How can governments deliver on the mandate to provide public services across territories efficiently, especially in places with low density facing depopulation and ageing? This report is the second of the sub-series Preparing Regions for Demographic Change, that aims at supporting policy makers navigate the challenge of providing services with equity and efficiency. This report complements the first report of the sub-series focused on policies and good practices, Delivering Quality Education and Health Care to All.

This report makes use of novel methods to simulate the location of education and health services and estimate the differences in access and costs at very granular geographical levels. The chapters apply these methods to Europe and provide a thorough analysis of territorial differences in the cost of and access to education and health services arising from local differences in demand. The report also identifies the areas facing the most difficult future challenges in provision based on available population projection grids. As the previous report of the series, the findings highlight the value-added of considering a spatial lens in developing policies to mitigate inequalities across different geographies. These stem due to the unique trade-off between costs and physical access to local services in rural areas.

This report was carried out as part of the OECD’s Regional Development Policy Committee (RDPC) Programme of Work and Budget. The RDPC provides a unique forum for international exchange and debate on regional economies, policies and governance. It was discussed in the 24th and 25th meetings of the Working Party on Rural Policy and was approved by the RDPC [CFE/RDPC/RUR(2020)6/REV2] on May 4th 2021.

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