Major geographical inequalities exist This is a major development issue Progress in some areas by government but little apparent appetite political will What can should donors do Health inputs ID: 574735
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Slide1
Equity
Major geographical inequalities exist
This is a major development issue
Progress in some areas by government – but little apparent appetite/ political will
What can/ should donors do? Slide2
Health inputsSlide3
Western districts spend less per capita on basic servicesSlide4
More than threefold variation in teachers
Substantially lower inputs Slide5
Substantially worse outcomes
Pass rate of
PSLE
exams,
b
y region, 2010Slide6
A consistent picture across sectors NUTRITION –
child stuntingSlide7
Variation in water availability – but the pattern is different Slide8
Variations in fertility likely to compound the issue
Slide9
Is this important?
Efficiency and effectiveness of spend
Waste of human capital
Politically destabilising
‘multiplier of deprivation’Slide10
What should donors do?
Focus on big issues
Work across
sectoral
silosEncourage consistent transparent approaches to monitoring progressRecognise achievements
Human resource the major driver in social sectorsPay and incentive strategy to meet sectoral prioritiesAgree one system and support consistentlyCelebrate achievements – eg in education staffingSlide11
There has been progress in key areas
PTR
is falling – but variance falls fasterSlide12
PAF 2013
Decrease the number of districts where:
Primary
PTR
is greater than 50Nurse / population ratio is worse than 3/1000Slide13
Do Donors do better?
Nutrition data Slide14
Key messages
Measuring geographic inequalities (let alone remedying them) is challenging.
LGA
level data is fragmented and unreliable
Major geographical inequalities exist whether one considers inputs outputs or outcomes. Key driver is staff recruitment and retention
Inequalities compound each otherDespite good political reasons for inertia, government has made progress in some areasDonors talk a lot about inequality – but is our investment any better?