1.Moving Towards a Better Understanding of Socioeconomic Inequalities in Preventive Health Care Use: A Life Course Perspective

Abstract

The aim of this book chapter is to outline how the life course perspective can move forward the debate on socioeconomic inequalities in preventive health care use. Recent theoretical developments in medical sociology, including health lifestyle theory and cultural health capital theory, have implicitly encapsulated a longer-term view of an individual’s life, in order to develop a better understanding of the social causes of good health and conversely illness. I will elaborate more explicitly on how the five central principles of the life course perspective apply to preventive health care use, using the empirical example of mammography screening. Central and unanswered questions pertain to (i) the life stages that are important in the development of cultural health capital or a healthy lifestyle (life-span development); (ii) the temporality of socioeconomic inequalities in preventive health care (timing); (iii) the impact of different socialization contexts for healthy lifestyles or cultural health capital (structure-agency debate); (iv) the change in preventive health care use across policy implementations (time and place); and (v) the role of significant others for health care use (linked lives).

Keywords Socioeconomic Inequalites; Health Care Systems; Life Course

http://link.springer.com/chapter/10.1007/978-3-319-20484-0_6

2.The Post-2015 Development Agenda: Keeping Our Focus On the Worst Off

Sharp, Daniel and Millum, Joseph

The American Society of Tropical Medicine and Hygiene. 2015 vol. 92 no. 6 1087-1089

Abstract 

Non-communicable diseases now account for the majority of the global burden of disease and an international campaign has emerged to raise their priority on the post-2015 development agenda. We argue, to the contrary, that there remain strong reasons to prioritize maternal and child health. Policy-makers ought to assign highest priority to the health conditions that afflict the worst off. In virtue of how little healthy life they have had, children who die young are among the globally worst off. Moreover, many interventions to deal with the conditions that cause mortality in the young are low-cost and provide great benefits to their recipients. Consistent with the original Millennium Development Goals, the international community should continue to prioritize reductions in communicable diseases, neonatal conditions, and maternal health despite the shifts in the global burden of disease.

http://www.ajtmh.org/content/92/6/1087

3. Breakthrough FFD3 outcome sets positive tone for global change

United Nations, Department of Economic and Social Affairs

Available online : 3 August 2015

The world marked a momentous event in international development in Addis Ababa, Ethiopia, last month, as Governments adopted a new global  framework for financing sustainable development. The Addis Ababa Action Agenda was adopted at the Third International Conference on Financing for Development (FFD3), held on 13-16 July in the Ethiopian capital. It establishes a strong foundation to support the implementation of future development efforts. The Addis Ababa Conference was the first in a series of landmark events leading up to the adoption of a new development agenda and a universal agreement on climate change by the end of this year. Turning needs into investment opportunities

“Financing needs for sustainable development are high, but the challenges are surmountable,” said UN secretary-General Ban Ki-moon at the opening of the Conference. “The Addis Ababa Action agenda will help to turn these needs into investment opportunities.”…

Keywords Global Health; Sustainable Development Goals (SDGs); Climate Change

http://www.un.org/en/development/desa/news/financing/breakthrough-ffd3-outcome.html

4. Systems change for the social determinants of health

Gemma Carey, Brad Crammond

BMC Public Health 2015, 15:662  

Published online: 14 July 2015

Abstract 

Background: Inequalities in the distribution of the social determinants of health are now a widely recognized problem, seen as requiring immediate and significant action (CSDH. Closing the Gap in a Generation. Geneva: WHO; 2008; Marmot M. Fair Society, Healthy Lives: The Marmot Review. Strategic Review of Health Inequalitites inEngland Post-2010. London; 2010). Despite recommendations for action on the social determinants of health dating back to the 1980s, inequalities in many countries continue to grow. In this paper we provide an analysis of recommendations from major social determinants of health reports using the concept of ‘system leverage points’. Increasingly, powerful and effective action on the social determinants of health is conceptualised as that which targets government action on the non-health issues which drive health outcomes. Methods: Recommendations for action from 6 major national reports on the social determinants of health were sourced. Recommendations from each report were coded against two frameworks: Johnston et al’s recently developed Intervention Level Framework (ILF) and Meadow’s seminal ‘12 places to intervene in a system’ (Johnston LM, Matteson CL, Finegood DT. Systems Science and Obesity Policy: A Novel Framework for Analyzing and Rethinking Population-Level Planning. American journal of public health. 2014;(0):e1-e9; Meadows D. Thinking in Systems. USA: Sustainability Institute; 1999) (N = 166). Results: Our analysis found several major changes over time to the types of recommendations being made, including a shift towards paradigmatic change and away from individual interventions. Results from Meadow’s framework revealed a number of potentially powerful system intervention points that are currently underutilised in public health thinking regarding action on the social determinants of health. Conclusion: When viewed through a systems lens, it is evident that the power of an intervention comes not from where it is targeted, but rather how it works to create change within the system. This means that efforts targeted at government policy can have only limited effectiveness if they are aimed at changing relatively weak leverage points. Our analysis raises further (and more nuanced) questions about what effective action on the social determinants of health looks like.

Keywords Social Determinants of Health; Inequalities; Health Systems; 

http://www.biomedcentral.com/1471-2458/15/662

5. Moving toward universal access to health and universal health coverage: a review of comprehensive primary health care in Suriname = Avanzando hacia el acceso universal a la salud y la cobertura universal de salud: un análisis de la atención primaria de salud integral en Suriname

Stephanie Laryea, Hedwig Goede, Francoise Barten

Rev Panam Salud Publica. 2015;37(6):415–21.

Published online: July 2015

Abstract

Objective. To provide an overview of comprehensive primary health care (CPHC) development and implementation in Suriname in peer-reviewed literature.

Methods. Building on work funded by the Teasdale-Corti Global Health Research Partnership Program/People’s Health Movement, the authors searched MEDLINE, the Cochrane Library, and POPLINE for articles focused on CPHC within the Surinamese context. Two authors independently reviewed abstracts and then jointly reviewed the selected abstracts. The final selection was completed using a data extraction form. Results. The initial search resulted in 1 556 abstracts. The initial review identified 58 articles. Only three of the 58 articles met the inclusion criteria for the final review. The three selected articles provided partial overviews of CPHC in Suriname and examples of its implementation, with a focus on the service delivery network in the interior of the country, which was designed to improve rural access to basic health care services by training community members as service providers. They also included examples of how preparations for health reform in Suriname in the late 1990s and early 2000s, influenced by global neoliberal reforms, led to expectations that disparities in health status, design of health system components, and service provision related to differences in power and historical context (e.g., the influence of medical professionals, political parties/ethnic groups, and wealthier populations concentrated in urban areas) would be addressed. Conclusions. Given the focus on primary health care in the Americas and the notable developments that have occurred in Surinamese health policy and health care, particularly in health care reform, the paucity of published research on CPHC in Suriname was an unexpected finding that may be partly due to prioritizing research on disease control rather than health policy and systems research. The limited amount of scientific literature on this topic 1) prevents clear understanding of CPHC development and implementation in Suriname and 2) underscores the need to strengthen the national health research system to better inform policies for moving the country toward universal health access and coverage to improve the health of all of its citizens.  

Keywords Equity in Health; Primary Health Care; Health Services Research; Universal Coverage; Health Policy, Planning and Management; Suriname.

bit.ly/1KgvkDR

6. Self-assessment tool for the evaluation of essential public health operations in the WHO European Region

English (PDF, 1.2 MB)

2015, vi + 104 pages

ISBN 978 92 890 5099 9

This publication is available online only

Through a process of extensive and iterative consultation, the WHO Regional Office for Europe devised 10 essential public health operations (EPHOs) that define the field of modern public health for the Member States in the WHO European Region. Formally endorsed by all of the Region's Member States, the EPHOs form a comprehensive package that all countries should aim to provide to their populations.

This publication presents a public health self-assessment tool that provides a series of criteria that national public health officials can use to evaluate the delivery of the EPHOs in their particular settings. Wherever possible, these criteria were developed on the basis of existing WHO guidance. The tool can be used to foster dialogue on the strengths, weaknesses and gaps in EPHOs; generate policy options or recommendations for public health reforms; contribute to the development of public health policies, or be used for educational or training purposes.

who.int.publications

7. City fact sheets: WHO European Healthy Cities Network

English (PDF, 31.8 MB)

Edited by Evelyne de Leeuw, Nicola Palmer and Lucy Spanswick

2015, iv + 100 pages

ISBN 978 92 890 5097 5

This publication is only available online.

This publication is a compilation of facts about 100 cities in nearly 30 of the 53 countries in the WHO European Region that were members of the WHO European Healthy Cities Network in Phase V. It includes data on population, economic stability, twinning with other cities, activity and longevity in the Network, and core data on social and environmental determinants of health.

http://www.euro.who.int/en/publications/abstracts/city-fact-sheets-who-european-healthy-cities-network

8. The European Mental Health Action Plan 2013–2020

English (PDF, 1.0 MB)

2015, iv + 19 pages

ISBN 978 

92 890 5095 1

This publication is only available online.

Mental disorders are one of the top public health challenges in the WHO European Region, affecting about 25% of the population every year. In all countries, mental health problems are much more prevalent among the people who are most deprived. The WHO European Region therefore faces diverse challenges affecting both the mental well-being of the population and the provision and quality of care for people with mental health problems.

The European Mental Health Action Plan focuses on seven interlinked objectives and proposes effective action to strengthen mental health and well-being. Investing in mental health is essential for the sustainability of health and socioeconomic policies in the European Region. The Action Plan corresponds to the four priority areas of the European policy framework for health and wellbeing, Health 2020, and will contribute directly to its implementation.

http://www.euro.who.int/en/publications/abstracts/european-mental-health-action-plan-20132020-the?utm_source=WHO%2FEurope+mailing+list&utm_campaign=c43df02495-PUBLICATION_NEWS_JULY_20157_8_2015&utm_medium=email&utm_term=0_60241f4736-c43df02495-94562105

9. Support tool to assess health information systems and develop and strengthen health information strategies

English (PDF, 2.6 MB)

Pусский (PDF, 2.9 MB)

2015, iv + 87

ISBN 978 92 890 5091 3

This publication is only available online.

Good health information supports public health policy-making. During its meeting in December 2013, the Standing Committee of the Regional Committee asked the WHO Regional Office for Europe to develop a practical tool to support Member States in developing and improving their national health information systems by developing national health information strategies. This would support countries in implementing the European policy framework, Health 2020. Good health information from strong national health information systems can help Member States identify areas for action to address Health 2020 priorities and evaluate the effects of Health-2020-related policies and interventions.

The support tool is based on existing tools developed by WHO's Health Metrics Network. This tool covers all the phases related to health information strategy development – from assessment of the current state of health information systems, through strategy development and implementation to evaluation. Moreover, it addresses all the different elements of health information systems, such as governance, databases and resources. This allows flexible use of the tool: Member States can either apply it as a whole or pick out specific phases or elements that require particular attention or have priority in their national contexts. The support tool has been set up to accommodate the diverse situations of health information systems and strategies within the WHO European Region.

http://www.euro.who.int/en/publications/abstracts/support-tool-to-assess-health-information-systems-and-develop-and-strengthen-health-information-strategies?utm_source=WHO%2FEurope+mailing+list&utm_campaign=c43df02495-PUBLICATION_NEWS_JULY_20157_8_2015&utm_medium=email&utm_term=0_60241f4736-c43df02495-94562105

10. Strengthening health system accountability: a WHO European Region multi-country study (2015)

Edited by Juan Tello and Claudia Baez-Camargo

2015, viii + 68 pages

ISBN 978 92 890 5093 7

CHF 20.00

In developing countries CHF 14.00

Order no. 13400158

This report takes stock of the measures that countries in the WHO European Region have put in place to strengthen their health systems' accountability since the adoption of the Tallinn Charter: Health Systems for Health and Wealth (2008) and the Health 2020 policy framework (2012). Recent years have undoubtedly brought significant challenges to the health systems in the Region, including international and national environments affected by an economic crisis, increased health needs and scarcity of resources. Nevertheless, countries across the Region have taken abundant and significant steps to improve health-system accountability.

This report summarizes countries' experiences with strengthening health-system accountability in the context of the momentum created by the Tallinn Charter and Health 2020, by setting rigorous goals and measuring and reviewing health systems' performance.

http://www.euro.who.int/en/health-topics/Health-systems/health-systems-governance/publications/2015/strengthening-health-system-accountability-a-who-european-region-multi-country-study-2015?utm_source=WHO%2FEurope+mailing+list&utm_campaign=c43df02495-PUBLICATION_NEWS_JULY_20157_8_2015&utm_medium=email&utm_term=0_60241f4736-c43df02495-94562105

11. Health sector employment: a tracer indicator for universal health coverage in national Social Protection Floors

Xenia Scheil-Adlung, Thorsten Behrendt, Lorraine Wong 

Human Resources for Health 2015, 13:66  

Published online: 31 August 2015

Abstract 

Background:Health sector employment is a prerequisite for availability, accessibility, acceptability and quality (AAAQ) of health services. Thus, in this article health worker shortages are used as a tracer indicator estimating the proportion of the population lacking access to such services: The SAD (ILO Staff Access Deficit Indicator) estimates gaps towards UHC in the context of Social Protection Floors (SPFs). Further, it highlights the impact of investments in health sector employment equity and sustainable development. Methods:The SAD is used to estimate the share of the population lacking access to health services due to gaps in the number of skilled health workers. It is based on the difference of the density of the skilled  health workforce per population in a given country and a threshold indicating UHC staffing requirements. It identifies deficits, differences and developments in access at global, regional and national levels and between rural and urban areas. Results:In 2014, the global UHC deficit in numbers of health workers is estimated at 10.3 million, with most important gaps in Asia (7.1 million) and Africa (2.8 million). Globally, 97 countries are understaffed with significantly higher gaps in rural than in urban areas. Most affected are low-income countries, where 84  per cent of the population remains excluded from access due to the lack of skilled health workers. A positive correlation of health worker employment and population health outcomes  could be identified. Legislation is found to be a prerequisite for closing access as gaps. Conclusions:Health worker shortages hamper the achievement of UHC and aggravate weaknesses of health systems. They have major impacts on socio-economic development, particularly in the world’s poorest countries where they act as drivers of health inequities. Closing the gaps by establishing inclusive multi-sectoral policy approaches based on the right to health would significantly increase equity, reduce poverty due to ill health and ultimately contribute to sustainable development and social justice.

Keywords : Universal Health Coverage; Social Protection; Health Worker Employment

http://www.human-resources-health.com/content/13/1/66

12. Promoting health equity: WHO health inequality monitoring at global and national levels

Ahmad Reza Hosseinpoor, Nicole Bergen and Anne Schlotheuber

[PAHO/WHO Equity list & Knowledge network]

Glob Health Action 2015, 8: 29034 

Published online: 18 September 2015

Abstract 

Background: Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective: This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design: We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions: The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

Keywords  Equity in Health; Health Inequalities; Sustainable Development Goals; Global Health

http://www.globalhealthaction.net/index.php/gha/article/view/29034

13. Equity and Noncommunicable Disease Reduction under the Sustainable Development Goals 

Harald Schmidt, Anne Barnhill

PLoS Med 12(9):e1001872. 

Published: September 8, 2015 

Summary Points 

·   Currently proposed Sustainable Development Goals (SDGs) include a timely call to significantly reduce the burden of noncommunicable diseases (NCDs).

·  Existing policy guidance highlights cost-effective interventions for NCDs, but focusing just on cost-effectiveness risks exacerbating socioeconomic and health inequalities rather than reducing them.

·    In implementing the SDGs, targets and interventions that benefit the worst off should be prioritized.

·   The United Nations should develop practical guidance to assist policy makers at the country level with incorporating equity considerations.

Introduction

Healthy life expectancy at birth in Sierra Leone is 46 years. In Japan, it is 84 years [1]. The UN Millennium Development Goals (MDGs) set out ambitious objectives to reduce such and further inequalities. Despite criticism, the MDGs are widely praised for having galvanized national and international development efforts in unprecedented ways [2]. Currently proposed successor Sustainable Development Goals (SDGs) seek to address newly emerged policy issues and include a call to significantly reduce the burden of noncommunicable diseases (NCDs). NCDs directly impact health inequality and poverty [1]. Their recognition is timely and to be welcomed categorically. However, ambiguity in the SDGs’ current guidance risks that states’ efforts to reduce NCDs exacerbate socioeconomic and health inequalities, rather than reduce them. We urge that more attention needs to be given to improving the situation of the worst off and make three concrete proposals towards this end.

Keywords Equity in Health; Noncommunicable Diseases; Sustainable Development Goals; Global Health

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001872

14. Human rights in the new Global Strategy

By recognising the centrality of human rights, the revised Global Strategy encourages some bold shifts in improving the health and wellbeing of women, children, and adolescents, say Jyoti Sanghera and colleagues

1.   Jyoti Sanghera, Lynn Gentile, Imma Guerras-Delgado, Lucinda O’Hanlon, Alfonso Barragues, Rachel Louise Hinton, Rajat Khosla, Kumanan Rasanathan

2.   Marcus Stahlhofer

BMJ 2015;351:h4184

Analysis

Women’s, Children’s, and Adolescents’ Health

Published online: 14 September 2015

The Global Strategy for Women’s and Children’s Health (2010), with its emphasis on participatory decision making processes, non-discrimination, and accountability, affirmed the importance of human rights. Despite important gains following its launch women, children, and adolescents continue to experience serious violations of their health and health related human rights, including discrimination in access to quality healthcare. A human rights based approach must thus be fully integrated throughout the Global Strategy.

The right to health is recognised by several legal tools and treaties relating to human rights, including the International Covenant on Economic, Social and Cultural Rights; the Convention on the Rights of the Child; and the Convention on the Elimination of All Forms of Discrimination against Women. A human rights framework for realizing the right to health of women, children, and adolescents calls for national governments to ensure that health facilities, goods, and services are of good quality, are available in sufficient quantity, and are physically accessible and affordable on the basis of non-discrimination. Health facilities, goods, and services must also be acceptable— that is, gender and child sensitive and  respectful of confidentiality and the requirement for informed consent, among other things. A human rights based approach is based on accountability and on empowering women, children, and adolescents to claim their rights and participate in decision making, and it covers the interrelated determinants of health and wellbeing (box). Because a human rights based approach promotes holistic responses, rather than fragmented strategies, and requires attention to the health needs of marginalised and vulnerable populations, it is a valuable tool for improving health outcomes…

Keywords Women’s Health; Child Health; Adolescent Health; Human Rights; Equity in Health

http://www.bmj.com/content/351/bmj.h4184.full.pdf+html

15. The Atlas of Sustainable Development and Health: Brazil 1991-2010 (abstract in English)

Atlas de Desenvolvimento Sustentável e Saúde. Brasil: 1991 a 2010 (resumo em Português)

Atlas de Desarrollo Sostenible y Salud. Brasil: 1991 a 2010 (resumen en Español)

Pan American Health Organization, Country Office - Brazil

Published online: August 2015

Abstract

The Atlas of Sustainable Development and Health: Brazil 1991-2010, prepared by the Pan American Health Organization/World Health Organization Country Office in Brazil, describes the magnitude and trends of relevant indicators on the social, economic, and environmental dimensions of health and informs the debate on the extent of inequalities in Brazil over the last two decades.  Those indicators correspond to the years 1991, 2000, and 2010 across all Federal Units, taking all 5,565 Brazilian municipalities as units of analysis.

This study was inspired by a key passage from the United Nations Conference on Sustainable Development (Rio +20; Rio de Janeiro, June 2012) outcome document (The Future We Want), which declares: “We recognize that health is a precondition for and an outcome and indicator of all three dimensions of sustainable development […]: social, economic, and environmental”. Selected indicators were those included within the targets of the Millennium Development Goals (MDGs), and that will have continuity within the Sustainable Development Goals (SDGs) to be set by the United Nations’ Member States for the post-2015 period. Those indicators are: infant and child mortality as health dimension indicators; population poverty prevalence as an economic dimension indicator; population illiteracy rate as a social dimension indicator; and, proportion of people without access to safe water as an environmental dimension indicator. Analyses at all federal units in the country show clear improvements over the two decades studied (1991 to 2010), especially from 2000 to 2010, in terms of progress in sustainable development, as assessed by a reduction in the average values of the indicators analyzed, as well as in progress in health equity, as assessed by a decline in absolute and relative health inequalities between regions and municipalities, which is by itself an extremely relevant fact to point out.

http://www.paho.org/bra/index.php?option=com_content&view=article&id=4897&Itemid=877

16. People's Republic of China health system review

The World Health Organization

Health Systems in Transition, Vol. 5 No. 7 2015 

Published online: September 2015

Abstract 

China has made great achievements in improving health status over the past six decades with a huge population that accounted for about 19% of total world population in 2012. The life expectancy at birth in China has increased from 35 years in 1949 to 75 years in 2012, mainly the result of government commitment to health, provision of cost effective public health programmes, coverage of health financial protection mechanisms, and a basic health care delivery network. China is facing many health challenges amid its demographic and epidemiological transition of rapid economic growth, urbanization and industrialization, population ageing, diseases and risk factors related to lifestyle and environmental pollution. […] Social health insurance schemes, including the rural cooperative medical scheme, urban employee-based health insurance scheme, and urban resident-based health insurance schemes, have reached universal population coverage. These are run by government subsidies and individual contributions and cover both outpatient and inpatient care. Governments provide subsidies for covering essential public health programmes. Access to health care has increased rapidly with the expanded coverage of financial protection mechanisms. Over the past decade, out-of-pocket payments as a proportion of total health expenditures have declined dramatically…

Keywords Health Care Reform; Health System Plans; 4. China. I. Asia Pacific Observatory on Health Systems and Policies.

http://iris.wpro.who.int/bitstream/handle/10665.1/11408/9789290617280_eng.pdf;jsessionid=9D2E0398D69E2CD263CF56D229F50EC0?sequence=1

17. Rio Political Declaration on Social Determinants of Health: A Snapshot of Canadian Actions 2015 = Déclaration politique de rio sur les déterminants sociaux de la santé : Aperçu des mesures canadiennes de 2015 

The Public Health Agency of Canada

Published online: September 2015

Summary:

The purpose of this report is to showcase Canada's recent actions that contribute to the advancement of the Rio Political Declaration on Social Determinants of Health (Rio Declaration), a non-binding pledge which calls on World Health Organization Member States to improve/influence the working and living conditions that affect health and well-being. In the lead up to the World Health Organization reporting on Member State implementation of this pledge at the World Health Assembly in May 2015, Canada compiled a selection of recent initiatives undertaken across sectors and levels of government and with non-governmental actors, which aligns with the five themes of the Rio Declaration. Since reporting on actions aligning with the Rio Declaration in 2013, Canada has made advancements across each of the five Rio Declaration themes and across different levels of government and sectors. The 29 initiatives profiled here demonstrate actions to advance health equity and fall under the following groupings: To adopt better governance for health and development …

Keyworkds Social Determinants of Health; Equity in Health; Health Inequities; Policy-Making; Canada

http://healthycanadians.gc.ca/publications/science-research-sciences-recherches/rio/index-eng.php?_ga=1.170171872.1554870192.1441408793#sum

18. Monitoring inequality: an emerging priority for health post-2015 

Ahmad Reza Hosseinpoor,Nicole Bergen, Veronica Magar

Bulletin of the World Health Organization 2015;93:591-591A

Published online: September 2015

The Millennium Development Goals focused on poverty and development and reducing inequalities between countries.1 Progress was monitored through national averages without adequate attention to within-country inequality. The post-2015 sustainable development goals (SDG) stress “leaving no one behind” – with goal 10 specifically calling for the reduction of inequality, within and among countries. 

Monitoring of inequalities within countries focuses on indicators and dimensions of inequality that are particularly relevant to each country. Drawing upon the outputs of within-country inequality monitoring, policies can be tailored to be maximally effective in reducing inequalities.3 At the same time, having comparable disaggregated data across countries is important to track within-country inequality at a regional or global level. One of the SDG targets specifically addresses the importance of disaggregated data, calling on countries to increase “…the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts”. 

Such disaggregated data are vital to identify where and why inequalities exist and ensure that policies, programmes and practices are successful in reaching the most vulnerable. Many countries have made major progress in monitoring health inequalities through household surveys such as Demographic and Health Surveys…

http://www.who.int/bulletin/volumes/93/9/15-162081/en/

19. Breakthrough FFD3 outcome sets positive tone for global change

United Nations, Department of Economic and Social Affairs

Available online : 3 August 2015

The world marked a momentous event in international development in Addis Ababa, Ethiopia, last month, as Governments adopted a new global  framework for financing sustainable development. The Addis Ababa Action Agenda was adopted at the Third International Conference on Financing for Development (FFD3), held on 13-16 July in the Ethiopian capital. It establishes a strong foundation to support the implementation of future development efforts. The Addis Ababa Conference was the first in a series of landmark events leading up to the adoption of a new development agenda and a universal agreement on climate change by the end of this year. Turning needs into investment opportunities

“Financing needs for sustainable development are high, but the challenges are surmountable,” said UN secretary-General Ban Ki-moon at the opening of the Conference. “The Addis Ababa Action agenda will help to turn these needs into investment opportunities.”…

Keywords: Global Health; Sustainable Development Goals (SDGs); Climate Change 

https://www.un.org/development/desa/en/news/financing/breakthrough-ffd3-outcome.html

20.Trends in Longevity in the Americas: Disparities in Life Expectancy in Women and Men, 1965-2010

Ian R. Hambleton , Christina Howitt, Selvi Jeyaseelan, Madhuvanti M. Murphy, Anselm J Hennis, Rainford Wilks, E. Nigel Harris, Marlene MacLeish, Louis Sullivan, U.S. Caribbean Alliance for Health Disparities Research Group (USCAHDR)

PLoS ONE 10(6): e0129778.

Published: 19 June, 2015

Abstract 

Objective: We describe trends in life expectancy at birth (LE) and between-country LE disparities since 1965, in Latin America and the Caribbean.Methods & Findings: LE trends since 1965 are described for three geographical sub-regions: the Caribbean, Central America, and South America. LE disparities are explored using a suite of absolute and relative disparity metrics, with measurement consensus providing confidence to observed differences. LE has increased throughout Latin America and the Caribbean. Compared to the Caribbean, LE has increased by an additional 6.6 years in Central America and 4.1 years in South America. Since 1965, average reductions in between-country LE disparities were 14% (absolute disparity) and 23% (relative disparity) in the Caribbean, 55% and 51% in Central America, 55% and 52% in South America. Conclusions: LE in Latin America and the Caribbean is exceeding ‘minimum standard’ international targets, and is improving relative to the world region with the highest human longevity. The Caribbean, which had the highest LE and the lowest between-country LE disparities in Latin America and the Caribbean in 1965-70, had the lowest LE and the highest LE disparities by 2005-10. Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response. The persistent LE inequity between Caribbean countries suggests that public health interventions should be tailored to individual countries to be most effective. Between- and within-country disparity monitoring for a range of health metrics should be a priority, first to guide country-level policy initiatives, then to contribute to the assessment of policy success.

Keywords: Life Expectancy; Health Disparities; Caribbean; Central America; South America.  

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129778

21. Tracking universal health coverage:  First global monitoring report

The World Health Organization, The World Bank Group

Released online: June 2015

Overview

Bringing universal health coverage (UHC) into focus: One of the main challenges faced in supporting UHC-oriented reform is the perception on the part of some decision-makers

that UHC is too diffuse a concept, and UHC-related progress unquantifiable. This first global monitoring report on tracking UHC is produced partly to challenge that notion. Most countries are already generating credible, comparable data on both health service and financial protection coverage, despite data blind spots on key public health concerns such as noncommunicable diseases (NCDs) and health service quality. Broadly defined, UHC means all people receiving the quality health services they need, without being exposed to financial hardship. UHC involves three coverage dimensions – health services, finance, and population – and is a dynamic, continuous process that changes in response to shifting demographic, epidemiological and technological trends, as well as people’s expectations […] 

The tracer health service indicators: The report presents the global and regional situation with regard to eight core tracer health service coverage indicators for: reproductive and newborn health (family planning, antenatal care, skilled birth attendance); child immunization (three doses of diphtheria, tetanus and pertussis (DTP)-containing vaccine); infectious disease (antiretroviral therapy (ART), tuberculosis (TB) treatment); and non-health sector determinants of health (improved water sources and improved sanitary facilities). The indicators have been chosen because they involve health interventions from which every individual in every country should benefit – no matter what the country’s level of socioeconomic development or epidemiological circumstances, and no matter what type of health system it may have – and because recent, comparable data are available for most countries. The picture they present is mixed. On the one hand more people have access to essential health services today than at any other time in history. In some cases, global population coverage already surpasses the 80% minimum proposed by the World Health Organization (WHO)/World Bank global monitoring framework […]

Moving forward: Notwithstanding the persistence of inequities in access to health services (400 million people lacking at least one of seven essential health services) and the relatively high level of impoverishment caused by health spending, it is apparent that UHC progress is a reality, and that key aspects of that reality are measurable. This first global monitoring report on tracking UHC shows that using a core set of tracer indicators of the kind recommended by the WHO/World Bank Group UHC monitoring framework, it is possible to track progress in key areas of financial protection and health services coverage not just for populations as a whole, but for critical subpopulations such as people living in rural areas and the poor.

Keywords  Universal Health Coverage; Delivery of Health Care; Healthcare Financing; Health Services Accessibility; Cost of Illness; Program Evaluation; Global Health

http://equity.bvsalud.org/

22. Achieving gender equality to reduce intimate partner violence against women 

Kathryn L Falb, Jeannie Annan, Jhumka Gupta

The Lancet Global Health, 2015, 3(6);e302-e303

Published online: June 2015

Abstract 

This year marks 20 years since 189 countries signed the Beijing Declaration and Platform for Action and committed to prioritisation of women’s empowerment and gender equality. Yet a recently released UN analysis1 shows that violence against women persists at “alarmingly high levels”. Worldwide, one in three women reports sexual or physical violence from a male partner at some point in their lifetime, and such experiences have been linked with harmful effects on health, including maternal morbidity, poor mental health, and vulnerability to HIV/AIDS.2 The UN report also contends that progress towards gender equality has been slow.1 Effective and scalable interventions to reduce intimate partner violence remain scarce, and questions remain about what drives individual violence and why prevalence differs across settings and countries. Lori Heise and Andreas Kotsadam’s study in The Lancet Global Health, is thus very timely, and is a major advance in the understanding of worldwide intimate partner violence. This analysis of data from 44 countries suggests that gender inequality at the macro-level (ie, country-level) serves as a key driver in women’s individual risk of violence and provides insight into why prevalence of intimate partner violence varies across countries…

Keywords: Gender and Health; Violence Against Women; Gender Equality

http://www.sciencedirect.com/science/article/pii/S2214109X15000066

23. Financing universal health coverage by cutting fossil fuel subsidies

Vinay Gupta, Ranu Dhillon, Robert Yates

The Lancet Global Health; 2015, 3(6);e306-e307

Published online: June 2015

Abstract 

Several countries that allocate large sums of public funds  to fossil fuel subsidies have low public health spending and associated low health coverage. Two such nations, Indonesia and Iran, have eliminated these subsidies to finance health coverage and other social priorities. Other countries with high expenditure on fossil fuel subsidies are considering similar reforms, suggesting that the reallocation of fuel subsidies could become an important mechanism for countries to pursue universal health coverage. Worldwide, nearly half a trillion dollars were spent on fossil fuel subsidies in 2010.1 Although these subsidies were at first intended to protect poor people from high fuel costs, in practice they are more likely to benefit wealthy households, promote overconsumption of fuel, and discourage energy efficiency. Furthermore, cutting of fossil fuel subsidies has been associated with favourable economic factors, including stronger currencies and improved current accounts deficits….

Keywords: Universal Health Coverage; Health Economics;  Health Expenditures; Investments; Fossil Fuels; Global Health

http://www.sciencedirect.com/science/article/pii/S2214109X15000078

24. Handbook on health inequality monitoring with a special focus on low- and middle-income countries

PowerPoint lectures based on the handbook

Lecture 1: Introduction

ppt, 574kb

Presents background information about monitoring and health inequality, and an overview of health inequality monitoring in the context of low- and middle-income countries.

Lecture 2: Health indicators and equity stratifiers

ppt, 522kb

Highlights considerations that underlie the selection of health indicators and equity stratifiers.

Lecture 3: Data sources

ppt, 878kb

Outlines types of data sources and their strengths, limitations, and areas for improvement; introduces data source mapping.

Lecture 4: Simple measures of health inequality

ppt, 885kb

Discusses the application and limitations of simple measures of inequality: difference and ratio.

Lecture 5: Complex measures of health inequality

ppt, 1.82Mb

Describes complex measures of inequality, and their application to health inequality monitoring: slope index of inequality, concentration index, absolute mean difference, Theil index, population attributable risk.

Lecture 6: Reporting inequalities I

ppt, 1.19Mb

Introduces the guiding principles to effectively report the results of inequality monitoring.

Lecture 7: Reporting inequalities II

ppt, 1.42Mb

Demonstrates additional considerations and practices for reporting health inequalities.

Lecture 8: Cumulative example

ppt, 1.61Mb

Provides an example of health inequality monitoring in the Philippines, applying concepts in lectures 1-7.

http://www.who.int/gho/health_equity/handbook/en/

25. State of inequality: reproductive, maternal, newborn and child health

The World Health Organization

Published online: May 2015

Abstract 

The health of the world’s population is in a state of inequality. That is to say, there are vastly different stories to tell about a person’s health depending on where they live, their level of education, and whether they are rich or poor, etc. Monitoring the state of inequality in health takes into account the current experiences of population subgroups, as well as the trends of how health experiences in these subgroups have changed over time. This 2015 report demonstrates best practices in reporting the results of health inequality monitoring, and introduces innovative ways for audiences to explore inequality data.  Interactive data visualization components – including story-points, equity country profiles, maps and reference tables – accompany the key messages and findings of this report, allowing users to customize data displays and engage in benchmarking according to their interests. A series of feature stories indicated that inequalities in reproductive, maternal, newborn and child health persist, despite having narrowed over the past decade. There is still much progress to be made in reducing inequalities in reproductive, maternal, newborn and child health through equity-oriented policies, programmes and practices. Though the report draws on data about reproductive, maternal, newborn and child health in low- and middle-income countries, the approach and underlying concepts can be widely applied to any health topic.

Keywords Equity in Health; Health Inequality; Maternal Health; Child Health; Newborn Health; Global Health;  

http://apps.who.int/iris/bitstream/10665/170970/1/WHO_HIS_HSI_2015.2_eng.pdf?ua=1