What did it do? A quote from Pakistan Picaresque in The Wilson Quarterly:
The year was 1992, and Lucymemsahib and I were helping the government of Pakistan prepare a grant proposal for the country’s Social Action Program (SAP)—a comprehensive effort to renovate Pakistan’s health, education, and water sanitation systems that the World Bank and a consortium of other multinational development organizations had pledged to support. Specifically, we were looking into ways to attract more women to provide midlevel health services in rural areas. As head of the Pakistan Nursing Council, Mrs. S. presided over the governmental organization responsible for the recruitment, training, and certification of nurses at Pakistan’s 60 civilian nursing schools and a handful of specialized military institutions.
The SAP we helped prepare, which ran from 1993 through 1998, turned out to be a dismal failure, as was the one that followed in 1999–2003. Subsequent programs, especially since 9/11, show every indication of being as unsuccessful. The critical indicators of maternal and child health tell it all. Estimates of Pakistan’s maternal mortality ratio since 1990 range from 300 to 800 maternal deaths per 100,000 live births; even the low end of this range is unacceptable. By contrast, Sri Lanka, another South Asian country, with an income per capita that was roughly comparable to Pakistan’s at the beginning of the 1990s, saw its maternal mortality ratio fall from 92 per 100,000 in 1990 to below 50 today. The infant mortality rate in Pakistan in 2003 was 76 per 1,000 live births, as compared with 11 in Sri Lanka. In the developed countries, the infant mortality rate is only about five per 1,000 live births.
Beyond the health care sector, the story is much the same.
It's a good case study of what really happens in the real world, despite the best of intentions.
