DAC Guidelines and Reference Series « Poverty and Health DAC Guidelines Health is higher on the international agenda than ever before. Concern for the health of poor people is a central development issue. In addition to its intrinsic value for individuals, and Reference Series investment in health is an important and previously underestimated means of economic development; substantially improved health outcomes are a prerequisite if developing countries are to break out of the cycle of poverty. This DAC Reference Document on Poverty Poverty and Health, jointly published by the OECD and WHO, extends the analysis and recommendations of the DAC Guidelines on Poverty Reduction by setting out the essential and Health components of a pro-poor health approach. It provides a framework for action within the health system – and beyond it, through policies in other sectors and through global initiatives. The Reference Document is aimed at a broad range of development agency staff working in policy and operations, at headquarters and in the field. The recommendations are also relevant for policy makers and planners in partner countries. DAC Guidelines and Reference Series: Poverty and Health DAC Guidelines and Reference OECD’s books, periodicals and statistical databases are now available via www.SourceOECD.org, our online library. This book is available to subscribers to the following SourceOECD themes: Development Emerging Economies Social Issues/Migration/Health Transition Economies Ask your librarian for more details on how to access OECD books on line, or write to us at: [email protected] www.oecd.org WHO ISBN 92-4-156236-6 ISBN 92-64-10018-0 43 2003 05 1 P World Health Organization -:HSTCOB=Z[WX[W: -:HSTCQE=VUUV]X: © OECD, 2003. © Software: 1987-1996, Acrobat is a trademark of ADOBE. All rights reserved. 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DAC Guidelines and Reference Series Poverty and Health ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT WORLD HEALTH ORGANIZATION ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT Pursuant to Article 1 of the Convention signed in Paris on 14th December 1960, and which came into force on 30th September 1961, the Organisation for Economic Co-operation and Development (OECD) shall promote policies designed: – to achieve the highest sustainable economic growth and employment and a rising standard of living in member countries, while maintaining financial stability, and thus to contribute to the development of the world economy; – to contribute to sound economic expansion in member as well as non-member countries in the process of economic development; and – to contribute to the expansion of world trade on a multilateral, non-discriminatory basis in accordance with international obligations. The original member countries of the OECD are Austria, Belgium, Canada, Denmark, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, Turkey, the United Kingdom and the United States. The following countries became members subsequently through accession at the dates indicated hereafter: Japan (28th April 1964), Finland (28th January 1969), Australia (7th June 1971), New Zealand (29th May 1973), Mexico (18th May 1994), the Czech Republic (21st December 1995), Hungary (7th May 1996), Poland (22nd November 1996), Korea (12th December 1996) and the Slovak Republic (14th December 2000). The Commission of the European Communities takes part in the work of the OECD (Article 13 of the OECD Convention). In order to achieve its aims the OECD has set up a number of specialised committees. One of these is the Development Assistance Committee, whose members have agreed to secure an expansion of aggregate volume of resources made available to developing countries and to improve their effectiveness. To this end, members periodically review together both the amount and the nature of their contributions to aid programmes, bilateral and multilateral, and consult each other on all other relevant aspects of their development assistance policies. The members of the Development Assistance Committee are Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, Luxembourg, the Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, the United Kingdom, the United States and the Commission of the European Communities. WORLD HEALTH ORGANIZATION The World Health Organization was established in 1948 as a specialized agency of the United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO's constitutional functions is to provide objective and reliable information and advice in the field of human health, a responsibility that it fulfils in part through its extensive programme of publications. The Organization seeks through its publications to support national health strategies and address the most pressing public health concerns of populations around the world. To respond to the needs of Member States at all levels of development, WHO publishes practical manuals, handbooks and training material for specific categories of health workers; internationally applicable guidelines and standards; reviews and analyses of health policies, programmes and research; and state-of-the-art consensus reports that offer technical advice and recommendations for decision-makers. These books are closely tied to the Organization's priority activities, encompassing disease prevention and control, the development of equitable health systems based on primary health care, and health promotion for individuals and communities. Progress towards better health for all also demands the global dissemination and exchange of information that draws on the knowledge and experience of all WHO's Member countries and the collaboration of world leaders in public health and the biomedical sciences. To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures the broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease throughout the world, WHO's books contribute to achieving the Organization's principal objective - the attainment by all people of the highest possible level of health. Publié en français sous le titre : Pauvreté et santé Les lignes directrices et ouvrages de référence du CAD © Organisation for Economic Co-operation and Development (OECD), World Health Organization (WHO) 2003 Permission to reproduce or translate all or part of this book should be made to OECD Publications, 2, rue André-Pascal, 75775 Paris Cedex 16, France. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization or of the Organisation for Economic Co-operation and Development concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The World Health Organization and the Organisation for Economic Co-operation and Development do not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. WHO Library Cataloguing-in-Publication Data Poverty and health. (DAC guidelines and reference series) 1.Poverty 2.Health status 3.Delivery of health care - organization and administration 4.Financing, Health 5.Public policy 6.Intersectoral cooperation 7.Guidelines I.Organisation for Economic Co-operation and Development. Development Assistance Committee. ISBN 92 4 156236 6 (WHO) (NLM classification: WA 30) 92 6 410018 0 (OECD) FOREWORD Foreword Over recent years OECD and WHO have been collaborating in a range of areas, including on the OECD Health Project which aims to analyse, measure and improve the performance of health systems in OECD countries. This DAC Reference Document dedicated to health and poverty in developing countries is another example of the fruitful collaboration between our two institutions. We have decided to publish it jointly in order to ensure a wide readership in both the development and public health communities. In developing countries, breaking the vicious circle of poverty and ill health is an essential condition for economic development. The fact that three of the eight Millennium Development Goals are specific to health is evidence of the consensus on this point across the international development community. In response to this global concern, this Reference Document deepens the approach taken by the DAC Guidelines on Poverty Reduction (2001). It adds further insight into the role of health in reducing poverty and the range of investments required to achieve better health outcomes for poor people as an integral component of poverty reduction strategies. Achieving better health for poor people requires going well beyond the health sector to take action in related areas such as education,