Institute for Development Studies (IDS)

According to the authors, this 26-page paper attempts to identify ways of tackling social exclusion through promising practices in health and education in the Asia region. The objective of this study was to accelerate progress towards achieving the Millennium Development Goals (MDGs) for primary education, child mortality and infant mortality through looking at educational and women's health delivery systems. The premise of the study is that development work on poverty must first address the issue of social exclusion in order to progress towards achieving the MDGS.

The research is based on six case studies from Nepal, Bangladesh, and both Mumbai and Orissa, India. Through these case studies, this paper examines processes through which ethnic minorities, disadvantaged castes, the ultra-[economically] poor, women, and migrants have been excluded. It then outlines the ways to realign incentives for greater inclusion and draws programmatic lessons for the design and implementation of more effective responses.

After a discussion of social exclusion providing contextual understanding for the reader, each case study is presented with project background, processes of social exclusion specific to the population, strategies of inclusion, and lessons from that particular project.

The conclusion offers some of the following lessons and strategies:

• At a policy level, health and education service delivery needs to focus on the prioritising of programmes for socially excluded populations. The study found that when this has occurred, the results demonstrated reforms within government systems at a level of effectiveness that goes beyond single projects.
• Incentives can enable communities to work together to address exclusion. Strategies in education include: financial incentives to schools for inclusion of ethnic and female minorities and a female stipend. The female stipend is money given to families and schools for increased attendance of girls as a strategy to raise the status of women, delay marriage and child bearing for population control purposes, and reduce poverty.
• Community participation and ownership can change exclusionary patterns. Examples are: participatory school planning and monitoring, creating residential schools that care for children whose parents need to migrate seeking employment, and involving social elites as protectors to generate social capital for the rural economically poor.
• Addressing livelihood security issues through women's micro credit and savings associations for access to financial capital can positively impact family health and women's willingness to seek health care.
• Social marketing of health care systems and client-centred services for women can build trust in existing systems accessible to excluded populations.

Finally, the study focuses on policy implications of donor relationships, research, service delivery systems reforms, and reforms that prioritise strategic mechanisms to address the needs of the socially excluded.

Click here to access a related peer-reviewed summary on the Health e Communication website, and to participate in peer review.