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28 September 2010, Ulaanbaatar – As the efforts for final steps in reaching the Millennium Development Goals (MDGs) is being widely deliberated globally, as well as here in Mongolia, a new UNICEF study: Narrowing the Gaps to Meet the Goals study and Progress for Children: Achieving the MDGs (PFC 2010) illustrates that many more lives can be saved by investing first in the most disadvantaged children and communities. The study argues that as we enter the last five years of the MDG cycle, we stand the best chance of achieving the MDGs, using resources most efficiently, and saving lives by prioritizing the delivery of life-saving interventions to women and children who are the most deprived, who suffer the greatest discrimination and who fall furthest outside existing safety nets. Since the establishment of the MDGs almost a decade ago, data shows there have been clear gains made in decreasing the number of women and children dying of preventable causes. However, in many countries, falling national averages for child mortality or improvements in education data conceal widening inequities particularly in rural and peri-urban areas, where disparities in access to services and the quality of services – is dragging overall development downwards. The UNICEF study examined sub-national trends in 26 countries where under-five mortality has declined by 10 per cent or more since 1990. In 18 of these countries, the gap between the child mortality rates of the richest and those of the poorest quintiles has either grown or remained unchanged. And in 10 of these 18, the gap has risen by at least 10 per cent.  UNICEF’s new study: Narrowing the Gaps then estimated the cost of reaching these children –addressing access concerns, delivering equipment, supplies and trained staff where they are most needed.  It has always been predicted that reaching these children directly would cost too much to the health or education budgets. The study findings however challenged this – and showed clearly that in fact it is more cost effective to target directly those affected by disparities – that in fact for every one million invested – 60% more children’s lives are saved.   “In this way, we will save more women and children per dollar spent than many traditional approaches to providing health interventions in developing countries”, said Rana Flowers, UNICEF’s Representative in Mongolia. “Economic growth alone has made little impact on poverty or achievement of development goals in Mongolia. We need to shift our strategies to make very conscious reallocations of budget. The study calls for  looking carefully at where the disparities in access and quality of basic social services is occurring and come up with a plan to specifically target these areas along with appropriate budgeting. Investing in health and nutrition today – will only save budget in the future, added Flowers. The Ministry of Health this week announced reductions by one third in child and maternal mortality figures for Mongolia. In line with an equity-based approach it has also been currently rolling out a ‘reach every child in every district’ strategy (RED) and has made the very positive move to include essential child medicines in the list of drugs to be subsidized through the Health Insurance scheme. Furthermore, signals of an incremental increase to the budget allocated for vitamin A and D in the coming years is also a key to achieving high impact interventions that save women and children’s lives. “The goal now is to introduce steps into the budget review process that carefully consider disparities and as the GDP and wealth of Mongolia grow, we need a stronger mechanism in place that ensures that a significant percentage of the growth is channeled back to addressing the situation of the poorest and most vulnerable. We have economic growth currently without a sustainable and direct link to human development and without achieving a sufficient reduction in poverty.  Such a system would ensure that in the future we achieve both. The equity-focused approach model aims to accelerate progress towards the health MDGs, reduce disparities, lower out-of-pocket expenditures for the poor, and enhance the cost-effectiveness of health investments.  This is an investment worth making,” she concluded.






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