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MDGs can be reached faster with focus on most disadvantaged children, says study
Published in Daily News Egypt on 13 - 09 - 2010

CAIRO: The global community can save millions of lives by investing in the most disadvantaged children and communities, studies by the United Nations Children's Fund (UNICEF) said.
The studies added that such an approach would also address the widening disparities that are accompanying progress toward the Millennium Development Goals (MDGs).
Even though great progress has been made internationally towards meeting the MDGs, much more needs to be done over the next five years before the 2015 deadline, the study said.
UNICEF conducted two studies comparing the effectiveness of different strategies for delivering critical health interventions to those in greatest need. The studies found that targeting the poorest and most disadvantaged children could save more lives per $1 million spent than the current path.
“Our findings challenge the traditional thinking that focusing on the poorest and most disadvantaged children is not cost-effective,” said UNICEF's Executive Director Anthony Lake. “An equity-focused strategy will yield not only a moral victory, right in principle, but an even more exciting one: right in practice.”
The new findings are presented in two publications: “Narrowing the Gaps to Meet the Goals” and “Progress for Children: Achieving the MDGs with Equity,” UNICEF's signature data compendium.
“Narrowing the Gaps to Meet the Goals” concluded that an equity-based strategy can move us more quickly and cost-effectively towards meeting MDGs four and five, those in relation to reducing child mortality and improve maternal health, than our current path, with the potential of averting million maternal and child deaths by the 2015 deadline.
The report's key findings show that national burdens of disease, under-nutrition, ill health, illiteracy and many protection abuses are concentrated in the most impoverished child populations.
Providing these children with essential services through an equity-focused approach to child survival and development has great potential to accelerate progress towards the MDGs and other international commitments to children.
Another key finding of the report is that an equity-focused approach could bring vastly improved returns on investment by averting far more child and maternal deaths and episodes of under-nutrition and markedly expanding effective coverage of key primary health and nutrition interventions.
The report also points out that a focus on equity for children has long been a moral imperative. For example the Convention on the Rights of the Child is founded on the principles of universality, non-discrimination and accountability, hence being “right in principle” as Lake put it.
However, it is questionable whether they are “right in practice” given their cost and complexity, as the report notes “it is hard to reach the poorest” as they tend to live in areas that are remote, that have weak transportation links and limited physical infrastructure which makes it far more costly to provide these services to them than to more affluent groups.
This raises a major issue for policy and decision makers, whether they should seek the best outcomes for the children who are easiest to reach in the time remaining until the 2015 MDGs deadline or focus on the children living in marginalized areas with the highest levels of deprivation, where the potential gains are the greatest.
This dilemma would be resolved, as the report suggests, if there were a more cost-effective strategy to simultaneously reduce disparities in the coverage of essential services, accelerate progress towards the MDGs and avert more deaths and other childhood deprivations than the current approaches.
The report titled “Progress for Children: Meeting the MDGs with Equity” is UNICEF's signature report on progress toward the MDGs and it presents evidence of disparities across a range of key indicators, including between developing and industrial nations, between richest and poorest quintiles within nations, between rural and urban populations, and between boys and girls, according to a press statement by UNICEF.
Among the report's key findings is that first, children from the poorest 20 percent of households in the developing world are more than twice as likely to die before reaching their fifth birthdays as children from the richest 20 percent of households.
Children in the poorest quintiles of their societies are more than twice as likely to be underweight and face a much greater risk of stunting compared to children from the richest quintiles.
Furthermore, despite great strides towards achieving gender parity in primary education over the past decade, girls and young women in developing regions remain at a considerable disadvantage in access to education, particularly at the secondary level.
According to the report, 84 percent of the 884 million people who lack access to improved drinking water sources live in rural areas.
The study was undertaken in consultation with a range of outside experts, who described the main findings as both surprising and significant.
“The results of the UNICEF study made me think that the equity focus can be persuasive on an instrumental as well as a values basis,” said Lawrence Haddad, director of the respected Institute of Development Studies, Sussex, author of the blog “Development Horizons,” and a participant in the working group of outside experts who reviewed the study's preliminary modeling.
The UNICEF reports are being released in conjunction with a report by Save the Children, "A Fair Chance at Life: Why Equity Matters for Children," which focuses on MDG 4: reducing under-5 mortality by two thirds between 1990 and 2015. The report examines the disparities in progress on child survival between the wealthy and less well-off in countries around the world. It asserts that reaching marginalized communities is the key to reducing inequities and achieving MDG 4.
“The Millennium Declaration was designed to improve the lives of the world's most disadvantaged people,” said Lake. “We believe this study's findings can have a real effect on global thinking about how we are pursuing the MDGs, and about human development generally – helping us improve the lives of millions of vulnerable children.”


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