Reaching the poor

doi:10.1136/bmj.331.7530.1417

BMJ 2005;331:1417 (17 December), doi:10.1136/bmj.331.7530.1417

Editorial

Reaching the poor

Need initiatives that reduce rather than exacerbate health inequities

The first 150 words of the full text of this article appear below.

Globally around 1.2 billion people live on less than $1 a day.The erosive impact of poverty on their health and the link betweenill health and poverty is well known.¹ But most interventionsaimed at alleviating poverty and improving health in poor countrieshelp the better off more than the most disadvantaged.² Suchinequity of impact is often conveniently masked by expressingoutcomes of evaluations as population averages, a flaw inherenteven in the three health related millennium development goals.Now a report from the World Bank looks at the evidence and suggestshow to reach the poor more effectively.³

The data in the report, from 78 programmes on health, nutrition,and population conducted in 56 poor and medium income countriesbetween 1990 and 2001, are sobering. Under-5 mortality was morethan twice as high among the poorest fifth of the populationthan the richest fifth (see bmj.com). . . . [Full text of this article]

Tessa Richards, assistant editor

(trichards@bmj.com)
BMJ, London WC1H 9JR