Every Last Child: Tackling exclusion in a new development era

Shaheen, Faiza; Glennie, Jonathan; Lenhardt, Amanda; Roche, Jose Manuel (2016). 'Every Last Child: Tackling exclusion in a new development era' Paper presented at the annual conference of the HDCA, Tokyo 2016.

Despite impressive progress over the last two decades, millions of children remain unable to access essential services and are not protected due to the combined effects of poverty and discrimination.  The exclusion faced by particular groups of children is not an accident but the result of actions at four levels - the household, local level, national level and international level.
This paper explores the causes, impacts, and possible solutions to the persistent exclusion of particular groups of children at each of these levels, particularly as it relates to unequal health and education outcomes. It highlights exclusion based on ethnicity, race, religion and caste, regional disadvantage, gender, conflict and displacement, disability, disadvantage in urban areas and informal urban settlements and young people with diverse genders and sexualities.
The Groups-based Inequality Database (GRID), developed by Save the Children, is used to undertake new analysis on the extent of inequalities between these groups of children and their peers. This database contains statistics on human development outcomes computed from direct data processing of more than 280 household surveys (191 time periods)  and a large compilation of aggregated public sources. We used GRID to compute a Child Development Index and to undertake a series of new analyses, including how the situation is evolving over time. The report also uses in-depth analysis undertaken in 28 countries where Save the Children works. Save the Children experts, working on the ground with the most excluded groups, produced a series of Country Spotlights, with rich evidence that helps to understand specific country contexts and the drivers behind the vast inequalities in children’s outcomes.
Our findings highlight that exclusion is apparent in every country and for millions of children. The report also shows that the extent of inequalities between these groups of excluded children and their peers are significant and in many cases increasing. It also shows that, in addition to hurting millions of children, the economic and social impacts of these forms of discrimination are profound. Exclusion undermines trust, community cohesion, economic growth and peace.
The report highlights three barriers that are faced by excluded children at each level which prevent them from accessing health and education services and from being protected: financial barriers, discriminatory barriers and a lack of accountability.
Financial barriers include insufficient, inefficient and unequal public investment in essential services which mean that for many excluded children, basic health, nutrition and education services are simply not available. Inequitable government spending has meant that budgets are too often inequitably distributed, resulting in regional and local governments lacking the financial resources to reach or cater for excluded children. High direct, indirect and opportunity costsmean families in excluded groups are often unableto afford the basic services their children need tosurvive and learn.
Discriminatory laws and policies often manifest at the point of service delivery. This includes health workers sometimes targeting people in specific groups for bribes and informal user fees – as reported in India, West Africa and Guatemala. Furthermore, social and cultural discrimination are persistent and deeply embedded phenomena; change requires substantial additional efforts. The right of every child to exist is both a symbolic and practical starting point by which to ensure equal treatment. Yet many children are uncounted, by national-level data or through birth registration, and hence excluded from essential services and exposed to danger.
A common feature among excluded groups is their lack of voice and political representation in decision-making bodies. For excluded children and their families, a lack of voice and political representation can in many ways exacerbate exclusion and widen inequality. The accountability void that often exists between governments and excluded groups can stem from a lack of acknowledgement of the challenges faced by excluded groups. For example, very few countries collect or publish data that are disaggregated by ethnic or religious groups, or by relevant geographical level.
The report concludes that there are three guarantees that must be met to reach these excluded children: fair finance, equal treatment and accountability. The report shows that interventions need to be made at all four levels – household, local, national and international – if progress is to be made, from a range of fully implemented laws, policies and programmes, to a shift in resource allocation, with devotion of greater resources to excluded groups.

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