Inequality a Major Hurdle to Education, Health MDGs, Says ADB

MANILA, PHILIPPINES - Many countries in Asia and the Pacific will not meet the Millennium Development Goal (MDG) targets for universal primary enrollment and a two-thirds reduction in child mortality unless governments rapidly intensify efforts to improve basic education and increase access to primary health care for the poor, ADB says in Key Indicators 2006, the bank’s flagship annual statistical publication.

“Without a concerted effort to reach the poor, Asia cannot - and will not - attain the health and education-related MDGs,” says Ifzal Ali, ADB Chief Economist.

“To sustain Asia’s success in reducing poverty governments must improve education opportunities for the poor, as this is a key driver of movements out of chronic poverty,” Mr. Ali says. “Health-related shocks can also be catastrophic from a household’s perspective, pushing entire families into poverty.”

Large primary school enrollment deficiencies remain in Pakistan, Azerbaijan, Mongolia, Nepal, and Papua New Guinea, according to Key Indicators 2006, which this year includes a theme chapter titled “Measuring Policy Effectiveness in Health and Education”. The theme chapter examines options for evaluating public sector effectiveness in improving health and education services and outcomes, especially among the poor.

Countries such as Bangladesh and India have made significant progress in improving access to primary schooling, but concerns remain regarding the quality of basic education and inequalities in enrollment rates. In many countries, primary-school age children from poorer households are almost three times more likely to be out of school than those from richer households. Gender-related inequalities in enrollment remain prominent in countries such as Pakistan.

Despite significant declines in child mortality rates in Indonesia, Viet Nam, and Sri Lanka, levels of child malnutrition remain worryingly high in the region. At current trends, many countries in the region will not attain the health-related MDGs, according to Key Indicators.

Cambodia, India, Pakistan, and several Central Asian republics are all in danger of falling short of the target to reduce the under-five child mortality rate to two thirds of 1990 levels by 2015. Inequalities in health are prominent in many countries with child mortality rates for the poor being two or three times higher than those for the rich.

The theme chapter highlights the importance of measuring and analyzing country-specific factors affecting MDG indicators, especially among the poor. Increased measurement, awareness, and dissemination of MDG indicators for the poor, contrasted with data for comparator countries, can itself be a catalyst for corrective policy action, according to the report.

“Policies aimed at reducing inequalities in health and education need to be based in careful, evidence-based analysis of the constraints at the country level,” says Ajay Tandon, an ADB economist and author of the chapter.

“In many countries inequalities are exacerbated by public spending that supports better-off segments of society, such as on tertiary education, but does little to help the poor,” he says.

The chapter underscores the importance of carefully targeted policies and actions aimed at improving health and education outcomes for the poor. Among effective options it identifies conditional cash transfers, food fortification, food-for-education programs, and targeted scholarships, as well as standard bricks-and-mortar improvements to social infrastructure.

Key Indicators 2006 contains 38 statistical tables that compare MDG indicators and other key statistics across ADB’s 44 developing member countries, each with an eight-year data series on social, economic and financial statistics.

Table 1. Millennium Development Goals (MDG) Indicators for Selected Asian Countries
DMC $1-a-day Poverty Rate (%) Prevalence of Underweight Children Under Five Years of Age Under-Five Mortality Rate (per 1,000 live births) Infant Mortality Rate (per 1,000 live births) Proportion of 1-Year Old Children Immunized Against Measles (%) Net Enrollment Ratio in Primary Education (%)
. 1990 2003 % Latest Year 1990 2004 1990 2004 1990 2004 1990 a 2004
China, People's Rep. of 33 13 8 (2002) 49 31 38 26 98 84 97 99
India 42 31 47 (1998-1999) 123 85 84 62 56 56 78 b 90
Philippines 20 14 28 (2003) 62 34 41 26 85 80 97 94
Bangladesh 34 30 48 . 149 77 100 56 65 77 71 94
Indonesia 21 7 28 (2003) 91 38 60 30 58 72 97 94
Nepal 44 24 48 (2001) 145 76 100 59 57 73 81 78
Sri Lanka 4 1 30 . 32 14 26 12 80 96 90 97
Viet Nam 51 10 28 . 53 23 38 17 88 97 90 93
Notes:
a Refers to 1991.
b World Bank estimate.
Source: ADB