Human development, in terms of adequate health, nutrition, and education outcomes, has an intrinsic benefit. But it is also a means to build the human capital of the poor, providing them a means to break out of poverty. Hence, the MDG of universal primary education is consistent with inclusive growth. Unfortunately, by several yardsticks, the country has fallen short of adequate service delivery (Figure 1.4). While the net enrollment rate peaked at 97 percent in 1999-2000, its drop to 85 percent and below by the late 2000s should be a cause for serious concern. Worse, the cohort survival rate stayed in the 70 percent range throughout the 1990s, only improving somewhat to the 70-75 percent range in the 2000s.
Most of the population is inadequately protected from shocks to their already meager human capital. While natural disasters can affect any population group, it is the poor who tends to be most vulnerable and least resilient to calamities. With respect to health care, catastrophic illnesses are capable of wiping out livelihoods, assets, and well-being of the poor and lower middle classes. Meanwhile, chronic illnesses (such as tuberculosis) may have less extreme impacts, but may prevent the poor from getting and keeping remunerative work.
The government has devoted considerable resources to deliver social services to those lacking access to health care and education. However, poor households in isolated areas have difficulty in going to health centers and schools, even when services are offered for free or at highly subsidized rates. Clearly, poor infrastructure provision, aside from being a hindrance to investment and business activity, also prevents physical access to basic services.
Compounding the problem of access is the propensity of poorer households for higher fertility rates, reducing households' assets and per-capita purchasing power. Parents may fail to internalize the intergenerational implications of child-bearing choice. Unfortunately, in the Philippine setting, the State has typically failed in its role in promoting responsible parenthood and reproductive health.