World Bank lending in the population, health and nutrition (PHN) sectors increased significantly in fiscal 1990. Over the past five years, PHN lending has grown rapidly both in the number of projects and in the amounts of loans and credits. The future lending portfolio indicates continued growth. Bank support of nutrition activities, both within the PHN sectors and as components of projects outside the PHN sectors, has expanded significantly. However, the Bank still faces important challenges in its effort to improve the effectiveness of its interventions in the PHN sectors. The review suggests a number of recommendations for further improving performance. On the technical side, the Bank should: (1) continue to focus and improve its interventions at the policy level; (2) address management and institutional development issues more rigorously and comprehensively through project, sector and research work; (3) squarely address and encompass the role of the private sector and NGOs in the design and delivery of PHN interventions; and (4) continue efforts to address and resolve PHN financing issues, given its comparative advantage in this regard. Internally the Bank should: (1) address the need to expand staff to accommodate continued growth likely in Bank work; and (2) encourage greater use of experts from developing countries and the participation of beneficiaries in Bank work.