Are There Identifiable Patterns of Urban Exclusion for Which Different Policies and Strategies Could Be Developed?
Several patterns or typologies of exclusion from care emerge from the data on health service use. These are characterised not only by inequalities in urban areas, but also by the variability of health service access in the rural areas that feed them. Three different urban scenarios can be distinguished, and are summarised in Figure 2. First, there are countries with a very large exclusion problem, where it is not only the poor who are excluded, but many others as well. These are countries with urban areas where less than 75% of mothers give birth in a health facility. Many countries fall into this “substantial urban exclusion” category, although they show a spectrum of concurrent rural service use: some with almost non-existent rural services, others where the rural rich have more access to services than the urban poor. The second scenario is where there is marginalisation of the urban poor. In these countries a high proportion of urban residents obtain health services, but most of the
