 Main Drivers and Challenges for Human Capital Development in South Asia SOUTH ASIA HUMAN CAPITAL ACCELERATION PLAN #InvestInPeople South Credit: Asia Human Visual Capital Plan News Associates 47 / World Bank INVESTMENTS NEED TO BE SMARTER, WITH A FOCUS ON QUALITY OF SERVICES A lack of quality and regulation undermines the impact of public and private sector service delivery #InvestInPeople South Asia Human Credit: Capital Plan Shutterstock 46 LOW AND INEFFICIENT PUBLIC SPENDING LIMITS THE EFFECTIVENESS OF THE STATE TO BOOST HUMAN CAPITAL OUTCOMES GOVERNMENT HEALTH + EDUCATION + % of GDP SAFETY NET SPENDING SHARE OF GDP 8 • As a share of GDP, public spending on education, health, or social protection is the lowest in the world in South Asia % of GDP 6 6 • This is due to a combination of low domestic revenue mobilization, low prioritization of social sectors, and variable absorptive capacity • In education, the % of public spending on early childhood development is 4 4 too low • In health, greater focus in public spending is needed on raising quality of 2 2 care and ending high out-of-pocket costs • In social protection, public spending is often dominated by schemes for formal sector workers, while programs targeting the poor and vulnerable 0 0 remain weak Sub-Saharan Africa India Bhutan Middle East & North Africa Nepal Latin America & Caribbean Europe & Central Asia Bangladesh South Asia East Asia & Pacific Sri Lanka Pakistan Maldives Source: World Development Indicators, 2019; WHO, multiple years #InvestInPeople South Asia Human Capital Plan 47 EVEN WHEN COVERAGE IS ACHIEVED, SERVICES OFTEN LACK THE QUALITY THAT 21ST CENTURY SOUTH ASIANS EXPECT AND DEMAND In social protection, benefits are often too Despite pockets of excellence, the overall 10.5 years of schooling per child falls to 6.2 small (only 6% of household expenditure Healthcare Access and Quality (HAQ) Index for years equivalent when adjusted for quality on average) to significantly reduce poverty South Asia Region is the 2nd lowest in the of learning: this “learning gap” is among the and/or to increase the use of basic services world highest in the world 2.0 20% HAQ Index 70 ECA 14 1.5 15% EAP 12 60 LAC 10 1.0 10% MENA 8 GLOBAL 6 50 0.5 5% 4 SAR SSA 2 40 0 0 0 Europe & Central Asia South Asia East Asia & Pacific Sub-Saharan Africa Middle East & North Africa Latin America & Caribbean Sri Lanka Pakistan Afghanistan India Nepal Bangladesh 30 2000 2005 2010 2015 Year Average per capita transfer (daily $ppp) Adequacy of benefits (%) Average years of attendance Leaning-adjusted years of school Source: ASPIRE database, multiple years Source: GBO 2015 Healthcare Account and Quality Collaborators, Lancet (2017) Source: World Bank Estimates, 2020 #InvestInPeople South Asia Human Capital Plan 48 LOCAL GOVERNMENTS ARE NOT SUFFICIENTLY EMPOWERED OR ACCOUNTABLE TO THE PEOPLE TO DELIVER FRONT-LINE SERVICES CRITICAL FOR HUMAN CAPITAL • In federal systems, political jockeying among different parties controlling • Unitary systems face long roads to build up local government capacities different federal jurisdictions can lead to limited cooperation/ coordination in service delivery • In Bangladesh, the central government collects and spends more than 95% of revenues, limiting local autonomy • In the “mature” federations of India and Pakistan, local governments are subordinated to states and provinces, which have centralized power and • In Afghanistan, all sub-national governments are presidential resources within their jurisdictions appointees with practically no fiscal autonomy • In Nepal, which is exploring federalism, the tradition of local/community governance is a strong building block but the risk of politicization of inter- governmental relations cannot be under-estimated • Both Federal/Unitary governments need to strengthen their own capacity for evidence-based policy-making, as well as regulation and coordination of equitable and efficient sub-national service delivery • Inter-governmental fiscal transfers play a critical role but the determination of their distribution is often politicized #InvestInPeople South Asia Human Capital Plan 49 MOST CITIES FAIL TO SERVE THE NEEDS OF THEIR BURGEONING POPULATIONS AS THEY ASPIRE TO BUILD BETTER LIVES FOR THEMSELVES, THEIR CHILDREN • South Asia is home to the largest global cluster of megacities, ESTIMATED SHARES OF URBAN with the urban population to rise by 250 million more by 2030 POPULATION LIVING IN SLUMS • More than half the urban populations in Afghanistan, Bangladesh, Urban population in slums (%) 100 and Nepal live in informal settlements or slums 80 • Issues are multi-sectoral: poverty, inadequate housing and infrastructure, missing basic services, limited transport and 60 accessibility, and low safety, especially for women • Weak coordination, lack of convergence across investments 40 20 0 India Nepal Bangladesh Sri Lanka Pakistan Afghanistan Source: UNESCAP 2012; UN-HABITAT 2013; Census of India 2013 #InvestInPeople South Asia Human Credit: Capital Plan Shutterstock 50 HUMAN CAPITAL OUTCOMES DEPEND ON SERVICES AND INVESTMENTS IN MULTIPLE SECTORS BEYOND HUMAN DEVELOPMENT • Almost 90% of households have access to electricity but per capita consumption in South Asia is only 1/3rd of the world average • In Bangladesh, only 21.5% of health facilities reported having regular electricity • In India, only 64.42% of schools had electricity connections in 2016-17 • More reliable and cleaner energy can lead to longer school/clinic hours, more nighttime learning, better functioning facilities • Over 134 million people still do not have access to improved drinking water, while an estimated 68 to 84% of water sources are contaminated • 27,000 children under 5 die from diseases caused by poor WASH in Bangladesh and Pakistan every year • 69 million people do not have access to proper sanitation facilities in Pakistan • In Nepal 46% of the rural population (10.3 million people) do not have access to an all-season road • In India, improved road connectivity led to increased school enrollment of younger children (5 to 14 year-olds) by 5 percentage points • In Pakistan, pregnant women in villages with road access were 14 percentage points more likely to go for prenatal consultations #InvestInPeople South Asia Human Capital Plan 51 GIVEN WEAK REGULATORY FRAMEWORKS AND CAPACITY, PRIVATE AND NON-STATE ACTOR PERFORMANCE IN SERVICE DELIVERY IS HUGELY VARIABLE • Private and/or non-state actors represent a significant share SHARES OF CHILDREN IN of provision of education and health services, often PRIVATE SCHOOL surpassing public provision, but with same gaps in quality Among age 6-16 enrolled in school, • Strong government oversight matters: In Afghanistan, basic using consumption quintiles health service delivery has been contracted out to NGOs under close performance management by the government, 80 resulting in sustained improvements in outcomes 60 • Private service delivery can bridge gaps in coverage but also 40 reinforce patterns of inequality: for example, schooling costs 20 segment the education service sector into different markets 0 Bangladesh India Pakistan Bottom 20 Top 20 Source: World Bank, “Ready to Learn”, 2020 #InvestInPeople South Credit: Asia Human Visual Capital Plan News Associates 52 / World Bank INEQUALITY OF OPPORTUNITIES: LARGE SEGMENTS OF THE POPULATION ARE BEING LEFT BEHIND Only if South Asia can include all of society, boosting and harnessing their potential, can it both leap ahead and sustain its productivity gains #InvestInPeople South Asia Human Credit: Capital Plan Shutterstock 53 TWO FOUNDATIONAL ISSUES ARE CRITICALLY HOLDING BACK HUMAN PRODUCTIVITY: CHILD STUNTING AND LEARNING POVERTY At 33%, South Asia has the highest levels of stunting in the world**: Poor learning outcomes severely constrain the ability of 56 million children under 5 face lifetime physical and cognitive deficits millions of children to learn and achieve their full potential CHILD STUNTING % LEARNING POVERTY: % OF CHILDREN WHO CANNOT READ AND UNDERSTAND AN AGE-APPROPRIATE STORY BY AGE 10 80 60 40 < 20.00% 20.01 - 30.00% 20 30.01 - 40.00% > 40.01% 0 Sub-Saharan Africa Middle East & North Africa Latin America & Caribbean Europe & Central Asia South Asia East Asia & Pacific Source: Afghanistan Health Survey 2018; Bangladesh DHS 2014; India NFHS 2015-16; Nepal DHS 2016; Pakistan DHS 2017-18; Sri Lanka DHS 2016 **At 33.2%, South Asia’s stunting level is now effectively tied with Sub-Saharan Africa (33%) as per UNICEF-WHO-World Bank Joint Malnutrition Estimates Source: World Bank Estimates, 2019 #InvestInPeople South Asia Human Capital Plan 54 LOW AVERAGES MASK PROFOUND INEQUALITIES Progress has been made, yet stubborn disparities affect people’s ability Lack of official IDs makes it harder still for the poor to access to access services or build human capital across income, gender, services, and harder also for governments to target services to ethnicity, geographies, etc those who need them the most TREATMENT FOR FEVER SOUGHT FROM A HEALTH FACILITY UNDER-5 BIRTH REGISTRATION BY INCOME QUINTILE Afghanistan BGD (2007) Bangladesh 2011) 2014 Bhutan IND (1998) 2005 India 2015 Maldives BGD (2007) 2011) Nepal 2014 IND (1998) Pakistan 2005 Sri Lanka 2015 10 20 30 40 50 60 70 80 % 0 20 40 60 80 100 Bottom 20% Top 20% Richest 20% Poorest 20% Source: various survey rounds of DHS Source: UNICEF, 2017 #InvestInPeople South Asia Human Capital Plan 55 SOUTH ASIA’S POTENTIALLY LARGE “DEMOGRAPHIC DIVIDEND” IS IN PERIL 1.1 1.9 1.9 Afghanistan 2015 Bangladesh 2015 Sri Lanka 2015 70-74 70-74 70-74 • Major demographic transitions have led to increases in 60-64 60-64 60-64 productive potential via rising worker-to-dependent ratios Age group Age group 50-54 Age group 50-54 50-54 40-44 40-44 40-44 in most countries in the Region 30-34 30-34 30-34 20-24 20-24 20-24 10-14 10-14 • But of today’s 340 million youth (15-24), the vast majority 10-14 0-4 0-4 0-4 are unemployed or in vulnerable, low paid informal jobs: 3000 2000 1000 0 1000 2000 3000 10000 5000 0 5000 10000 1000 500 0 500 1000 from 66% of the population in Sri Lanka to 91% in Population (thousands) Population (thousands) Population (thousands) Bangladesh (except in the Maldives where it is <½ of total WORKER TO DEPENDENT RATIO employment) 2.2 2.1 1.5 • 33 million new labor market entrants annually until 2030, Afghanistan 2050 Bangladesh 2050 Sri Lanka 2050 with job creation expected to cover only 30% of them 70-74 70-74 70-74 60-64 60-64 60-64 Age group Age group 50-54 50-54 Age group 50-54 • 28% youth are Not in Education, Employment or 40-44 40-44 40-44 Training (NEET) 30-34 30-34 30-34 20-24 20-24 20-24 10-14 10-14 10-14 • And in the Maldives and Sri Lanka, falling worker-to- 0-4 0-4 0-4 dependent ratios are posing challenges to ensure healthy, 3000 2000 1000 0 1000 2000 3000 10000 5000 0 5000 10000 1000 500 0 500 1000 Population (thousands) Population (thousands) Population (thousands) productive aging and elder care PRE-DIVIDEND EARLY DIVIDEND LATE DIVIDEND Source: World Population Prospects, 2019 #InvestInPeople South Asia Human Capital Plan 56 DESPITE MASSIVE EXPANSION OF SCHOOLING ACROSS THE REGION, YOUNG PEOPLE LACK THE SKILLS REQUIRED FOR TODAY’S ECONOMY Basic digital skills among youth/young adults 16 % of surveyed workers in Sri Lanka and 4 % in Pakistan in India are low but increasing have digital skills INDIA SRI LANKA PAKISTAN 80 70 60 60 50 50 40 40 40 30 30 30 20 20 20 10 10 10 0 0 0 15-19 years 20-24 years 25-29 years Low-skilled High-skilled Low-skilled High-skilled Low-skilled High-skilled Low-skilled High-skilled Self-employed Wage-employed Total Self-employed Wage-employed Total Secondary Higher secondary Computer use English skills Computer use English skills Source: Enterprise surveys, multiple years #InvestInPeople South Asia Human Capital Plan 57 ACCESS TO HIGHER EDUCATION HAS EXPANDED RAPIDLY, BUT EQUITY AND QUALITY CHALLENGES REMAIN • In South Asia, enrollment in higher education grew 387% over 15 years, ACCESS TO HIGHER EDUCATION IN SOUTH ASIA IS HIGHEST from 11 million students in the early 2000s to 42 million students today FOR NEPALI MEN AND INDIAN WOMEN IN URBAN AREAS AND LOWEST FOR MALDIVIAN MEN AND WOMEN IN RURAL AREAS • However, there are not enough qualified faculty to teach them: e.g. the number of qualified teachers, particularly those with PhDs is limited Afghanistan MALE Bangladesh Rural Urban • Enrollment growth has been steep but less so for the students from lower Bhutan income quintiles India Maldives • Economic returns to higher education are high - difference in median wage Nepal between higher education and upper secondary graduates is substantial Pakistan 0 10 20 30 40 50 60% Afghanistan FEMALE Bangladesh Rural Urban Bhutan India Maldives Nepal Source: Most recent Demographic and Health Surveys, 2012 Bhutan Living Standards Survey, Pakistan and India National Sample Survey round 71. h 0 10 20 30 40 50 60% #InvestInPeople South Asia Human Capital Plan 58 LOW FEMALE LABOR FORCE PARTICIPATION RATES MEAN HUGE MISSED OPPORTUNITIES… OR… HUGE POTENTIAL FOR FUTURE GAINS • While fertility has declined in most countries, South Asia has the lowest FEMALE-MALE LABOR FORCE PARTICIPATION RATIO average labor force participation for women (36%)* in the world *Alongside Middle East and North Africa Region • In India or Pakistan only 30 women for each 100 men are in the labor market; moreover, female participation is declining in India • Starting around age 13-14 years, girls start to drop out of school at higher rates than do boys and face greater economic disadvantages: they are neither learning nor earning • Women are less frequently employed for wage or salary (except in Sri Lanka), resulting in more precarious productive engagement 60 - 97 50 - 60 35 - 50 29 - 35 Source: ILOSTAT Database, 2018 #InvestInPeople South Asia Human Capital Plan 59 A MAJOR BARRIER TO ECONOMIC PARTICIPATION OF WOMEN AND GIRLS IS GENDER-BASED VIOLENCE (GBV) AND LACK OF SECURITY • South Asia has the highest rates of women who experienced intimate partner • Women’s presence in public spaces is limited, even if increasing violence, child marriage, and other forms of GBV • Safety concerns and limited access to transport reduce probability • 87% of Afghan women experience at least one form of of women participating in the labor market by 16.5% physical/sexual/psychological violence, 62% experience multiple forms of GBV • In Bangladesh, 84% of women faced verbal abuse and sexual SHARE OF WOMEN WHO HAVE EXPERIENCED remarks in public spaces across 6 cities PHYSICAL/SEXUAL INTIMATE PARTNER VIOLENCE • In Lahore, 90% of women face harassment on public transport 29% Europe • In Delhi, 95% of women and girls feel unsafe in public spaces 21% & Central Asia North America 40% 29% • Several countries have legislation against sexual harassment in Middle East & North Africa 43% East Asia public spaces, but enforcement remains inadequate South Asia & Pacific 33% 40% 28% Latin America Sub-Saharan Australia & the Caribbean Africa & New Zealand Source: United Nations Statistics division #InvestInPeople South Asia Human Capital Plan 60 LOW EMPOWERMENT OF GIRLS AND WOMEN PERPETUATES INTER-GENERATIONAL CYCLES OF LOST OPPORTUNITIES FOR GIRLS AND BOYS Children of adolescent mothers fare far worse than children of older Many adolescent girls begin childbearing before the age of 18 mothers: higher mortality and malnutrition, lower cognitive development Adjusted odds ratio INDIA 1.8 1.53 1.57 1.55 1.6 1.4 1.22 1.16 1.2 1.00 1.00 1.00 1.00 1.00 1.0 0.8 0.6 0.4 0.2 0 Neonatal death Infant death Child death Stunting Underweight Adolescent mothers <20 Mothers >20 < 5% Source: WB staff analysis using 2015-16 India NHFS-4 5 – 15% 15 - 25% Preferential health and nutrition for sons plus sex-selective abortions PERCENTAGE OF ADOLESCENT GIRLS > 25% lead to ratios of over 110 boys per 100 girls in 10 Indian States WHO HAVE BEGUN CHILDBEARING Source: DHS data, multiple years #InvestInPeople South Asia Human Capital Plan 61 SOUTH ASIANS ARE INCREASINGLY VULNERABLE TO A SPECTRUM OF SHOCKS AND RISK FACTORS Given inadequate prevention and protection mechanisms, these factors can disrupt service delivery, prevent human capital accumulation, and lead to “coping” mechanisms which often result in permanent reversals in human capital outcomes An extreme event such as the COVID-19 pandemic, highlights the fundamental need for better preparedness of systems and protection for households #InvestInPeople South Asia Human Credit: Capital /Plan UN Women 62 Allison Joyce EXTREME VULNERABILITY TO CLIMATE CHANGE IS PUTTING AT RISK THE HUMAN CAPITAL OF HUNDREDS OF MILLIONS OF SOUTH ASIANS Scale of exposure to climate shocks is massive Inadequate ex-ante preparedness and ex-post safety nets can mean dis-investments in human capital for the poor, with slow or no recovery • 800 million people at risk of lower incomes, 100 million of falling back into poverty • By 2050, under a carbon-intensive scenario, changes in average weather • 50 million people in mega-cities exposed to extensive flooding (eg are predicted to lead to declines in living standards of 6.7% for Dhaka, Karachi, Kolkata, Mumbai) Bangladesh, 2.8% for India, 2.9% for Pakistan, and 7.0% for Sri Lanka • 40 million people at risk of becoming climate refugees • In Andhra Pradesh, India, 44% of households falling into poverty cite • Cyclones with rising event-intensity expected to affect low-lying drought, irrigation failure, or crop disease Bangladesh and the Maldives • In Afghanistan, much of the migration towards cities in the last few years is attributable to crippling drought after drought – not the insurgency HOW CLIMATE AFFECTS AFGHANISTAN HUMAN CAPITAL THE COST OF INACTION Impacts occur through different channels, 1 in 5 year drought affecting a range of interconnected outcomes. Population food insecure < 20% population The impacts on human capital – which depend on physical exposure and adaptative capacity – < 40% population are location specific, and disproportionately < 60% population affect the poor. Research suggests that < 80% population investments in human capital enhance adaptive • 18.8 million food insecure < 100% population capacity, thereby reducing vulnerability • 3.6 million drought-affected • $295 million additional aid needed Source: World Bank estimates based on Afghanistan Living Conditions Survey 2016/17 #InvestInPeople South Asia Human Capital Plan 63 ENVIRONMENTAL POLLUTION – PARTICULARLY AIR POLLUTION – IS A LEADING RISK FACTOR FOR PREMATURE DEATHS DEATHS FROM ENVIRONMENTAL RISKS Air pollution has reached alarming levels in AIR POLLUTION IN SOUTH ASIA AS A SHARE OF TOTAL DEATHS (%) much of South Asia, urban and rural, outdoors and inside the home Bangladesh High air pollution levels lead to school closures Nepal and higher morbidity, impacting learning; and India across the Region, it is now a major risk factor for premature mortality Pakistan Afghanistan Water pollution is a key risk for poor health and child growth too, eg. in Bangladesh exposure to Bhutan E. coli contamination leads to a 6-9% increase Sri Lanka in stunting prevalence in young children Maldives Ambient PM2.5 in South Asia, 2016 (micrograms per cubic meter) 0 5 10 15 20 25 0 – 10 (WHO guideline) 10 – 35 (WHO interim target 1) 35 - 50 Source: Global Burden of Disease Study, 2016 50 – 75 75 – 100 Above 100 Source: IHME 2016, van Donkelaar et al. 2017, Shaddick et al. 2018 #InvestInPeople South Asia Human Capital Plan 64 HUMAN CAPITAL ON THE MOVE: DISPLACEMENT CAN JEOPARDIZE HUMAN CAPITAL ACCUMULATION, OFTEN AMONG THE MOST VULNERABLE South Asia is home to large displaced groups of people within and across borders, especially in Afghanistan, Bangladesh, and India • Displacement puts those already among most vulnerable even more at risk: • Increased social pressures • Precarious living conditions • Large exposure to shocks • Limited access to basic services • Limited productive opportunities • Challenges of integration and rehabilitation As of August 2017, 915,000 displaced Rohingya people have arrived in Cox’s Bazar, one of the poorest districts of Bangladesh: • 50% are under the age of 15 • More than 60% of adults never attended school • Only a third of adults work, one in 10 for women • 95% live in temporary dwelling • Less than 4% child immunization rate prior to arrival • Only 10% own productive assets (from 83% before displacement) #InvestInPeople South AsiaUN Human Capital Women 65 PlanJoyce / Allison NCDs* ARE NOW THE TOP HEALTH RISKS DRIVING LOSS OF PRODUCTIVE LIFE-YEARS ACROSS SOUTH ASIA * Non-Communicable Diseases eg, hypertension, diabetes, cardiovascular, cancer Costs to households and society are high: more than 3.2 million deaths per year; MORTALITY DUE TO ROAD TRAFFIC INJURY prolonged illness; need for costly, chronic care (PER 100,000 PEOPLE) Behind this shift lies rising environmental, lifestyle, and dietary risk factors (eg, diets high in transfat, sugar, and salt); aging in the population; and inadequate 30 systems for early NCD screening and diagnostics 25 Communicable diseases such as TB also persist, and the last 2 countries in the world to suffer from wild polio virus transmission are here: Afghanistan and Pakistan 15 10 1990 Afghanistan 2017 1990 5 Bangladesh 2017 1990 Bhutan 0 2017 Sri Lanka Maldives Pakistan Afghanistan Bhutan India Nepal Bangladesh 1990 India 2017 1990 Maldives 2017 1990 Nepal 2017 1990 Pakistan 2017 Road safety is also at crisis levels, costing the Sri Lanka 1990 lives of 380,000 people each year, 77% of 2017 Communicable diseases Non-communicable diseases Injuries whom die during their most productive years Source: Institute for Health Metrics and Evaluation, 2017 Source: WHO Global Status Report on Road Safety, 2018 #InvestInPeople South Asia Human Capital Plan 66 UNINSURED SHOCKS CAN HAVE CATASTROPHIC FINANCIAL CONSEQUENCES FOR HOUSEHOLDS, LEADING TO DEPLETION OF THEIR HUMAN CAPITAL South Asia has the highest share of health financing from • 30% of households in Sri Lanka are one shock away from falling into poverty out-of-pocket sources among all regions (52%), as a result of which more than 60 million individuals are impoverished annually • Despite recent gains, only 28% of the poorest 20% in South Asia currently benefit from social protection, the lowest coverage rate in the world SOUTH ASIA COVERAGE OF ALL SOCIAL PROTECTION OR LABOR MARKET PROGRAMS 6% 100 6% 80 35% 60 40 Government 0% 20 SHI 52% OOP 0 External World South Asia Sub-Saharan Middle East & East Asia & Latin America Europe & Africa North Africa Pacific & Caribbean Central Asia Other Total population Poorest quintile Source: Global Health Expenditure Database, 2019 Source: ASPIRE database, multiple years #InvestInPeople South Asia Human Capital Plan 67 SOURCES OF DATA 4i4HCA – 4 “i”s FOR HUMAN CAPITAL ACCELERATION IN SOUTH ASIA Data sources for target indicators Outcome indicators Source Year of data* HUMAN CAPITAL INDEX World Bank Human Capital Index 2020 Invest smarter Index of government effectiveness (percentile rank) World Bank World Governance Indicators 2018 Include Stunting (age 0-5 years) Demographic and Health Surveys (or similar) 2010-2018 Child survival (age 0-5 years) UN Interagency Group for Child Mortality Estimates 2018 Percent of 10-year-olds unable to read basic paragraph (learning poverty)** World Bank and UNESCO Institute of Statistics Learning Poverty Database 2013-2017 Female labor force participation International Labor Organization, ILOSTAT Database 2019 Prevalence of modern contraception use among adolescent girls Demographic and Health Surveys (or similar) 2010-2018 Net enrolment rate in secondary school among girls World Bank World Development Indicators 2002-2018 Youth activation (share working among those who are not studying/training, age 15-24) † World Bank World Development Indicators 2016-2018 Insure PM 2.5 air pollution (mean annual exposure, micrograms per cubic meter) Global Burden of Disease Study 2017 2017 Adult survival (share of 15-year olds who survive to age 60) UN Population data 2019 Number of deaths due to NCDs (ages 30-70, total of all countries) Global Burden of Disease Study 2017 2017 Death rate due to road crashes (per 100,000) WHO Global Status Report on Road Safety 2018 2016 National disaster risk reduction and shock-responsive safety net score (out of 4) ‡ World Bank estimates, SPJ South Asia team 2020 Social safety net coverage of the poorest quintile ASPIRE Database 2009-2013 Proportion of children under 5 years of age whose births have been registered with a civil authority UNICEF State of the World’s Children 2007-2018 * The most recent data available was used. Ranges reflect year of data availability for the countries with the most and least recent data available ** No data available for Bhutan, the Maldives, and Nepal † No data available for Bhutan ‡ No data available for Pakistan #InvestInPeople South Asia Human Capital Plan 68 ACKNOWLEDGEMENTS South Asia Human Capital Acceleration Plan Preparation Core Team Members: Lynne D. Sherburne-Benz (Regional Director, HSADR); Trina Haque (Practice Manager, HSAHN and South Asia Human Capital Acceleration Plan Team Leader); Ajay Tandon (Lead Economist, HSAHN); Aline Coudouel (Lead Economist, HSASP); Tazeen Fasih (Lead Economist, HSAED); Chris Andersen (ETC, HSAHN); Zaineb Majoka (ETC, HSASP); Muneeza Mehmood Alam (Economist, ISAT1); Martha P. Vargas (Program Assistant, HSAHN); Jewelwayne Salcedo Cain (Consultant, HEAHN); Rifat Hasan (Sr. Health Specialist, HSAHN); Kelly Suzanne Johnson (Sr Social Protection Specialist, HSADR); Vivek Agarwal (Strategy and Operations Officer, HSADR); Urvashi Narain (Lead Economist, SSAE1); Ramesh Govindaraj (Lead Specialist, HEAHN); Pallavi Anand Mittal (GIS Consultant, HSAHN); Furqan Ahmad Saleem (Lead Public Sector Specialist, GGEV); George Joseph (Senior Economist, SSAW2); Zelalem Yilma Debebe (Economist, HSAHN); Amer Hasan (Sr. Economist, HEAED); Peter Darvas (Sr. Economist, HSAED); Sybille Crystal (Sr. Operations Officer, HSAHN) South Asia HD Practice Managers and HD Program Leaders: Cristian Aedo (Practice Manager, HSAED); E. Gail Richardson (Practice Manager, HSAHP); Stefano Paternostro (Practice Manager, HSASP); Trina S. Haque (Practice Manager, HSAHN); Cristina Panasco Santos (Program Leader, HSADR); D. H. C. Aturupane (Program Leader, HSADR); Jorge A. Coarasa (Program Leader, HSADR); Tekabe Ayalew Belay (Program Leader, HSADR);Yasuhiko Matsuda (Program Leader, HSADR) Extended Team Members: Koen Martijn Geven (Economist, HSAED); Hideki Higashi (Sr. Economist, HSAHN); Mohini Kak (Sr. Health Specialist, HSAHN); Nandini Krishnan (Sr. Economist, ESAPV); Aarushi Bhatnagar (Economist, HSAHN); Deepika Eranjanie Attygalle (Sr. Health Specialist, HSAHN); Rahul Pandey (Operations Officer, HSAHN); Shaza Khan (Operations Analyst, HSAHP); Ajay Ram Dass (Program Assistant, SARHNP); Anastasiya Denisova (Economist, HSASP); Jason Allen Weaver (Sr. Education Specialist); Benu Bidani (Practice Manager, ESAPV); Yoichiro Ishihara (Sr. Economist, SACBT); Maria Eugenia Genoni (Sr. Economist, ESAPV); Urmila Chatterjee (Sr. Economist, ESAPV); Yeon Soo Kim (Economist, ESAPV); Silvia Redaelli (Sr. Economist, ESAPV); Rinku Murgai (Lead Economist, ESAPV); Sutirtha Sinha Roy (Economist, ESAPV), Joe Qian (Communications Officer, HDECR) #InvestInPeople South Asia Human Capital Plan 69 4i4HCA: A Framework for Human Capital Acceleration in South Asia #InvestInPeople South Asia Human Capital Plan 70