Exclusion, cohesion and health important elements of many development pro- grammes, one can argue that these aspects are generally implicitly recognized and as such are too often applied as convenience allows. The three- pronged approach to social exclusion has benefit over current development discourse not only be- cause it emphasizes the dynamics between individ- ual capability and societal structures, underscoring the important question of who or what is causing or contributing to the exclusion but also because it explicitly identifies key dimensions of deprivation and emphasizes longitudinal processes, thus add- ing breadth and depth to deprivation analysis. Health is an essential component of individual and societal livelihood. A growing body of literature demonstrates the negative two-way relationship between deprivation and health. However, fewer studies have explored relationships between the structural factors that contribute to deprivation and health status. Health is not a dimension typi- cally included in social exclusion analysis. Factors that contribute to different levels of depri- vation are not straightforward, are typically mul- tiple, and can include health status and access to social, cultural, political and economic capabilities and resources. Health has a critical role for deve- lopment in low-income countries like Bangladesh: better health translates into greater and more eq- uitably-distributed wealth by building human and social capital and increasing productivity (10). Like- wise, cost of healthcare can be a cause of poverty through loss of income, catastrophic health ex- penditure, and potentially irreversible crisis-coping mechanisms that involve asset and savings deple- tion (11,12). The income erosion effect of ill-health for the poor households, especially the bottom 15- 20%, is also well-documented in Bangladesh (13). The social exclusion and health framework of the Social Exclusion Knowledge Network does include health status as a prominent outcome of and con- tributor to exclusion (Fig.). The model also shows the importance of a number of actors (state, reli- gion, civil society, labour movements, international agencies, private enterprises, households, individu- als, etc.) in contributing to individuals’ positions on the continua of social, economic, political and cultural capabilities and resources. Differential ca- pabilities and resources contribute to health status. Health inequities, in turn, influence one’s position in society and affect individual capabilities and resources. Multiple dimensions of inclusion or exclusion have impact to greater or lesser degrees, 428 Johnston HB depending on the individual or group. The task im- plicit in the model is to identify who or what in society contributes to exclusion or inclusion, shift- ing the analytical focus from the excluded to the actors and processes that impact exclusion. This analytical shift could impact the understanding of exclusion and the processes to ameliorate exclu- sion. Recognizing who or what in society contrib- utes to exclusion takes us a step closer to reducing exclusion and its negative impact on health (14). It is this model, presented by the Social Exclusion Knowledge Network of the World Health Organi- zation Commission on Social Determinants of Health, that provides the theoretical framework for the analysis presented in this paper. SOCIAL EXCLUSION AND HEALTH POLICY ACTION APPRAISALS This paper is an analysis of select policies and ac- tions implemented in Bangladesh that have the potential to shift the relationship between societal structures and individuals to reduce deprivation. As- sociations between the policies or actions and shifts in exclusion and health status are explored to the extent that available documentation has allowed. The topics of the case studies conducted as back- ground papers for this analysis were selected pur- posively, to represent diverse policies and actions addressing multiple capabilities and resources and to represent policies and actions implemented by a range of actors. The policies and actions included are also believed to have relevance in Bangladesh and internationally for addressing exclusion. Each description of a policy or action includes the implementing agency, the action, links to social ex- clusion, evidence of impact, particularly on health, if data are available, and enablers and barriers to success. The presentation of policies and actions is organized according to category of implementing agency: state, not-for-profit non-governmental or- ganizations (NGOs), and private for-profit organi- zations. Examples of multisectoral action are also included; for example, NGOs working with private sector and the state working with communities. State action In Bangladesh, a patchwork of social protection programmes provide benefit to an estimated 15 million people. Coverage of the social protection programmes has decreased in recent years, from the equivalent of 1% of GDP in the late 1990s to less than half of 1% of GDP in 2004, or less than 5% of public expenditure (15). The Female Second- JHPN