In the context of four of the OECD Development Assistance Committee's (DAC) development objectives -- reducing extreme poverty; providing universal primary education; lowering infant and maternal mortality; and transmitting health -- this book is particularly timely. The authors demonstrate that in the case of very poor countries, policies aimed at universal provision of education and health services benefit the poor significantly more than more expensive targeted schemes. The book draws attention to the absolute need for coherence and co-ordination so that schools are not built without teachers and dispensaries without drugs. Moreover, national macroeconomic policies have to be realistic if the health and education sectors are not to be deprived of resources. Finally, the quality of governance is shown to have a direct effect on the efficiency of social spending.