scenario in which all low-income countries meet more stringent standards for revenue allocation and health sector financing. While only indicative in nature, this estimate provides a valuable ballpark figure for the additional international public financing that would be needed to bring the 2030 child and maternal 114 health targets within reach. Targeted schemes to finance services for the poor, exempt them from user fees and provide them with insurance have a mixed record of success. experience shows that targeted financing often has a negligible impact on service utilization. financing the entry of poor households into existing national health insurance programmes, which pool risk across populations, has 115 produced more positive results. Brazil’s family health Programme, for example, expanded coverage from 10.6 million to 100 million people between 1998 and 2010, with an initial focus on disadvantaged areas. The programme provides access to health care – free at 116 the point of use – to more than 90 per cent of the country’s municipalities. Thailand’s Universal Coverage Scheme (UCS) enhanced equity by bringing a large uninsured population under the umbrella of a national programme, greatly reducing ’catastrophic‘ health payments among the poor and improving BOx 1.3 BANGLADESH SHOWS THE CHALLENGE OF SUSTAINED PROGRESS IN CHILD SURvIvAL In recent years, Bangladesh has made solid progress behind the rest of the country. And fewer than one third in reducing mortality rates among children under age of women received the recommended minimum of four 5. Part of its success can be traced to the expansion antenatal care visits in 2014. of community-level health interventions. Accelerated progress will depend on expanded and more equitable on a more positive note, Bangladesh has been making provision of antenatal care and skilled birth attendance. progress towards equity in terms of deliveries that take place in health facilities. In 2004, the ratio of poorest-to- Starting from a low base, the country has already richest women delivering in a health facility was 1 to 12. achieved a rapid expansion of coverage in both areas. By 2014, the ratio had improved to one to four. The proportion of babies delivered in health facilities increased from 8 per cent to 37 per cent between 2000 Recognizing that sustained improvements in maternal and 2014. Antenatal coverage by skilled providers also and child health will require a greater reduction in rose, from 33 per cent to 64 per cent. disparities between different social and economic groups, the government has introduced a range of equity targets Nevertheless, large disparities remain. The wealth gap for key interventions. The targets form the basis for in access to skilled antenatal care has declined only monitoring coverage in low-income communities, urban marginally. Coverage is 36 per cent for the poorest slum areas, poor-performing districts and areas with women and 90 per cent for the wealthiest. The ratio ethnic minorities, such as the Chittagong Hill Tracts in of poor-to-rich women benefitting from skilled birth south-eastern Bangladesh. Taken together, they represent attendance in 2014 was about one to four, with two of a potential pathway to equity for the country’s most the country’s divisions – Sylhet and Barisal – lagging far disadvantaged mothers and children. Source: national institute of Population research and Training (niPorT), Mitra and associates, and iCf international, Bangladesh demographic and health Survey 2014: Key indicators, dhaka, Bangladesh, and rockville, Maryland, USa, 2015. The STaTe of The World’S Children 2016 35