PHA-Exchange> Who Would Gain most from Efforts to Reach the MDGs for Health?

[claudio]

From: "Ruggiero, Mrs. Ana Lucia (WDC)" <ruglucia at PAHO.ORG>
> Who Would Gain most from Efforts to Reach the Millennium Development Goals
for Health?  An Inquiry into the Possibility of Progress that Fails to Reach
the Poor.
>
> Davidson Gwatkin
> Principal Health and Poverty Specialist
> The World Bank, 2002
> Available online as PDF file  [4.6 MB] at:
>        <http://poverty.worldbank.org/files/13920_gwatkin1202.pdf>
>
> "............This paper is an inquiry into the possibility of progress
> toward the Millennium Development Goals (MDGs) targets for health that
does
> not significantly benefit the disadvantaged people whom the MDGs are
> intended to serve. The possibility arises because the MDGs health targets,
> unlike most other prominent Millennium Development Goals MDGs targets, are
> stated in terms of improvement in societal averages rather than in terms
of
> gains among poor groups within societies. Since improvements in any group,
> including the better-off, would produce improvements in societal averages,
> progress toward targets expressed in those terms does not necessarily
> reflect improvements in conditions among the poor.
>
> The inquiry begins by examining the implications of two alternative
> scenarios for progress toward the Millennium Development Goals MDGs
> under-five mortality target: a "top-down" scenario, with gains highly
> concentrated among the better-off; and a convers, "bottom-up" scenario,
> under which gains flow primarily to the poor. Quantitative illustrations
for
> typical countries in Latin America and the Caribbean, South and Southeast
> Asia, and Sub-Saharan Africa indicate that the amount of benefit accruing
to
> the poor would vary greatly according to the scenario folllowed.
>
> The second part of the inquiry examines the plausibility of the two
> scenarios. The conclusion is that, while the "pure" top-down scenario is
> unlikely, some approximation of it is considerably less improbable than a
> bottom-up scenario. The implication is that special efforts will be
required
> to ensure that health and development initiatives reach poor people if
they
> are to gain significantly from progress toward the Millennium Development
> Goals MDGs health targets....."
>