Can the Poor Lift the Poor?

Stories of despair. News of atrocities. Articles on disparities.

Countries, whether developed or developing, undergo turmoil, suffer from economic deprivation and social unrest sometimes due to the decisions of a few in power, sometimes due to other forces like natural disasters and civil wars. Thanks to globalisation the world is a much smaller place now where the news of a far away country has equal significance and implications as that of an event that occurs locally. Such reports are important for the masses to have access to.

However, much too often we hear about all the wrongs in the world with experts providing models and suggestions to solve the issues that are only theoretically attainable.

There are other ways in which countries can find inspiration, perhaps not to solve economic issues, but to help raise the health outcomes of their people, provide better standard of living and increase life expectancies. As working on health and social standards of a nation will only set the wheel in motion to improve other aspects of a country.

And what better way of finding solutions than looking at evidence-based initiatives that have proven to be successful even in the more hostile and poverty-stricken environments.

World Bank, Gates Foundation and the Dutch and Swedish government initiated a programme that looked at all recorded interventions conducted specifically in developing nations that aim to assist and improve provisions for the poorest 20% of a country.

Too often the better-off, richer individuals, benefit from public and private services even when the facilities are specifically set up to help the disadvantaged including basic provisions like maternal and child health services.

The Reaching the Poor Program constitutes an find ways of reducing...inequalities by raising coverage among the poor. By assessing the record of current and recent health, nutrition, population initiatives, it hopes to alert sponsors of poorly-performing programs to a problem of which they are likely to be unaware, and to draw their attention to approaches that have proven more effective and are thus potentially worthy of adoption.”

In essence a database was created of programmes which nations can access to search for a suitable initiative by looking for countries with similar pointers or characteristics like GDP, Corruption Perceptions Index, population etc and implement on their poorest communities with a realistic view of possible challenges and issues that will need to be taken account of in order for the programme to be successful.

The programmes were assessed by:

  • Focus (or incidence); i.e. the proportion of an initiatives benefits that go to different economic groups within a population. The higher the proportion of a programmes benefits going to the destitute, the more effective a programme is in terms of reaching the poor.
  • Coverage i.e. the percentage of poor people within the country who are reached by the programme. This is specifically used to assess a programme’s poverty impact—how much benefit the initiative brings to the poor, irrespective of what has reached the better-off.

Figure from Reaching the Poor program brochure.

A number of beacon countries outshone the rest in their pro-poor programmes, benefitting and continue to benefit, the poorest 20% of the nation.

Mexico’sProgresa” programme for instance pays poor families for clinic and school attendance. Progresa serves over 20 million people where almost 60% of the people reached are amongst the poorest 20%; 80% of beneficiaries are in the Mexican population’s poorest 40%.

Colombia provides health insurance to the disadvantaged where 35% of the total programme subsidy goes to the poorest 20%; and 65% to the poorest 40%.

And countries like Ghana and Zambia have managed to distribute insecticide-treated bednets to 90% of the poorest population in Ghana and 82% in Zambia through measles immunisation campaigns initiated by the Red Cross and the Government Health Service.

These programmes, and others, though vary in scope and approach, have one thing in common: triumphant impact upon the health and social outcomes of their poorest.

Other nations seeking to change the state of their population are spoilt for choice by the “multiple, very different promising, approaches with the suitability of each depending heavily upon the characteristics of the setting”.

Thus my humble ‘expert’ suggestion to countries undergoing turmoil, suffering from economic deprivation and social unrest; seek solutions that have already proven to be successful.

Package resolutions are provided; use it.

Image from Unseenob.