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Addressing Geographical Inequalities in Development: Roles for Donors and Governments

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Major geographical inequalities pose significant challenges in development, particularly in health, education, and nutrition. While government efforts have yielded some progress, political will remains lacking. Donors must be proactive by focusing on large-scale issues, collaborating across sectors, and adopting transparent monitoring methods. Additionally, recognizing achievements and prioritizing human resources are key to driving social sector improvements. Effective strategies can help address disparities in service provision and improve outcomes for vulnerable populations, thereby reducing the multiplier effect of deprivation.

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Addressing Geographical Inequalities in Development: Roles for Donors and Governments

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  1. Equity Major geographical inequalities exist This is a major development issue Progress in some areas by government – but little apparent appetite/ political will What can/ should donors do?

  2. Health inputs

  3. Western districts spend less per capita on basic services

  4. More than threefold variation in teachers Substantially lower inputs

  5. Substantially worse outcomes Pass rate of PSLE exams, by region, 2010

  6. A consistent picture across sectors NUTRITION – child stunting

  7. Variation in water availability – but the pattern is different

  8. Variations in fertility likely to compound the issue

  9. Is this important? • Efficiency and effectiveness of spend • Waste of human capital • Politically destabilising • ‘multiplier of deprivation’

  10. What should donors do? • Focus on big issues • Work across sectoral silos • Encourage consistent transparent approaches to monitoring progress • Recognise achievements • Human resource the major driver in social sectors • Pay and incentive strategy to meet sectoral priorities • Agree one system and support consistently • Celebrate achievements – eg in education staffing

  11. There has been progress in key areas PTR is falling – but variance falls faster

  12. PAF 2013 • Decrease the number of districts where: • Primary PTR is greater than 50 • Nurse / population ratio is worse than 3/1000

  13. Do Donors do better? Nutrition data

  14. Key messages • Measuring geographic inequalities (let alone remedying them) is challenging. • LGA level data is fragmented and unreliable • Major geographical inequalities exist whether one considers inputs outputs or outcomes. • Key driver is staff recruitment and retention • Inequalities compound each other • Despite good political reasons for inertia, government has made progress in some areas • Donors talk a lot about inequality – but is our investment any better?

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