Publication: 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
Date
2002-12
ISSN
Published
2002-12
Author(s)
Gwatkin, Davidson R.
Abstract
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 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 MDGs
under-five mortality target: a "top-down"
scenario, with gains highly concentrated among the
better-off; and a converse, "bottom-up" scenario,
under which gains flow primarily to the poor. The second
part of the inquiry examines the plausibility 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 MDGs health targets.
Citation
“Gwatkin, Davidson R.. 2002. 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. HNP discussion paper series;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/a7cdd3e6-260d-5acb-b6ee-c68180064db7 License: CC BY 3.0 IGO.”