PHA-Exchange> 12 - In preparation of PHA II

[Claudio]

From: Ruggiero, Mrs. Ana Lucia (WDC) 

Poverty Alleviation through Geographic Targeting: How Much Does Disaggregation Help? 

 

Chris Elbers, Tomoki Fujii, Peter Lanjouw, Wesley Yin, and Berk Özler 

World Bank Policy Research Working Paper 3419, October 2004

 

Available online as PDF file [42p.] at:      http://econ.worldbank.org/files/39003_wps3419.pdf  

 

"....Using recently completed "poverty maps" for Cambodia, Ecuador, and Madagascar, the authors simulate the impact on poverty of transferring an exogenously given budget to geographically defined subgroups of the population according to their relative poverty status. They find large gains from targeting smaller administrative units, such as districts or villages. But these gains are still far from the poverty reduction that would be possible had the planners had access to information on household level income or consumption. The results suggest that a useful way forward might be to combine fine geographic targeting using a poverty map with within-community targeting mechanisms. ..."

 

 Commetary:  Many currently proposed approaches to resolve health problems, including those of the WB, focus on targeting.  It is a fallacy to propose targeting as an alternative to PHC as originally conceived in Alma Ata 25 years ago. Individual targeting is equivalent to the discredited Selective PHC approach: "Go for the worst cases, fix them, and improve the statistics". But where are the sustainable changes to avoid the recurrence of the same problems to be seen? Targeting keeps a semblance of equity. Targeting can and does stigmatize the poor creating second-class citizen that can be manipulated. Individual targeting is not a substitute for a more redistributive public policy.  Geographic targeting has probably more potential.  Starting with targeting interventions as the central thrust to achieve equity is the wrong approach; it pursues what is rather a 'mirage of equity'. It tacitly blames the most vulnerable for being where they are and tends them a rescuing hand. 

Let inputs on ways out of non-equity-redressing targeting schemes come from the more directly affected themselves. Devoting our energies to facilitate such a process will be a big leap forward for all of us.

Claudio

claudio at hcmc.netnam.vn 

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