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(Reuters Health) Nov 14 - Poor people in developing countries are not getting access to basic health services, such as immunizations and maternity care, according to a new series of reports released today by the World Bank.

The reports highlight pronounced gaps between the care of rich and poor people in 44 developing countries, underscoring the need for more effective outreach.

In other words, when it comes to health programs for the poor, it’s quality - not quantity - that matters. “They’re good for the poor only if they reach the poor,” Davidson Gwatkin, a health and poverty specialist with the World Bank, told Reuters Health.

The economic divide is evident, for example, in the death rates of Bolivian and Turkish children under 5 years of age. The poorest children’s mortality rates can be four times higher than those of their rich counterparts in the same countries. Furthermore, fewer than 40% of the poorest children are fully immunized compared with nearly 70% of children from the richest households in sub-Saharan Africa, according to the reports.

The report on Nicaragua shows that an average woman living in poverty will have more than six children in her lifetime, versus two for a woman of means.

The Bangladesh report shows that a rich woman is 15 times more likely than a poor woman in that country to have a medically trained person, such as a nurse, nurse-midwife or physician, present during the delivery of her baby.

“These reports clearly show that basic health programs are not serving the poor well enough to close the inequality gap with the rich,” Gwatkin said.  “They point to an obvious and pressing need for redoubled and more effective efforts to reach people in greatest need.”

While conceding that such inequalities have long existed, Gwatkin said that the economic comparisons made in the reports illustrate, quite starkly, the magnitude of the gulf between the rich and the poor. “One would hope by quantifying these things...it becomes more difficult to ignore,” he said.

The reports were commissioned by the World Bank’s group on Socioeconomic

Differences in Health, Nutrition and Population. Rather than presenting data

for entire national or regional populations, the studies report health,

nutrition and population data for each 20% of a country’s population measured

by household wealth.

 

“This makes it possible to examine each 20% separately, and to compare conditions between the separate groups,” Gwatkin said.

 

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