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Missing Targets: An alternative MDG midterm report impact. It is important that these new set of policy initiatives adequately address critical issues of health inequities since most of the deficiencies in the health indicators are occurring in the poorest segments of the population. The evidence presented here clearly shows that poor people have worse health outcomes than the better-off, and that publicly-financed health care has not been able to reach its intended beneficiaries. Given the relative disempowerment of the poor that limits their availment of intended benefits, new initiatives for health programs and strategies should consider the following important points: Increase and prioritize investments in health conditions that affect the poor more. Focusing on family planning, EmOC, immunization, infectious diseases, infant and child mortality, maternal ill-health, and malnutrition is a strategy to improve the health of the poor women and children and reduce poor and nonpoor health differences. Prioritize investments in types of services that are likely to benefit the poor. Primary health care, public health interventions, and preventive or promotive (rather than curative) services can improve the health of the poor. Prioritize investments in regions or areas where the poor are concentrated (geographic targeting). Resources should be reallocated in favor of poorer geographic areas, and to the lower tiers of service delivery. Health infrastructure should be expanded to provide more service delivery points where the poor live, especially in remote rural communities. The number and reach of outreach clinics should be increased. Services can be tailored to the needs of vulnerable groups, such as slum dwellers, migrant, etc. Reduce barriers to financial access. When universal provision of subsidized care is considered too costly and/or not effective in reducing poverty, <strong>one</strong> alternative is targeted subsidies. Targeting is primarily an attempt to increase fairness in financing. From another perspective, it involves redistributing resources and transferring purchasing power to the poor without increasing public spending. International agencies and donors can help prevent maternal and infant deaths by improving the quality of aid. Health is a right. There needs to be a reorientation in policy towards this view. The government is dutybound to provide the health system which ensures that pregnant women and children can access quality health care, especially life-saving emergency obstetric care. It should be held accountable for every woman who dies because the health services she needed were not available or accessible. Health providers must view the provision of services as an obligation. Policies and standards must be set at the highest level of government and forcefully implemented. In the absence of such leadership there is little hope of achieving health security for our people, or even only the minimum MDG health targets. • 48 S O C I A L W A T C H P H I L I P P I N E S
Missing Targets: An alternative MDG midterm report ENVIRONMENTAL INSECURITY The cost of misgovernance By JONATHAN D. RONQUILLO and RACHEL o. MORALA* Introduction IN the last week of July 2007, the Philippine media carried headlines on the pending water crisis in the country. The lack of rain and the consequent severe drought was wreaking havoc on the country’s already problematic agriculture sector. The drying up of dams was causing panic among water consumers. As if on cue, the very next day after the water crisis landed in the headlines, the Philippine government attributed the problem to global climate change and immediately announced a plan to take mitigating measures to address the crisis. Apart from declaring that all government offices shall begin implementing energy- and water-saving schemes and vowing to disburse millions of funds for mitigating measures, the government also gallantly pronounced that it shall employ emergency powers if necessary to address the severe impact of the crisis, particularly for the poor. * Jonathan D. Ronquillo and Rachel O. Morala are Senior Associates of La Liga Policy Institute. S O C I A L W A T C H P H I L I P P I N E S 49
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C O N T E N T S Key to Acronyms....
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Table A4: Annual Per Capita Poverty
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