224
Gwatkin and Ergo
e av er ag
a bi m Za
M
oz a
m
bi
Gh
qu
an
a
e
90 80 70 60 50 40 30 20 10 0
Et hi op ia
poor population, percent
Figure 12.2 Geographic Distribution of Poverty in Ethiopia, Ghana, Mozambique, and Zambia
living outside a poor district
living outside a very poor district
Source: World Bank data. Note: A poor district is one of the country’s poorest 50 percent of districts; a very poor district is one of the country’s poorest 25 percent of districts. Ethiopian data are available for only around 90 percent of zones (referred to as “districts” here for the sake of comparability). Averages are unweighted.
portion of the population below the poverty line lives outside the poorest districts. On average, almost half (46 percent) of the poor live outside the economically poorest half of districts; nearly three-quarters (74 percent) live outside the poorest quarter of districts. These people would be missed by a program taking only a geographic approach to identifying the poor. At this point, the second of the two considerations mentioned at the start of this section comes into play: the economic status of the people served by the additional health workers within the parts of the country where they are assigned. This consideration is important because, as just seen, some nonpoor people live in even the poorest districts, while some poor people live in the districts where poverty rates are lowest overall. Such a pattern presents two possibilities. First, additional health personnel assigned to the poorest district might serve many people who are not economically poor. To be sure, it would be hard to go too far astray when working in an area where, for example, more than 80 percent of the population is below the poverty line. Still, in even the poorest parts of the poorest countries, there is likely a significant minority of people who are considerably less poor than others; and some types of health personnel (for example, specialized surgeons in district hospitals that charge for