Health and education services may be provided free or at low cost by development
assistance agencies to local residents in order to increase local access throughout the city. In
addition to these direct services, development agencies may support the improvement of local
commercial services, training traditional birth attendants to improve the quality of service
offered or providing new teaching material for the schools. This support may extend beyond
training to credit for improving health centres and school buildings or for purchasing
necessary equipment. In other cases, development agencies may train community leaders to
use existing municipal services more effectively and to work with those services to ensure
improved access for low-income residents. For example, SPARC in India have sought to
ensure that municipal hospitals offer basic medical care to street children. Through specific
projects and programmes, development agencies may seek to work specifically with groups
that are not effectively provided for through state services, such as literacy programmes aimed
at women.