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On inequality in health and pro-poor development: the case of Southeast Asia

Jacques Silber (Department of Economics, Bar-Ilan University, Ramat-Gan, Israel AND CEPS/INSTEAD, Esch-sur-Alzette, Luxembourg)

Journal of Economic Studies

ISSN: 0144-3585

Article publication date: 12 January 2015




The purpose of this paper is to aim at taking a closer look at the decline in the inequality of the distribution of four health variables, infant and child mortality, child stunting and underweight, that took place in various Southeast Asian countries during the past 25 years. More specifically its goal is to check the extent to which this decline in health inequality, as well as the overall reduction in infant and child mortality, in child stunting and underweight, affected the poorest wealth quintile of the population of these countries.


In the first part of the paper the author presents a systematic comparison of the values taken by various consistent measures of the inequality of health attainments and shortfalls for several countries in Southeast Asia and for four health indicators: infant mortality, child mortality, child stunting and underweight. The second part of the paper uses the concept of Shapley decomposition to determine the respective impacts of the decrease in the average value of these health variables and in the inequality of their distribution on the reduction observed for each of these variables in the lowest wealth quintile.


During the period examined there was an important decline infant and child mortality as well as in child stunting and underweight in all countries of Southeast Asia for which data were available. As far as the poorest wealth quintile is concerned this decline was mostly the consequence of the overall decline in these health variables rather than to the reduction of the inequality of their distribution.

Research limitations/implications

Data were available for only four health variables and for many countries data were available for only one period.

Practical implications

A decline in health inequality should be considered as an important aspect of poverty reduction.

Social implications

Development should not be limited to its economic components. A broader view of development is indispensable.


This study is probably one of the first ones to provide the reader with data on the reduction in health inequality in Southeast Asia as well as on the impact of this decline on the poorest wealth quintile.



©Asian Development Bank. The views expressed in this publication are those of the authors and do not necessarily reflect the views and policies or the Asian Development Bank (ADB) or its Board of Governors or the governments they represent. ADB does not guarantee the accuracy of the data included in this publication and accepts no responsibility for any consequence of their use. By making any designation of or reference to a particular territory or geographic areas, or by using the term “country” in this document, ADB does not intend to make any judgments as to the legal or other status of any territory or area.

JEL Classification — D63, I19

This paper is an extension of the first part of a presentation I gave at the ADB workshop on “Poverty Reduction in Asia: Drivers, Best Practices and Policy Initiatives” held at Sogang University, Seoul, South Korea, on August 23-24, 2013. The author would like to thank the discussant, Satya Chakravarty, and other participants to this workshop for their very helpful comments.


Silber, J. (2015), "On inequality in health and pro-poor development: the case of Southeast Asia", Journal of Economic Studies, Vol. 42 No. 1, pp. 34-53.



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