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In respect to kinds and levels of social security benefits, ve have stressed already the incomparably higher importance of social services in relation to income maintenance measures in a developing country in view of the vast numbers of the population remaining outside the wage-earning group. A proper analysis of needs of
the people living on the margin of the money economy and the possible ways of meeting them is still lacking but studies are under way to fill this gap. As ve have already mentioned, the order of priorities shown
by these studies is food, health and housing, and although the meeting of these basic needs is normally outside the classical scope of social security, this does not mean that social security schemes could not be adapted to meet them.
The importance of the supply of medical care was recognised a long time ago and is still generally featured as the number one objective of social security schemes. The Sixth Asian Regional Conference of the ILO, recognising that "in rural areas in developing Asian countries where cash income is generally very low and medical facilities are very scarce or non-existent, the classical social insurance approach designed for persons with employed status may not be appropriate ..... It may be advisable from the outset to try to develop a non-contributory benefit scheme providing both curative and preventive medical services for the entire rural population". It further stated that "medical services under the social security scheme should be organised in the light of the prevailing practice and distribution of medical doctors and facilities in the country. Medical care thus organised under social security may contribute to better distribution of medical personnel and facilities". As to the institutional form of the provision of medical care in developing countries, some hesitation may still be noticeable in certain circles regarding the advisability of creating medical care schemes under social security systems. However, planning has a considerable role to play in reconciling differences of opinion on this question, as pointed out in what has sc far been the most authoritative international recommendation on the subject: "Social security programmes for personal health care should be planned within the framework of over-all national health plan; the relevant national health planning authorities should take the initiative in incorporating existing or potential social security programmes of this type into the total health plan."2
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In the field of employment injuries, cash benefits will require supplementing by rehabilitation measures, no matter what the economic argument regarding the economic function of such measures in a developing country may
The "social demand" or "social justice" claim of wage-earning groups of the population for these measures will be based on social aspects of the problem and will no doubt gain ground as soon as the demand is formulated at the political level.
Among the social services operating in the urban sector, such as those which are currently being developed by social security institutions in the French-speaking countries of Africa, will be medico-social centres, centres fcr mothers and children, kindergartens and nurseries, housing projects, as well as holiday colonies. 3 The development of social services in the rural sector, such as the family and child welfare projects in certain states of India, will have to rely largely on the financing from the national budget.
The introduction of social security planning in developing countries will greatly advance the studies of social needs of the population and their immediate exploitation for the purpose of active policy measures through the national development plans. However, they will not tell the decision maker how much of the available resources he should spend on the services and how Buch on income maintenance measures. This, by definition, is a question of a political choice from which there is no escape, but the analysis of needs should make the choice acre
rational.
1 See "Social Security in Asia: Trends and Problems", op. cit., p. 93.
2 See "Personal Health Health Care and Social Security Report of a Jcint ILO/WHO Committee", WHO, Geneva, 1971 (Technical Report Series, No. 480, p. 53).
3 These services are mainly financed out of social security contributions, with the percentage varying from 0.2 to 15 per cent, the average being in the neighbourhood of 4.5 per cent. See A. Gueye: "Health, Social and Family Services of Social Security Funds in Africa", in International Social Security Review, No. 3, 1973.
4 See T.I. Mathew, op. cit.,
P. 324.
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