1. Social Inclusion: What Can We Do
Social Inclusion: What Can We Do? Designing Inclusive Programs and Policies
February 24, 2015 | 9:00 AM EST
Speaker: Maitreyi Bordia Das
Lead Social Development Specialist,
World Bank Group

2. Outline Basics on social inclusion Main messages Case example
Stylized steps to “doing” social inclusion
Final reflections on the nature of change towards social inclusion

3. What is social inclusion?
The process of improving the terms for individuals and groups to take part in society
The process of improving the ability, opportunity and dignity of people disadvantaged on the basis of their identity to take part in society
Social inclusion is…
Specific to time, place and identities
Multidimensional
Related to poverty and inequality, but goes beyond these
Both an outcome and a process

4. Inclusion in Markets, Services and Spaces
Taking part in society
Improving the terms

5. We can influence change towards social inclusion
Examples of change
Institutions can change (e.g. local justice in Bangladesh)
Framing of an issue can change (e.g. race in Brazil)
Cultural practices can change (e.g. foot-binding in China)
Outcomes can change (e.g. education of women in Jordan)
Change is inevitable. It could be towards inclusion or exclusion
Policies, programs and activism play a crucial role
Change may well be political but that’s not necessarily bad
Change needs multiple actors
Policies for social inclusion don’t always do more.
They do things differently.

6. Example
Understanding high maternal mortality among tribal women in India
‘Asking why’ and diagnosing the problem is often the first step toward social inclusion
No female provider 1%
80% of Adivasi women deliver their babies at home, versus 60% of all Indian women.
They do not trust facility 2%
Facility not open 5%
High maternal mortality among tribal women in India
Husband, family do not allow 5%
They don’t deliver babies in health institutions
Not customary 7%
(One of the reasons)
(One of the reasons)
(Most frequent reason)
They don’t think it necessary 72%
They are not treated with dignity
Why?
Why?
Too costly 23%
Why?
Too far, no transport 17%
Improve public & private transport
Provide vouchers, grants
Hold providers accountable for their behavior in addition to their technical expertise
Source: World Bank team adapted from World Bank, 2011 based on National Family and Health Survey 2005 in India.
Note: Percentages denote reasons for not delivering at health institutions by respondents who delivered their babies at home.
mitigating measures

7. Create avenues for recourse and feedback loops
Stylized steps to social inclusion
Diagnose 'Ask Why?'
Design Action
Monitor Progress
Create avenues for recourse and feedback loops

8. 1. Diagnose: ‘Ask why’
Why do a large majority of tribal women say they don’t think it’s necessary to give birth in health facilities?
If the reason is poverty, why are these women overrepresented among the poor?
If the reason is lack of knowledge, why are they not better informed?
If the reason is remoteness, why are they not connected?
Through:
Conducting innovative ex-ante analysis
Holding meaningful consultations, including through the use of information and communications technology (ICT) to allow women to respond to questions anonymously

9. 2. Design action
Provide vouchers, grants, and culturally appropriate incentives
Launch education/awareness campaigns in local language and idiom
Register births and deaths
Involve the community in health surveillance
Use tribal systems of knowledge
Establish links to other programs
Make innovative use of private providers, including private transport agencies, while regulating their quality
Hire more female staff from tribal communities
Require cultural competency training for service providers
Hold providers accountable for their behavior as well as technical skills
Create incentives to providers to reside in remote areas

10. 3. Monitor progress
Establish a monitoring framework that can be accessed by tribal people
Create community monitoring mechanisms
Establish third-party monitoring mechanisms
Use social audits and hold public meetings
Conduct “verbal autopsies”
Mandate citizen report cards
Publicly disclose results of monitoring, including through electronic channels
Use ICT to solicit anonymous feedback

11. 4. Create avenues for recourse and feedback loop
Establish an empowered ombudsman-like institution that enforces tribal rights
Empower tribal women through legislation and provide them with legal assistance
Create independent help-lines
Establish local tribal health committees with access to district administration
Form empowered grievance redress committees
Establish systems to report back to communities on action taken

12. Maternal deaths are a somber symptom Deeper institutional issues lie beneath
Alienation from traditional lands and forests
Low voice
Efforts have been made to address these:
Legislation that gives tribal areas some measure of autonomy
Special programs and special budgetary arrangements
Quotas in jobs and education
But implementation has been patchy:
Same institutional issues have prevented adequate progress
Elites have taken better advantage of quotas even as seats remain vacant due to lack of qualified candidates

13. The case example can be more generally applied
e.g. Land Reforms;
Fair Wages;
Access to Credit
e.g. Child Care;
Transport Vouchers; Cultural Competence of Service Providers
e.g. Language Policy; Safety; National Statistics 13

14. Promising initiatives
Cultural competency training by the professional nursing and social welfare practices in the US
Tailored programs for the Maori in New Zealand
On-boarding programs for migrants in Norway
Supra national institutions to enforce the rights of the excluded – EEOC in the US

15. Final reflections
Social inclusion is a long term agenda – there can be long gestation periods
“One stroke of the pen” changes are few; incremental changes are more common
Change is often non-linear
Policies may have unintended consequences
Lasting change builds on inclusive settlements and institutions with appropriate incentives
Social inclusion is usually “work in progress”