Progress on global health goals : are the poor being left behind?

Abstract

The authors examine differential progress on health Millennium Development Goals (MDGs) between the poor and the better off within countries. Their findings are based on an original analysis of 235 Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) surveys spanning 64 developing countries over the 1990–2011 period. The authors track five health status indicators and seven intervention indicators from all four health MDGs. In approximately three-quarters of countries, the poorest 40 percent have made faster progress than the richest 60 percent on MDG intervention indicators. On average, relative inequality in these indicators has been falling. However, in terms of MDG outcome indicators, in nearly half of the countries, relative inequality has been growing. Moreover, in approximately one-quarter of the countries, the poorest 40 percent have been slipping backwards in absolute terms on both MDG interventions and outcomes. Despite reductions in most countries, relative inequalities in MDG health indicators are still appreciable, with the poor facing higher risks of malnutrition and death in childhood and lower odds of receiving key health interventions.