In many developing countries, health inequalities are both stark and visible. Maternal mortality, child survival, infectious disease burden, and malnutrition disproportionately affect the poorest, rural populations, and marginalised groups.

This chapter moves from describing inequality to confronting how it can be reduced. It examines the structural drivers of disparity - poverty, weak infrastructure, limited education, gender inequity, political instability, and underfunded health systems.

We explore strategies that have demonstrated measurable impact: expansion of primary healthcare, immunisation campaigns, conditional cash transfers, community health worker programmes, improved water and sanitation systems, and targeted maternal and child health interventions.

The chapter also discusses governance and financing. Domestic resource mobilisation, fair taxation, donor alignment, and accountability mechanisms determine whether inequality reduction efforts are sustained or fragmented.

Importantly, reducing inequality requires deliberate prioritisation of the most disadvantaged - not simply expanding services in aggregate.

Equity does not emerge automatically from growth. It requires design.

Key Takeaways

* Health inequalities in developing countries are often extreme and visible.

* Rural, poor, and marginalised populations bear disproportionate burdens.

* Strengthening primary healthcare is central to equity improvement.

* Community-based interventions can bridge geographic and social gaps.

* Social protection policies can indirectly improve health outcomes.

* Governance quality strongly influences programme success.

* Targeted maternal and child health strategies reduce mortality gaps.

* Sustainable progress requires long-term financing commitments.

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