Health Equity: July 2008

Friday, July 25, 2008

[EQ] Social protection in health schemes for mother and child population: lessons learned from the Latin American Region

Social protection in health schemes for mother and child population:
lessons learned from the Latin American Region

Pan American Health Organization. Area of Health Systems Strengthening. Health Policies and Systems Unit.

Washington, D.C.: PAHO/WHO - 2008.

English: PDF [178p.] at: http://www.paho.org/english/AD/THS/OS/SPHS-eng.pdf

Spanish: PDF [181p] at: http://www.paho.org/spanish/AD/THS/OS/SPHS-spa.pdf

“….Due to the wide variety of interventions in place, the task of identifying and describing social protection in health schemes (SPHS) for mother, newborn and child populations in the Latin American and Caribbean (LAC) region is an arduous one. While nearly all Latin American countries have implemented immunization and nutrition programs that are standardized according to a global consensus based on worldwide experience on what works best, health protection schemes aimed at guaranteeing access to health care to mothers and children are heterogeneous and have achieved varying degrees of success.

Along with those factors within the health sector that hinder the timely delivery and quality of health services, a number of conditions outside the health sector play a key role in determining access to care and health outcomes in LAC countries. The political situation and social determinants of health are of paramount importance in the performance of social protection in health schemes SPHS in the region, given the fact that political instability and inequity shape the social landscape of many countries….” from Pedro Brito

Content:

Executive Summary

1. Introduction

2. Background

3. Conceptual Framework

3.1) Description of the Social Protection in Health Schemes (SPHS) currently in place in the region -

3.2) Analysis of the strengths and weaknesses of the SPHS

4. Analytical Framework

4.1) Objectives

4.2) Methods

4.3) Conducting the Analysis

4.4) Information Sources

4.5) Limitations of the analysis

5. Case Studies

5.1) Universal Mother & Child Insurance (Bolivia)

5.2) The Family Health Program (Brazil)

5.3) Mother & Child Social Health Protection Policy (Chile)

5.4) Free Maternity and Child Care Law (Ecuador)

5.5) Mother and Child Voucher (Honduras)

5.6) OPORTUNIDADES Program (Mexico)

5.7) Integrated Health Insurance (Peru)

6. Results

7. Discussion and Lessons Learned

References

This report is the product of a joint initiative between PAHO/WHO, USAID, SIDA and AECI

Two teams: from the Health Policies and Systems Unit (HSS-HP) and the Women and Reproductive Health Unit (FCH-CLAP/WR) and Child and Adolescent Unit (FCH-CA), under the supervision of Eduardo Levcovitz and Gina Tambini. - Cecilia Acuña, HSS-HP led the research team.
The research team: Virginia Camacho, FCH-CLAP/WR; Andrew Griffin, HSS-HP; Rafael Obregon, FCH-CA; Jessica Rada, Intern, HSS-HP; Caroline Ramagem, HSS-HP; Sarah Watson, Intern, HSS-HP. Information support: Soledad Urrutia, HSS-HP and Rachel Kauffmann, FCH-WR. Administrative support, Cristine Sulek

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
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“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] How have Global Health Initiatives impacted on health equity?

How have Global Health Initiatives impacted on health equity?

Johanna Hanefeld

Health Policy Unit, London School of Hygiene and Tropical Medicine
Promotion & Education, Vol. 15, No. 1, 19-23 (2008)

PDF online at: http://ped.sagepub.com/cgi/reprint/15/1/19

Website: http://ped.sagepub.com/cgi/content/refs/15/1/19

“……..This review examines the impact of Global Health Initiatives (GHIs) on health equity, focusing on low- and middle-income countries.

It is a summary of a literature review commissioned by the WHO Commission on the Social Determinants of Health. GHIs have emerged during the past decade as a mechanism in development assistance for health.

The review focuses on three GHIs, the US President's Emergency Plan For AIDS Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria. All three have leveraged significant amounts of funding for their focal diseases — together these three GHIs provide an estimated two-thirds of external resources going to HIV/AIDS.

This paper examines their impact on gender equity. An analysis of these Initiatives finds that they have a significant impact on health equity, including gender equity, through their processes of programme formulation and implementation, and through the activities they fund and implement, including through their impact on health systems and human resources.

However, GHIs have so far paid insufficient attention to health inequities. While increasingly acknowledging equity, including gender equity, as a concern, Initiatives have so far failed to adequately translate this into programmes that address drivers of health inequity, including gender inequities.

The review highlights the comparative advantage of individual GHIs, which point to an increased need for, and continued difficulties in, harmonisation of activities at country level. On the basis of this comparative analysis, key recommendations are made. They include a call for equity-sensitive targets, the collection of gender-disaggregated data, the use of policy-making processes for empowerment, programmes that explicitly address causes of health inequity and impact assessments of interventions' effect on social inequities. ….”

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[EQ] HIV/AIDS in Latin America and the Caribbean

HIV/AIDS in Latin America and the Caribbean

The Lancet, Volume 372, Number 9635, 26 July 2008

Website: http://www.thelancet.com/journals/lancet/article/PIIS014067360861082X/fulltext

“…..Mexico City is gearing up to host the XVII International AIDS Conference (AIDS 2008) on Aug 3–8. Around 20000 people are expected to attend this biennial meeting, which for the first time is being held in Latin America and the Caribbean. The conference should provide a unique opportunity to focus attention on a region that often gets sidelined in the global response to HIV/AIDS.

Nearly 2 million people are estimated to be living with HIV/AIDS in Latin America and the Caribbean—more than in the USA, Canada, western Europe, Australia, and Japan combined. Most transmission is through unprotected sex but of growing concern is the spread from unsafe injecting drug use. The average HIV prevalence rate in adults in Latin America is low (0·5%) compared with Africa (5%), yet the numbers of people affected are still considerable. Most infections are in men who have sex with men, followed by sex workers and their clients, intravenous drug users, and migrants. An increasing problem in the region is that many men have sex with both men and women, which is contributing to the rapid spread of the epidemic in women….”

Financing the response to AIDS in low- and middle- income countries: International assistance from
the G8, European Commission and other donor Governments, 2007 (

UNAIDS and Kaiser Family Foundation release new report assessing funding for AIDS by G8 countries and other major donors

PPT; http://data.unaids.org/pub/Presentation/2008/080704_unaids_kff_g8_slide_set_en.ppt

UNAIDS 2007 AIDS epidemic update

Website: http://www.unaids.org/en/Knowl...

The 2007 AIDS epidemic update reports on the latest developments in the global AIDS epidemic.
The 2007 edition provides the most recent estimates of the AIDS epidemic and explores new findings and trends in the epidemic’s evolution.

AIDS epidemic update 2007
Regional Summaries - 16 April 2008

Asia ( en | fr | es | ru )
Sub-Saharan Africa ( en | fr | es | ru )
Caribbean ( en | fr | es | ru )
Eastern Europe and Central Asia (en | fr | es | ru)
Latin America (en | fr | es | ru )
Middle East and North Africa (en | fr | es | ru )
North America, Western and Central Europe (en | fr | es | ru )

AIDS 2008 - XVII International AIDS Conference 3-8 August 2008, Mexico City

Website: http://www.aids2008.org/

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[EQ] Challenging orthodoxies: The road ahead for health and human rights

Challenging orthodoxies: The road ahead for health and human rights

“….Health and Human Rights will include two synergistic sections. The first, entitled “Critical Concepts,” will examine the conceptual foundations of a human rights approach to health through rigorous scholarship. The second, “Health and Human Rights in Practice,” provides a forum to analyze challenges and solutions in implementing rights-based approaches to health. These two rubrics will resist the traditional dichotomy between theory and practice, seeking instead to foster engaged scholarship and reflective activism. In doing so, they will open directions for informed action by and with communities to realize the full spectrum of human rights….”

Table of Contents, Vol 10, No 1 (2008), Health and Human Rights

Introduction

From the editors Paul Farmer, Alexander Irwin, Evan Lyon, Vivek Maru, Alicia Ely Yamin

HTML PDF

Challenging orthodoxies: The road ahead for health and human rights

Paul Farmer Abstract HTML PDF

Excluding the poor from accessing biomedical literature: A rights violation that impedes global health

Gavin Yamey Abstract HTML PDF

Critical Concepts

Critical concepts: From the editor Alicia Ely Yamin Abstract HTML PDF

Will we take suffering seriously? Reflections on what applying a human rights framework to health means and why we should care

Alicia Ely Yamin Abstract HTML PDF

What is a human-rights based approach to health and does it matter?

Leslie London Abstract HTML PDF

Heath systems and the right to the highest attainable standard of health

Paul Hunt, Gunilla Backman Abstract HTML PDF

A human rights approach to quality of life and health: Applications to public health programming

Armando De Negri Filho Abstract HTML PDF

Spanish:
El enfoque de los derechos humanos en calidad de vida y salud y su aplicación en la reestructuración programática y la reorganización de los servicios: reflexiones alrededor de una estrategia de aplicación
http://hhrjournal.org/blog/perspectives/a-human-right-approach-to-quality-of-life-and-health-spanish/

Health and Human Rights in Practice

Health and human rights in practice: From the editors Evan Lyon, Vivek Maru

Abstract HTML PDF

Notes on the rights of a poor woman in a poor country

Tarek Meguid Abstract HTML PDF

“Nationals” and “expatriates”: Challenges of fulfilling “sans frontières” (“without borders”) ideals in international humanitarian action

Olga Shevchenko, Renée C. Fox

Abstract HTML PDF

From market competition to solidarity? Assessing the prospects of US health care reform plans from a human rights perspective

Anja Rudiger Abstract HTML PDF

The right of children in developing countries to be born and live HIV-free

Agnès Binagwaho Abstract HTML PDF

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Thursday, July 24, 2008

[EQ] Business and Poverty: Opening markets to the poor

Business and Poverty: Opening markets to the poor

New Development Outreach showcases how forward-looking companies are reaching out to the 4 billion people who live on less than $5 a day….

Development OUTREACH - Flagship Magazine -Global knowledge for development - Learning programs of the World Bank

Website: http://www1.worldbank.org/devoutreach/

July 23, 2008—Can the private sector help transform the lives of the poor? Can poor producers and consumers in turn transform business models and shape new opportunities for companies?

For a growing number of innovative entrepreneurs, the most effective way to end poverty is to focus on the potential of the poor as the world’s largest and fastest-growing market of producers, workers, and consumers.

The current issue of Development Outreach magazine showcases how forward-looking companies are reaching out to the four billion or so people who make do with incomes of less than $5 a day.

The magazine captures the experiences of companies engaging with the poor, presenting a dozen case studies, including Unilever's Project Shakti network of women entrepreneurs, CEMEX's Patrimonio Hoy initiative, which provides housing to low-income communities in Mexico, and Nestlé’s Milk District model.//”

Business and Poverty: Opening markets to the poor
—Guest Editorial
Djordjija B. Petkoski, V. Kasturi Rangan, and William S. Laufer
Highlights features of the Special Report that discuss the role businesses can play in addressing poverty, and offers case studies as examples.

The Next 4 Billion: Characterizing BoP markets
Allen L. Hammond, William J. Kramer, Robert S. Katz, Julia T. Tran, and Courtland Walker
Points out significant opportunities for market-based approaches to meet the needs of the 4 billion people at the base of the economic pyramid.

Creating Shared Value through Basic Business Strategy
Niels Christiansen
Demonstrates how Nestlé’s milk district model achieves a balance between meeting the needs of the poor and expanding Nestlé’s own business.

The Shakti Revolution
Gavin Neath and Vijay Sharma
Shows what can be done by a multinational firm (Unilever) in meeting both business and social objectives.

Social Issue-Oriented BoP Business and Japanese Companies
Mari Kogiso, Mia Matsuo, and Tokutaro Hiramoto
Shows how by engaging local companies Sumitomo could capitalize on a business opportunity while providing malaria prevention.

Lighting Africa
Katia Theriault, Lindsay Madeira, and Patrick Avato
Describes industry efforts to transform and accelerate the off-grid lighting market and extend benefits to the poor, with the support of the World Bank Group.

Developing the Local Supply Chain for the Contract of the Century
Ibrahim Ismayilov, Samir Taghiyev, Olga Godunova, and Farzin Mirmotahari
Summarizes how a BP/IFC partnership helped develop linkages between Azerbaijani SMEs and the global oil and gas industry.

Patrimonio Hoy
Israel Moreno Barcelo
Shows how CEMEX’s progressive housing program took a proactive approach in Mexico with Patrimonio Hoy.

ZMQ Enabling Bottom-up Development
Subhi Quraishi
Tells the story of a small-sized company that helped social development by combining philanthropic efforts with its ICT products.

Business and Malnutrition
Marc Van Ameringen, Berangère Magarinos, and Michael Jarvis
Presents new business models that help to make foods available and affordable to the poor.

Bridging Gaps in Reproductive Health Care in Egypt through Private Sector Involvement
Andy Cole, Mohamed Afifi and Reem Salah
Illustrates the reproductive health project Takamol, which seeks to increase the availability and quality of reproductive health services.

Improving Health Improves Economic Well-being
Christy L. Wistar
Explores the positive impacts and unexpected challenges of Abbott’s investment in a public-private partnership to modernize Tanzania’s health system.

Access to Finance and Markets as a Strategy to Address Poverty
Nachiket Mor and Bindu Ananth
Emphasizes the value of access to financial services for the very poor through partnerships between banks and local financial institutions.

Bringing Bangladesh into the Digital Age
DEFTA Partners Group, The Alliance Forum Foundation, and George Hara
Shows how a multistakeholder partnership improved access to ICT to enhance health and education services in Bangladesh.

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[EQ] Global Atlas of the Health Workforce

Global Atlas of the Health Workforce

The WHO Department of Human Resources for Health 2008

Website: http://www.who.int/globalatlas/

There is a growing need for high quality information on human resources in health systems to inform decision making for policies and programmes at the national and international levels. The WHO Department of Human Resources for Health has been collecting and compiling cross-nationally comparable data on health workers in all WHO Member States.

Estimates of the stock (absolute numbers) and density (per 1000 population) of the health workforce are available here for 193 Member States. National-level data refer to the active health workforce, that is, all persons currently participating in the health labour market. Counting health workers poses challenges, including how to define them. The World Health Report 2006 defines health workers as "all people engaged in actions whose primary intent is to enhance health." Various permutations and combinations of what constitutes the health workforce potentially exist depending of each country's situation and the means of measurement. The information presented here reflects a framework for harmonizing the boundaries and constituency of the health workforce across contexts.

Two sets of data are contained in the Global Atlas: a main (aggregated) set and a disaggregated set. The aggregated dataset includes estimates of the stock and density of health workers for up to 9 occupational categories. This includes:

(i) physicians;
(ii) nursing and midwifery personnel;
(iii) dentistry personnel;
(iv) pharmaceutical personnel;
(v) laboratory health workers;
vi) environmental and public health workers;
(vii) community and traditional health workers;
(viii) other health service providers; and
(ix) health management and support workers,
that is, those who do not provide services directly but are critical to the performance of health systems.

In the disaggregated dataset, estimates of the stock of health workers are available for some countries for up to 18 occupational categories, reflecting greater distinction of some categories of workers according to assumed differences in skill level and skill specialization. More information on the framework for categorizing health workers can be found in the definition notes.

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