- Nearly twice as likely to not receive measles immunizations
- Twice as likely to die before their fifth birthday
- Significantly less likely to have access to improved drinking
water sources
- Less likely to attend primary school
- Much less likely to benefit from malaria interventions
- Three times as likely to get married before the age of 18 (for
girls)
than those children from households in the richest income quintile
of the same country.
In sum, there is overwhelming evidence that those at the bottom of
the income chain are those most likely to be excluded from essential
health care services, improved water and sanitation facilities, and
primary and secondary education, among others. Moreover, in
many instances trends in social inequalities can be exacerbated over
time. In India, for example, 166 million people gained access to
improved sanitation between 1995 and 2008, but little progress was
made in the poorest households, which furthered social inequalities
(UNICEF 2010b:43). In West and Central Africa, measles
immunization coverage increased by ten percent in the wealthiest
quintile of the population but only three percent in the poorest
quintile, thus widening the gap in social inequalities (UNICEF
2010b:25).
- Beyond the Bottom Billion: Bringing Equity to the
Development Agenda
Given that the bottom billion requires urgent attention to alleviate
their enduring hardships, social progress in the 21st century requires
much greater efforts. To start with, attention needs to focus on the
fact that the world’s policy-making is accruing mostly to the top
billion.
The extreme inequality in the distribution of income globally,
regionally and nationally, coupled with the resounding negative
effects associated with higher levels of income disparities, should