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Rising income inequality has emerged as a major policy issue facing policymakers, but there is a dearth of empirical work on inequality in small states, including the Caribbean. Despite data limitations, the empirical analysis using a sample of small states finds that increased openness and deeper economic integration including financial market openness is associated with lower income inequality, whereas elevated debt levels limit fiscal space and are associated with higher income inequality. An important policy implication is that well targeted social sector spending aimed at improving education and health indicators will support increased redistribution and reduce income inequality.

Exports and Imports --- Macroeconomics --- Public Finance --- Economic Development: General --- Globalization: Economic Development --- Health, Education, and Welfare: General --- Aggregate Factor Income Distribution --- Debt --- Debt Management --- Sovereign Debt --- International Investment --- Long-term Capital Movements --- Public finance & taxation --- Finance --- Income inequality --- Public debt --- Income --- Income distribution --- Foreign direct investment --- Debts, Public --- Investments, Foreign --- South Africa --- Income distribution. --- Exports and Imports. --- Macroeconomics. --- Public Finance. --- Economic Development: General. --- Globalization: Economic Development. --- Health, Education, and Welfare: General. --- Aggregate Factor Income Distribution. --- Debt. --- Debt Management. --- Sovereign Debt. --- International Investment. --- Long-term Capital Movements. --- Public finance & taxation. --- Finance. --- Income inequality. --- Public debt. --- Income. --- Foreign direct investment. --- Debts, Public. --- Investments, Foreign. --- South Africa.

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This paper analyzes Central America's track record on inequality, poverty, and quality of fiscal adjustment in relation to economic growth; health and education outcomes; adequacy of social safety nets; and governance. It then assesses the degree to which the track record can be traced to reforms in public expenditure and governance. Despite the considerable heterogeneity among the countries in the region, there are some policies that all countries need to pursue. Sustained growth and a better quality of fiscal adjustment are needed, as well as policies aimed at increasing individuals' productivity and improving governance.

Macroeconomics --- Public Finance --- Poverty and Homelessness --- Health, Education, and Welfare: General --- Economywide Country Studies: Latin America --- Caribbean --- Comparative Studies of Countries --- Health: General --- Education: General --- Aggregate Factor Income Distribution --- Welfare, Well-Being, and Poverty: General --- National Government Expenditures and Health --- Health economics --- Education --- Poverty & precarity --- Public finance & taxation --- Health --- Income inequality --- Poverty --- Health care spending --- National accounts --- Expenditure --- Income distribution --- Expenditures, Public --- Costa Rica

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The paper examines Madagascar's education, health, and social assistance spending and outcomes. Government spending on education is relatively low compared to peers, and the quality of education has deteriorated. The paper recommends allocating more resources to the sector, ensuring transparent and merit-based teacher recruitment mechanisms, and strengthening teacher training and incentives. Health spending is also low, and the health system faces challenges in malnutrition, immunization, and service delivery. Additional domestic resources and large-scale structural reforms are needed. Social safety net programs have limited coverage and low spending, and expanding them should be a top priority to reduce poverty and support vulnerable populations.

Money and Monetary Policy --- International Economics --- Public Finance --- Health Policy --- Monetary Policy --- International Agreements and Observance --- International Organizations --- Health, Education, and Welfare: General --- Education: General --- Health: General --- National Government Expenditures and Welfare Programs --- National Government Expenditures and Related Policies: General --- National Government Expenditures and Education --- Monetary economics --- International institutions --- Public finance & taxation --- Education --- Health economics --- Health systems & services --- Monetary policy --- International organization --- Health --- Social assistance spending --- Expenditure --- Education spending --- International agencies --- Expenditures, Public --- Medical care --- Madagascar, Republic of