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Reaching the Poor with Health, Nutrition, and Population Services : What Works, What Doesn't, and Why


  • Davidson R. Gwatkin
  • Adam Wagstaff
  • Abdo S. Yazbeck


Health services can make an important contribution to improved health conditions among disadvantaged groups. Yet as the contents of this volume make clear, the health services supported by governments, and by agencies like ours too often fail to reach these people who need them most. This is not acceptable. Nor need it be accepted. The studies presented here point to numerous strategies that can help health programs reach the poor much more effectively than at present. In doing so, they strongly reinforce the messages of the 2004 World Development Report and other recent publications about the importance and possibility of making services work better for poor people. Different views will be formed about which of the strategies are most promising for a particular setting-whether, for example, one would be best advised to follow Brazil's approach of seeking universal coverage for basic health services, Cambodia's strategy of contracting with non-governmental organizations, Nepal's use of participatory program development, or some other approach. The report provides a discussion on issues like these, in order to build upon the important basic findings presented herewith, i.e., that better performance is possible. In brief, better performance in reaching the poor is both needed and feasible. These are the two messages from this report that will be discussed further.

Suggested Citation

  • Davidson R. Gwatkin & Adam Wagstaff & Abdo S. Yazbeck, 2005. "Reaching the Poor with Health, Nutrition, and Population Services : What Works, What Doesn't, and Why," World Bank Publications, The World Bank, number 7393.
  • Handle: RePEc:wbk:wbpubs:7393

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    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Mollie Fair, 2008. "From Population Lending to HNP Results : The Evolution of the World Bank's Strategies in Health, Nutrition and Population," World Bank Publications, The World Bank, number 6406.
    2. Damien De Walque & Deon Filmer, 2013. "Trends and Socioeconomic Gradients in Adult Mortality around the Developing World," Population and Development Review, The Population Council, Inc., vol. 39(1), pages 1-29, March.
    3. White, Howard, 2007. "Evaluating Aid Impact," MPRA Paper 6716, University Library of Munich, Germany.
    4. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    5. Abdo S. Yazbeck, 2009. "Attacking Inequality in the Health Sector : A Synthesis of Evidence and Tools," World Bank Publications, The World Bank, number 2583.
    6. Johns, Benjamin & Steinhardt, Laura & Walker, Damian G. & Peters, David H. & Bishai, David, 2013. "Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: A seemingly unrelated regression approach," Social Science & Medicine, Elsevier, vol. 89(C), pages 25-31.
    7. David Epstein & Dolores Jiménez-Rubio & Peter C. Smith & Marc Suhrcke, 2009. "Social determinants of health: an economic perspective," Health Economics, John Wiley & Sons, Ltd., vol. 18(5), pages 495-502.
    8. Tannahill, Carol & Sridharan, Sanjeev, 2013. "Getting real about policy and practice needs: Evaluation as a bridge between the problem and solution space," Evaluation and Program Planning, Elsevier, vol. 36(1), pages 157-164.
    9. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press, vol. 32(1), pages 147-189.
    10. Ridde, Valéry & Yaogo, Maurice & Kafando, Yamba & Kadio, Kadidiatou & Ouedraogo, Moctar & Bicaba, Abel & Haddad, Slim, 2011. "Targeting the worst-off for free health care: A process evaluation in Burkina Faso," Evaluation and Program Planning, Elsevier, vol. 34(4), pages 333-342, November.
    11. Spangler, Sydney A. & Bloom, Shelah S., 2010. "Use of biomedical obstetric care in rural Tanzania: The role of social and material inequalities," Social Science & Medicine, Elsevier, vol. 71(4), pages 760-768, August.


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