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The Definition
of Social Protection
Child Protection
Early child development activities—e.g., basic nutrition, preventative health,
and educational programs
Educational assistance (e.g., school-feeding, scholarships, fee waivers)
Health assistance (e.g., reduced fees for vulnerable groups)
Street children initiatives
Child rights and advocacy/awareness programs against child abuse, child labor etc,
Youth programs to reduce health risks (especially HIV/AIDS and drugs) and
anti-social behaviour.
Family allowances (e.g., in-kind or cash transfers to assist families with young
children to meet part of their basic needs).
Source: Derived from I. Ortiz (ed.), Defining an Agenda for Poverty Reduction—Proceedings of the First
Asia and Pacific Forum on Poverty, Volume 2, p. 57, ADB, Manila, 2002; ADB, Social Protection Strategy,
pp. 14–22, Manila, 2001.
19 Socialist Republic of Viet Nam, 2003, Comprehensive Poverty Reduction and Growth Strategy.
Ha Noi.
The overall conclusion is that Asian countries, even if they do not use
the term “social protection,” implicitly see it as constituting a narrower range
of programs than contained in ADB’s definition, primarily consisting of: the
more traditional components of social protection, i.e., social welfare/assistance
to vulnerable groups (including targeted pro-poor schemes), social insurance,
and labor market programs; and targeted poverty reduction programs.
20 See Halcrow, 2005, op. cit, Main Report, Volume 1, Chapter 2 and Viet Nam Country Report
in Weber, 2006, op. cit.
Table 2.2 contains a schedule of the types of programs that are considered
to fall within the definition above. The table also indicates those programs
falling within ADB’s categorization of social protection activities that will
not be considered in this study. The latter mainly includes programs that
either involve the construction of physical or social infrastructure, integrated
community development schemes and programs that traditionally fall within
the education and health sectors, such as primary and preschool education,
immunization, health and nutrition education, and pre- and postnatal care.
child protection; it was feared that including all health care would overwhelm
the more traditional aspects of social protection, which were exactly those
which the study was designed to highlight. On the other hand, if health care
is primarily funded through health insurance schemes, it does fall within the
definition of social protection.
During the course of technical assistance (TA) 6120, it was realized
that this approach creates an anomaly whereby, depending on the funding
mechanism, expenditure on health may or may not be included in the
calculations for this study. This issue (which could also apply to expenditure
on basic education) was discussed during the concluding stages of the
previous study, but no conclusion was reached about how best to proceed.
Accordingly, the current study has proceeded using the same methodology as
for TA 6120. This issue was raised again in this study by the consultants in
Sri Lanka and Uzbekistan. Given the concern relating to this issue, we have
re-examined this issue in Annex 5 which contains an analysis of the impact of
including all health care in the definition of social protection.
This analysis21 showed that incorporating general health services into
the calculations would lead to a domination of the social protection summary
indicators (SPSIs), and the SPI in many countries by this sector and would
make it harder to identify issues relating to the traditional components of
social protection. This is particularly the case for countries where provision
is very low—in these countries, over 75% of the SPI value would relate
to health expenditure and coverage. Furthermore, the social protection
distribution (SPDIST) indicator would be redundant as it would be the same
for all countries and would thus say nothing about the coverage of the poor by
non-health social protection programs. SPDIST and the health target group
coverage rate would also say nothing about the quality of coverage of the
health system, i.e., how well does it provide for the needs of the population,
and the poor in particular.
Based on this analysis, incorporating health care into the current
formulation of the SPSIs and the SPI is not considered to be either feasible
or desirable. It is not feasible because the SPDIST indicator would become
redundant as it would have the same value for all countries and the health
target group coverage ratio would give little indication of the quality of the
health care provided as, again it would be the same for all countries; and not
desirable, because, in many cases, health services would dominate the SPSIs
21 Because this analysis replicates the methodology used to calculate the SPSIs and the SPIs
which will be described later in this report, it is not recommended that it be read until the
reader has been through the rest of the report.
and the SPIs, making it much more difficult to identify the characteristics
of, and variations in, the provision of the traditional components of social
protection, which were always the primary focus of this study. These
conclusions would still apply if a more sensitive approach could be devised
to assessing the coverage indicators for health care than has been possible in
this study.
In the future, a possible solution would be to exclude all health-related
programs from the current SPI formulation and create a parallel index
consisting of three or four component indicators relating only to health care
coverage and expenditure, i.e., a health protection index. This option is not,
however, achievable with the resources available to this study as it would
require additional data collection and analysis. Consultations and discussions
are also needed to achieve a consensus as to how such this index should be
formulated.
The overall conclusion is that the methodology used in this and the
previous study should be retained. As will be demonstrated, the results
from this study can be used to provide an initial assessment of the current
provision of social protection and give pointers to possible priorities for new
interventions. This would become much harder if all health care services
were to be included into the study (and implicitly ADB’s) definition of social
protection.