Use of Medical Care: How People in Informal Employment Rate Access to Health Services Figure 2.5 Demand for better state services(top priority) 50% 45% 43.6% 40% 35% 30% 25% 20% 15% 10% 5% 0% Senegal 41.2% 33.5% Côte d'Ivoire Benin 28.4% 23.0% Kenya Zambia better health services better roads and bridges better pensions for the elderly better schools and education better food programmes in times of crisis better police services 19.7% 31.5% Ethiopia 6-country average better water supply better electricity supply Figure 2.6 Demand for better health services(first priority), by urban–rural residence Côte Benin d'Ivoire Senegal -3.0% Urban Rural Urban/rural-gap Urban Rural Urban/rural-gap Urban Rural Urban/rural-gap Urban Rural Urban/rural-gap Urban Rural Urban/rural-gap Urban Rural Urban/rural-gap –1.0% 7.0% 2.3% 5.7% 3.4% 9.5% 7.9% 17.0% 27.0% 25.4% 18.0% 25.9% 22.4% 23.4% Zambia Ethiopia Kenya 37.0% 47.0% 44.7% 42.4% 38.1% 43.8% 35.3% 31.9% 34.9% tions of a supply–demand gap. We look at four of them: urban and rural residence, age, income, and gender. A. URBAN–RURAL DIVIDE Rural and urban areas differ mainly in the provision of state services. Cities with high population densities are usually provided with physical infrastructure before remote areas. In general, the availability of public goods such as roads, water and electricity improve with population density, as is the case with health facilities. We do not look at absolute supply indicators, however, but at the relative positioning of the demand for better health services, which reflects the personal needs hierarchy and may differ from the factual supply side. The results are presented in Figure 2.6. In Kenya, Ethiopia and to some extent in Côte d’Ivoire, we ob­serve some shifts in the demand for health services. In those countries, urban residents assign health a higher preference than do rural residents. In other countries the urgency with which health is identified as highest priority is not connected to residence. Overall, the observed differences in priorities do not allow us to talk of a substantial urban–rural divide. B. AGE It is difficult to predict the impact of age on people’s priorities concerning better state services. The older generation may be more interested in better police services, better health services, better water supply and availability of pensions. Younger age groups may prioritize education, electricity connection and transport infrastructure to improve their(so­cial) mobility. Where old and young people live together in a 13