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Poverty
Growth or safety net?
I AM not aware of any maternal deaths in the community in the past two or three years, says the medic on duty at a remote rural clinic in the Terai, Nepals lowlands. I think this is because medicines are available, services are free and we have a 24-hour delivery service. A young mother at the post agrees. She tells researchers from Britains Overseas Development Institute (ODI), a think-tank, When I gave birth several years ago, I was not taken to a health facility. But recently my in-laws decided to take my sister-in-lawbecause [of] the 24-hour delivery. Nepals improvements to maternal health have been extraordinary. In the early 1990s Nepal was one of the poorest countries in the world. It is still the poorest country in South Asia; its income has grown respectably, though not quickly; and it has had a civil war. Yet by doubling health spending and concentrating on the poorest areas it cut maternal mortality in half between 1998 and 2006 and reduced deprivation and misery by more than its income gains alone would suggest. On a measure called the MPI, or multidimensional poverty index, invented by Sabina Alkire at the Oxford Poverty and Human Development Initiative, since 2006 Nepal has seen the largest falls in poverty, broadly defined, of any country in the index. This provides a microcosm of the changes that development agencies want to see spread globally. Between 1990 and 2010 the proportion of the population living on less than $1.25 a day in developing countries halved to 21%, or 1.2 billion people (see chart). That enabled the 189 governments who signed a pledge to halve the share of the poorest between 1990 and 2015 to claim they had met their goal early. It is not clear how much the pledge itself caused the fall in povertyarguably not much, since China, where the biggest decline took place, took no notice of the goal. Still, the correlation has been strong enough for almost all countries to want a new set of global development aims after the current lot expires in 2015. On September 25th their delegations will gather at the United Nations in New York to refine the list of proposed Sustainable Development Goals. Jeffrey Sachs, a professor at Columbia University, says rather grandly that these have the potential to open up a new era of technological and organisational breakthroughs (see article). Barack Obama has committed the American administration to the aim of eradicating extreme poverty by 2030, meaning to reduce the percentage of people in the world on $1.25 or less to 3%. Britains prime minister, the World Bank and a series of international charities have signed up to that goal, as well. Yet as Nepal shows, cutting poverty is not just about boosting incomes. Deprivation takes many forms, including the lack of schools, clean water, medicines and family planning. Using her MPI measure, Ms Alkire finds that about one-sixth of Vietnams population is poor by income, and one-sixth is multidimensionally poor. But they are not the same people: only about a third of the groups overlap. Emma Samman of ODI says, It is not clear that the $1.25-a-day poverty line, the measure upon which this vision of a poverty-free world exists, is necessarily the best way to think about and measure poverty. So charities and others are urging the governments meeting in New York to adopt exacting targets for nonincome measures of deprivation. Save the Children thinks the world should aim to end preventable deaths in childbirth by 2030; ensure universal safe water; reduce child mortality from about 50 per 1,000 live births to 20; and halve the rate of child stunting (meaning below-average growth in childhood, a measure of malnutrition). Several countries have managed to reduce the social deprivations that the poor face (bad education, health and so on) by more than they have improved the incomes of the poorest. Nepal is one. Bangladesh is another: it has made some of the greatest improvements in infant and maternal mortality ever seen, despite modest income growth. But these are exceptions.
Sep 21st 2013 / The print Edition http://www.economist.com/news/international/21586601