2012年-世界发展银行全球_Madagascar_-_Three_Years_into_the_Crisis___An_Assessment_of_Vulnerability_and_Social_Policies_and_Prospects_for_the_Future_Volume_2_Background_Papers_397页_4mb

Summary of "Madagascar Three Years into the Crisis: An Assessment of Vulnerability and Social Policies and Prospects for the Future"

Core Content

This report, prepared by the World Bank in 2012, evaluates the state of social protection in Madagascar three years after the political and economic crisis that began in 2009. It outlines the current vulnerability and risk profile, existing social protection programs, and the strategic challenges in developing a more effective and sustainable social protection system.

Main Risks and Vulnerability Dimensions

• Risks: Environmental (drought, cyclones, floods), economic (rising food prices, especially rice), and political (crises in 2002 and 2009) shocks have significantly increased vulnerability in Madagascar.
• Vulnerability Profile:
  • Monetary Poverty: High, affecting 76.5% of the population in 2010.
  • Human Development Deprivations: Most severe in the poorest quintiles, but still significant across all quintiles.
  • Spatial Dimension: Rural areas, especially the drought-prone south, are more vulnerable due to geographic concentration of risks and limited access to markets and services.
  • Life Cycle Dimension: Young children and the elderly are most vulnerable, with higher rates of malnutrition, morbidity, and mortality among children.
  • Gender Dimension: Women and girls face additional risks due to patriarchal attitudes and limited opportunities.

Existing Social Protection Programmes

• Social Insurance: Limited, covering only a small proportion of the population (less than 4% of workers) and a narrow set of risks.
• Social Assistance: Minimal, with only a few programs such as nutritional supplements and school feeding, which are often donor-funded and lack sustainability.
• Labour Intensive Public Works (HIMO):
  • Provide wage-based social transfers.
  • Aim to improve income and food security, as well as rural infrastructure and environmental protection.
  • Cover only about 10.5% of the poor (including indirect beneficiaries) and provide less than 25 days of work per person annually.
  • Quality and durability of infrastructure are often criticized.
• Tsena Mora:
  • A government-led initiative providing subsidized rice and cooking oil to the urban poor.
  • Has wide urban coverage but excludes rural areas, where food insecurity is most acute.
• Education and Health Sectors:
  • Education: Fee abolition in 2003 and free school kits have been introduced, but school feeding is limited to vulnerable areas and has not been implemented in 2010/11.
  • Health: Reintroduction of health fees in 2004 led to a regressive system. Free services are limited, and fee exemptions are not widely utilized due to stigma.

Policies, Institutions and Resources

• Policy Framework: Social protection programs have been developed ad hoc, often by donors, without a coherent national policy.
• Institutional Weakness: The core ministry for social protection is weak and has faced instability. Coordination between different sectors and institutions is poor.
• Resources: Government expenditure on social protection has declined sharply, with a 89% drop at current prices and 91% at constant prices between 2008 and 2010. Donor aid has partially offset this decline.
• Human Resources: A major constraint in implementing and managing social protection programs.
• Monitoring and Evaluation: Weak culture and systems in place.

Strategic Challenges

• Programme Priorities: Should be based on risk/vulnerability profile, potential impacts, cost-effectiveness, and feasibility.
• Labour Intensive Public Works (HIMO):
  • Scaling up HIMO could be the best option for supporting the poorest and building resilience.
  • Needs better design and implementation, particularly in terms of wage rates and quality of work.
  • A common manual and a dedicated national agency would help improve coordination and efficiency.
• Education:
  • Reducing the burden of community-paid teachers is a top priority.
  • Stabilizing the teaching corps and reducing the financial load on parents are key challenges.
• Health:
  • More equitable health financing mechanisms are required.
  • Selective fee exemptions based on medical priorities could be a viable option to reduce under-5 and maternal mortality.
  • Generalized fee abolition is not feasible due to budget constraints and administrative challenges.
  • Stigma remains a barrier to the effectiveness of fee exemptions and other social protection mechanisms.

Key Recommendations

• Develop a long-term social protection strategy based on a comprehensive understanding of risk and vulnerability.
• Scale up and improve the design of HIMO programs to ensure broader coverage and sustainability.
• Focus on reducing the financial burden of education on households, particularly for the poorest.
• Implement more targeted and effective health financing mechanisms, including selective fee exemptions.
• Strengthen institutional capacity and coordination to ensure the sustainability and effectiveness of social protection initiatives.
• Encourage government leadership and co-financing to support pilot programs and ensure their long-term viability.

Conclusion

Madagascar faces significant challenges in establishing a robust and sustainable social protection system. While some initiatives exist, they are often limited in scope, coverage, and effectiveness. A strategic and coordinated approach, supported by adequate funding and institutional capacity, is essential to address the deep-rooted vulnerability and improve the well-being of the population.