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Annual Review of Development Effectiveness 2003 examines the effectiveness of Bank support for developing country policy reform. The report finds that reform has been widespread across countries during the last few years and across a wide spectrum of policy areas. Countries that improved their policies over this period - on average - achieved substantially higher per-capita economic growth than those that did not. The report also finds that Bank support has contributed to reform in a number of cases. But there are also cases where the Bank's support has not been associated with improvements in the policy environment. This is especially noticeable in countries with no track record at all - or an inconsistent or deteriorating record -of policy reform. Several countries have absorbed large amounts of adjustment lending with only mixed results on reform and a substantial increase in indebtedness. The report finds, in conclusion, that management should consider ways to better customize its support to clients' needs and should explore pilot mechanisms to introduce a more direct linkage between its support and results in terms of poverty reduction.