The Poverty Reduction Strategy (PRS) Initiative was introduced in 1999, by the World Bank and the International Monetary Fund, with the aim of making development aid more effective in reducing poverty in low-income countries. This publication gives an independent assessment of the PRS Initiative, reviewing the extent of progress made so far, with particular focus on the role and effectiveness of the World Banks support. The analysis draws on discussions with national stakeholders in PRS countries as well as from country case study reports from Albania, Cambodia, Ethiopia, Guinea, Mauritania, Mozambique, Nicaragua, Tajikistan, Tanzania and Vietnam. Findings include that the PRS Initiative has led to improvements in the poverty focus of national strategies in some low-income countries, but its benefits have been varied, especially in more difficult country environments lacking strong governance and aid management processes. To address these issues, significant changes are identified in relation to process, content, partnership framework and alignment aspects.