A HUB FOR IDEAS, DEBATE AND RESOURCES ON HOW THE WORLD IS DOING ON INTERNATIONAL DEVELOPMENT GOALS
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, Nepal’s 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 Britain’s 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-law…because [of] the 24-hour delivery.”
Nepal’s 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.