Getting to zero: How we can be the generation that ends poverty

from Save the Children
Published on 17 Sep 2013 View Original

Our generation can end extreme poverty. We can finish the job the Millennium Development Goals (MDGs) began.

That’s the exciting conclusion of Save the Children’s major new report, Getting to Zero: How we can be the generation that ends poverty. If incomes become a bit more equal and governance improves, 850,000 children’s lives could be saved every year by 2030 in Sub-Saharan Africa alone.

But what does ‘improving governance’ mean?

For essential services like health clinics and schools, it’s about running them better. In Liberia, services should respond to Liberians’ needs, and Liberians should be able to participate in running their services, holding those in charge to account.

Helping Liberians to help themselves

At Save the Children, we support the Liberian government’s efforts to improve essential services. We help people to hold providers to account. We see more responsive services improving health, saving lives, and reducing poverty.

So how can better governance practically help?

Here’s a good example.

Medicine shortages at Liberian clinics cause tragedies, but they also have indirect costs. Around 40% of Liberians live over 5km from their nearest facility – a problem Save the Children is helping to fix. This means that if they walk to health clinics and find no medicine, they are less likely to come back next time.

Why do shortages like these occur?

Sometimes, it’s because of corruption. There’s clearly an incentive to cook the books and sell drugs to those in need – undermining trust and sapping people’s often meagre incomes.

County oversight and sanctions can help. Yet fundamentally, those running clinics must be directly accountable to the people with the greatest interest in those precious medicines: those taking them.

Enter Community Health Development Committees. Introduced by the Liberian government and run by local volunteers, these fantastic forums hold clinics to account.

These institutions don’t exist everywhere in Liberia. They should. They should be empowered to take ownership of services. One interesting idea is for committee chairs to oversee bookkeeping and literally hold the keys to the warehouse, helping ensure drugs are available.

Accountability rooted in responsibility

But these volunteers already have busy, tough lives. It is worth considering how best to provide incentives to facilitate their vital contribution, while preserving their independence.

In the long run, sustained commitment by donors and government to local ownership can ensure scarce funds are invested in making services accountable.

The post-2015 agenda – global goals being designed to replace the Millennium Development Goals – can help. Big targets can sustain political will, focus funding, and help government and partners to work together. By helping Liberians and others to hold providers of essential services to account, we really can achieve something that a few decades ago seemed impossible: ending extreme poverty in our generation.