E N S W - United Nations Development Programme

More documents

Recommendations

Info

Universal public health and education policies can be designed and implemented without sacrificing quality for the sake of greater coverage care providers were given incentives by linking resources to performance. As a result, health care became more affordable in rural areas. And there were visible improvements in health outcomes. Under-five mortality fell from 196 deaths per 1,000 live births in 2000 to 103 in 2007, and the maternal mortality ratio declined more than 12% a year over 2000–2008. Rwanda is on track to reach the Millennium Development Goal for maternal health. One concern in a number of countries is the emergence of dual-track services. Even if public provision is universal in principle, quality and access may be poor, driving people towards expensive private providers. • China. Much of China’s health care success took place between 1950 and 1980, when the government established a three-level system of village clinics, township health centres and county hospitals in rural areas and health centres and district hospitals in urban areas. Since the 1980s, however, the health sector has been driven by a fee-for-service model. As a result, while China’s overall health status has continued to improve, disparities have grown between the eastern and western provinces and between rural and urban areas. In many parts of the country quality health care has become unaffordable for the poor. • Chile. Before 1980, Chile’s health system was publicly financed through social security and public funds. After health reform in 1981, however, risk insurance was introduced, and market mechanisms began to regulate levels of protection. By 2006, a dual system of coverage was in place. The National Health Care Fund, funded by federal government tax revenues and by premiums from beneficiaries, covered 69% of the population, but its resource constraints have prevented it from ensuring timely and quality services. Private health insurance companies covered 17% of the population. The National Health Care Fund offers a universal health plan. This dual system has been criticized because it leaves low-income and high-risk populations to be treated mainly in the public system, which is poorly resourced and thus tends to provide lower quality service. In 2004, aware of the risks, the state introduced El Plan de Acceso Universal de Garantías Explícitas, which guarantees a medical benefits package consisting of a prioritized list of diagnoses and treatment for 56 health conditions, as well as universal coverage for all citizens. Providing universal health care and at least nine years of compulsory education requires strong state commitment, involvement and consistency over time. The challenge for countries in the South is to ensure equity in access to health and education services and basic quality standards to prevent a dual-track service industry that provides low-quality public services (or none at all) to the poor and higher quality private services to the rich. Universal public health and education policies can be designed and implemented without sacrificing quality for the sake of greater coverage. Poor people have no alternatives to a public system, while wealthier people can pay for private services. Such dynamics entrench inequalities, reduce social integration and undermine sustainable human development. New programmes, such as those in China, Mexico and Thailand, illustrate the possibilities of ensuring that basic services are universal and of reasonable quality. When financial resources are adequately provided, publicly provided services need not be inferior to private services. Increasing social cohesion by broadening development Transforming development requires that all citizens feel vested in the broader goals of society, showing respect and compassion for others and a commitment to building social cohesion. This requires that states and citizens understand that human development is about more than just enhancing individual capabilities. Individual capabilities are embedded in a broader social system whose health requires enhanced social competencies (see box 1.7 in chapter 1). More effective social protection systems are also needed to help individuals and communities manage risks to their welfare. Globalization has contributed to the dismantling of some aspects of social protection and social insurance, especially for systems relying on universal 82 | HUMAN DevELOPMENT REPORT 2013
coverage and large government expenditures. At the same time, it has increased the need for social protection, as fluctuations in economic activity become more frequent. Thus, social policies become as important as economic policies in advancing human development. In fact, social and economic policies can hardly be disentangled because their goals and instruments are analogous. 104 In many parts of the South, states have introduced and provided social protection programmes to integrate poor people into the new economy. Cash transfer programmes have been particularly important in reducing poverty and improving income inequality through redistribution. But transfers cannot substitute for public provision of essential goods and services (box 3.8). At best, they can supplement resources of the poor. Offering cash so that households can buy health care of their choice is unlikely to work where high- quality health care is in short supply. Similarly, giving cash to households so that they can choose their school is unlikely to help the poor if few schools offer high- quality education. Nor can cash transfers substitute for incomes earned through decent work. • India. India’s National Rural Employment Guarantee Scheme provides up to 100 days of unskilled manual labour to eligible rural poor at the statutory minimum agricultural labour wage. This initiative is promising because it provides access to income and some insurance for the poor against the vagaries of seasonal work and affords individuals the self-respect and empowerment associated with work. 105 In addition, it aims to help build economies in rural areas by developing infrastructure. The scheme has innovative design features such as social audits and advanced monitoring and information systems. Cash transfer programmes—important in reducing poverty and improving income inequality—cannot substitute for public provision of essential goods and services Box 3.8 Cevdet Yılmaz, Minister of Development, Turkey Strengthening social protection in Turkey As recently as 2002, an estimated 30% of Turkey’s people lived below the government’s poverty threshold of $4.30 a day. Government spending on social protection accounted for just 12% of GDP, less than half the EU average of 25%. And expenditures on social assistance for the poor accounted for only 0.5% of GDP, prompting criticism that Turkey’s social support systems were both fragmented and insufficient. Over the past decade, however, Turkey’s strong economic performance, pro-poor approach to social policies and targeted assistance with greater resources have helped accelerate poverty reduction. Key policy changes include systematic strengthening of social assistance programmes, conditional cash transfers, social security reforms and an ambitious transformation of the national public health system. Under the conditional cash transfer programme alone, launched in 2003, more than 1 million children have received health care support, and about 2.2 million have benefited from education aid. School children have received more than 1.3 billion textbooks since 2003 under a new free schoolbook programme, and nearly 1 million now get free transportation to school. As a result of these and other initiatives, the share of the population living on less than $4.30 a day fell sharply, to 3.7% in 2010, and the share of GDP devoted to poverty assistance and related social services nearly tripled, to 1.2%. The share of social expenditures in Turkey’s GDP is still less than the EU average, and social assistance schemes have not yet had the desired impact on poverty rates. To increase their effectiveness, the government is working on new methods of poverty measurement and social protection, new approaches to in-kind and cash assistance, stronger links to job opportunities and continuing consultations with targeted communities and households. Similarly, the expansion and modernization of health services have had a direct, measurable impact on public health. Health insurance is now available to the entire population. Under the Health Transformation Programme launched in 2003, family practitioners were assigned to families to strengthen basic health services, with primary and emergency health care provided free of charge. The results have been swift and encouraging. For the first time, almost all children are getting free regular vaccinations. Seven million schoolchildren get free milk every day. Iron and vitamin D supplements are provided without charge to mothers and children. Infant mortality rates have fallen sharply, to 10 per 1,000 live births in 2010, down from 29 in 2003, according to government figures. This two-thirds drop greatly exceeds the reduction targeted under the Millennium Development Goals. Pro-child policies go beyond health care and education, to broader assistance for their home communities. The government started a new Social Support Program in 2008 to develop social cohesion and ensure social integration, particularly in the less-developed eastern regions of the country. Its projects aim to increase participation in national economic and social life by disadvantaged people marginalized by poverty and social exclusion. The goals of the programme’s several thousand projects to date go beyond job creation in these lower income regions to include support for young people and women to express themselves through cultural, artistic and athletic accomplishments. More important, though, is what these improvements already mean to the lives of ordinary Turkish families. Throughout the country, parents and children alike can now look forward to healthier, more secure, more fulfilling lives—the underlying goal and core principle of human development. Chapter 3 Drivers of development transformation | 83
Page 1 and 2:
W N S E Human Development Report 20
Page 3 and 4:
Human Development Report 2013 The R
Page 5 and 6:
Human Development Report 2013 Team
Page 7 and 8:
Finally, the Report also calls for
Page 9 and 10:
Musa, Thangaval Palanivel, Anuradha
Page 11 and 12:
3.6 India’s Supreme Court issues
Page 13 and 14:
Overview One of the most heartening
Page 15 and 16:
Human Development Report also stres
Page 17 and 18:
sudden opening but of gradual and s
Page 19 and 20:
two scenarios for 2010-2050: a base
Page 21 and 22:
messages and demands challenge gove
Page 23 and 24:
Introduction When developed economi
Page 25 and 26:
leading economies—Brazil, China a
Page 27 and 28:
comparable access to information, e
Page 29 and 30:
mobile phones: cellular banking is
Page 32 and 33:
“The political problem of mankind
Page 34 and 35:
Box 1.1 Fairness, macroeconomics an
Page 36 and 37:
Box 1.3 Amartya Sen, Nobel Laureate
Page 38 and 39:
Figure 1.1 Income per capita is ris
Page 40 and 41:
Box 1.4 Subjective indicators of we
Page 42 and 43:
Figure 1.4 There is notable variati
Page 44 and 45: Figure 1.6 Most regions show declin
Page 46 and 47: Progress in human development achie
Page 48 and 49: Box 1.7 Social competencies: human
Page 50 and 51: Table 1.3 Inequality and satisfacti
Page 52 and 53: Not all countries have the precondi
Page 54 and 55: “When the music changes, so does
Page 56 and 57: Box 2.1 The South’s integration w
Page 58 and 59: Figure 2.1 As a share of world merc
Page 60 and 61: Box 2.2 Acquisitions by the South o
Page 62 and 63: Figure 2.3 Between 2000 and 2010, I
Page 64 and 65: Figure 2.4 Export earnings per capi
Page 66 and 67: Box 2.6 Final assembly is about mor
Page 68 and 69: Instead of having a centre of indus
Page 70 and 71: Figure 2.6 Emerging market economie
Page 72 and 73: developing countries trade more amo
Page 74 and 75: “We cannot expect that all nation
Page 76 and 77: Table 3.1 Selected developing count
Page 78 and 79: A common feature of countries that
Page 80 and 81: More important than getting prices
Page 82 and 83: Box 3.5 Eastern Europe and Central
Page 84 and 85: states have to be conscious that th
Page 86 and 87: As countries develop, they tend to
Page 88 and 89: Having weathered the Asian financia
Page 90 and 91: providing public services that cont
Page 92 and 93: Advancing health requires more than
Page 96 and 97: • China. The Minimum Livelihood G
Page 98 and 99: “Each generation will reap what t
Page 100 and 101: concerns will make for a complex en
Page 102 and 103: A greater emphasis on education can
Page 104 and 105: Figure 4.1 Under the fast track sce
Page 106 and 107: Around the world people are calling
Page 108 and 109: Figure 4.4 Different environmental
Page 110 and 111: Figure 4.5 Education policies can a
Page 112 and 113: Box 4.2 China and Ghana: who benefi
Page 114 and 115: Figure 4.8 countries thus converge
Page 116 and 117: “Let us join hands to try to crea
Page 118 and 119: Areas of global international conce
Page 120 and 121: Addressing climate change requires
Page 122 and 123: International governance is increas
Page 124 and 125: Box 5.2 Jo Leinen, Member of the Eu
Page 126 and 127: facilitates reserve investments and
Page 128 and 129: esponsible sovereignty takes the lo
Page 130 and 131: Figure 5.1 Under the accelerated pr
Page 132 and 133: Good policymaking requires greater
Page 134 and 135: a fair and less unequal world requi
Page 137 and 138: Notes Overview 1 Atsmon and others
Page 139 and 140: 25 Blinder 2006. 26 UNIDO 2009. 27
Page 141 and 142: which is 61.7 deaths per 1,000 live
Page 143 and 144: References Abdurazakov, A., A. Mins
Page 145 and 146:
urban_world_cities_and_the_rise_of_
Page 147 and 148:
Kamau, P., D. McCormick, and N. Pin
Page 149 and 150:
Labor Administration. Geneva: Inter
Page 151 and 152:
Page 153 and 154:
Statistical acknowledgements The Re
Page 155 and 156:
Key to HDI countries and ranks, 201
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Statistical references ADB (Asian D
Page 213 and 214:
Core features of the model pertinen
Page 215 and 216:
Countries and HDI ranks in 2012 and
show all

E N S W - United Nations Development Programme

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?