In five countries the gap widened.9 In the remaining four countries out of the 13, reductions in the national U5MR had a neutral impact on health distribution. Indeed, such society-wide improvements seem as likely to be accompanied by increasing as decreasing inequalities. Moreover, reaching some groups requires efforts in other areas such as improving communications between local authorities and targeted groups, facilitating increased participation by local communities, and greater access to education and information so as to increase people’s awareness of health issues, among others.