Poverty Reduction Strategy Paper (PRSP)
The stated aim of the PRSP is to present a coherent strategy that helps poor countries to experience faster sustainable growth and achieve a substantial reduction in poverty. If successful, PRSPs could provide improved national coordination and higher levels of resources for comprehensive poverty reduction activities. As PRSPs prioritize spending that reduces poverty, the health sector is expected to benefit.
PRSPs replace the World Bank's Policy Framework Paper. Countries must produce a PRSP to qualify for multilateral debt relief under the HIPC (Highly-Indebted Poor Countries) initiative or to access concessional lending through the International Monetary Fund's Poverty Reduction and Growth Facility (previously called the Enhanced Structural Adjustment Facility). The PRSP approach came as a response to the criticism of Structural Adjustment Programmes (SAPs) and the success of anti-debt campaigns. It is regarded by many as an important departure from the previous top-down approaches of the World Bank and as a shift away from the neo-liberal Washington consensus.
PRSPs describe macroeconomic, structural, and social policies and programmes to promote economic growth and reduce poverty, as well as associated external financing needs and major sources of financing. The process of developing a PRSP starts with a country-based diagnosis of poverty. It then defines the poverty reduction outcomes a country wishes to achieve and the key public actions needed. The PRSPs should be conceived and authored by the government, which will outline its own development priorities and the strategies needed to achieve them. The process shows a greater emphasis on ownership, transparency and participation than previous approaches.
WHO research into the health content of PRSPs shows that they recognize the need to make health investments as part of an overall development strategy. This recognition is most typically manifested in strategies to extend health services, particularly primary services, and make them more efficient and responsive. However, this commitment is based on assumptions about what works to reach the poor, rather than a systematic evaluation of the specific needs in the local situation.