Monday, March 10, 2008

[EQ] Canada Senate Subcommittee Reports: International Community?s Approach to Population Health

Senate Subcommittee Releases Two Reports on the International Community’s Approach to Population Health

Ottawa (February 26, 2008)

 – The Senate Subcommittee on Population Health has released two interim reports on its study of the determinants of health:

Second Report: Eighth Report of the Standing Senate Committee on Social Affairs, Science & Technology, which deals with:
 Maternal Health and Early Childhood Development in Cuba

- First Report: Seventh Report of the Standing Senate Committee on Social Affairs, Science & Technology, which deals with:
Population Health Policy: International Perspectives


“We learned many lessons from this comparative review,” said Conservative Senator Wilbert J. Keon (Ottawa - Ontario), the Subcommittee’s Chair, and one of Canada’s pre-eminent surgeons.  “For example, establishing health goals and targets facilitates monitoring and evaluation, while undertaking health impact assessments ensures that health considerations are taken into account when developing policies."

"There is greater emphasis on reducing health disparities in the countries profiled. This must create a positive climate for action in Canada," continued former health professional Senator Lucie Pépin - Lib. - (Shawinegan - Quebec).  "Cuba has made interesting strides with its maternal health and early childhood education programs.  Indicators show progress over the past 30 years in child and maternal health.  Daycare and polyclinics have played a vital role in this respect, by integrating health, education and science."

The Subcommittee will continue to examine government policies, programs and best practices that influence the health of Canadians.  It will investigate ways in which governments could better coordinate their activities in order to improve health outcomes, whether these activities involve the different levels of government or various departments and agencies within a single level of government.  The Subcommittee has therefore set an ambitious agenda to review the data and help chart a way forward toward dramatically reducing health disparities in Canada.

The Subcommittee’s members are the Honourable Senators:

Bert Brown - C - (Alberta), Catherine S. Callbeck - Lib. - (Prince Edward Island), Ethel M. Cochrane - C - (Newfoundland and Labrador), Joan Cook - Lib. - (Newfoundland and Labrador), Joyce Fairbairn, P.C. - Lib. - (Lethbridge - Alberta), Wilbert J. Keon - C - (Ottawa - Ontario), and Lucie Pépin - Lib. - (Shawinegan - Quebec).

For more information on the Subcommittee, please visit “Subcommittee on Population Health”, under “Social Affairs”
at: www.parl.gc.ca/sencom-e.asp .  


The interim reports are available on the Committee’s website: http://senate-senat.ca/SOCIAL.asp  

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Population Health Policy:

International Perspective and Maternal Health and Early Childhood Development in Cuba
Available online as PDF file [40p.] at: http://www.parl.gc.ca/39/2/parlbus/commbus/senate/com-e/soci-e/rep-e/rep08feb08-e.pdf


TABLE OF CONTENTS


EXECUTIVE SUMMARY

INTRODUCTION

GEOGRAPHY AND HISTORICAL BACKGROUND

MATERNAL HEALTH AND HEALTHY CHILDHOOD DEVELOPMENT

1. Polyclinics

2. Maternal and Child Health

2.1 Medical Genetic Services

2.2 Partogram

2.3 Maternal Home

2.4 Child and Maternal Health Outcomes

3. Early Child Development and Education

3.1 Círculos Infantiles

3.2 Educa a Tu Hijo

3.3 Teaching Staff

3.4 Children with Disabilities

3.5 Arts in Early Education

3.6 Sports, Education and Health

MONITORING AND EVALUATION

INTERNATIONAL ASSISTANCE

SUMMARY OF SUBCOMMITTEE’S FINDINGS AND OBSERVATIONS

APPENDIX 1 & 2

 

POPULATION HEALTH POLICY: INTERNATIONAL PERSPECTIVES

First Report of the Subcommittee on Population Health of the Standing Senate - Committee on Social Affairs, Science and Technology
Available online as PDF file [62p.] at: http://www.parl.gc.ca/39/2/parlbus/commbus/senate/com-e/soci-e/rep-e/rep07feb08-e.pdf

 

TABLE OF CONTENTS

 

EXECUTIVE SUMMARY

INTRODUCTION

CHAPTER 1: Australia

1.1 Main Findings

1.2 Government Responsibility

1.3 Development and Implementation of Population Health Policy

1.4 Monitoring and Evaluation

CHAPTER 2: England

CHAPTER 3: Finland

CHAPTER 4: New Zealand

CHAPTER 5: Norway

CHAPTER 6: Sweden

CHAPTER 7: Comparative Analysis

7.1 Introduction

7.2 Shift in Public Policy Thinking and Action

7.3 Goals, Objectives and Targets

7.4 Monitoring, Evaluation and Research

7.5 Role of the Health Sector and Others

7.6 Health Impact Assessment (HIA)

7.7 Regionalization

7.8 Intersectoral Approach

7.9 Government Intervention

7.10 Concluding Remarks

APPENDIX 1

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Message From: Dr. Dennis Raphael, PhD, Professor and Undergraduate Program Director
School of Health Policy and Management - York University
4700 Keele Street Toronto ON M3J 1P3 Canada

 

 

  *      *      *     * 

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;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“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] Constructing the evidence base on the social determinants of health: A guide

Constructing the evidence base on the social determinants of health: A guide

 

Josiane Bonnefoy, Antony Morgan, Michael P. Kelly, Jennifer Butt, Vivian Bergman With Peter Tugwell, Vivian Robinson, Mark Exworthy, Johan Mackenbach, Jennie Popay, Catherine Pope, Thelma Narayan, Landon Myer, Sarah Simpson, Tanja Houweling, Liliana Jadue

The Measurement and Evidence Knowledge Network (MEKN) of the WHO Commission on Social Determinants of Health

November 2007

 

Available online as PDF file [337p.] at: http://whqlibdoc.who.int/hq/2007/a91145.pdf

 

“……This guide is designed for practitioners interested in developing and implementing policies and programmes to tackle the social determinants of health inequities. It sets out state of the art recommendations on how best to measure the social determinants of health and the most effective ways of constructing an evidence base which provides the basis for translating evidence into political action…

 

The guide is divided into two parts:

I Issues and principles

II Tools and techniques...”

 

Table of contents

 Introduction

PART I - ISSUES AND PRINCIPLES

1 The challenge of measurement and evidence about the social determinants of health

1.1 Conceptual and theoretical issues

1.2 Eight principles for developing the evidence base

1.3 Conclusion

2 Taking an evidence based approach

2.1 Lessons from evidence based medicine

2.2 Applying the evidence based approach to the social determinants of health

2.3 Building an integrated evidence base for the social determinants of health

2.4 ‘Equity proofing’

2.5 Illustrative case studies

3 Gaps and gradients

3.1 The pioneering work of Antonovsky and Victora

3.2 Health gaps

3.3 Health gradients

3.4 Shape of health gradients

3.5 Illustrative case study

3.6 Remainder of this guide

PART II - TOOLS AND TECHNIQUES

4 Framework for policy development, implementation, monitoring and evaluation

5 Getting social determinants on the policy agenda – understanding the policymaking process

5.1 Introduction

5.2 Understanding policy-making

5.3 SDH and the policy-making process

5.4 Policy-making in context

5.5 Models to inform policy-making

5.6 Conclusions

5.7 Illustrative case studies

CONSTRUCTING THE EVIDENCE BASE ON THE SOCIAL DETERMINANTS OF HEALTH: A GUIDE

6 Getting social determinants on the policy agenda – making the case for change

7 Getting social determinants on the policy agenda – equity proofing

7.1 Equity filter/ lens

7.2 Equity audits/ health equity audits

7.3 Equity-effectiveness loop

7.4 Equity gauge

7.5 Equity-focused health impact assessment

7.6 Conclusion

7.7 Illustrative case studies

7.8 Specific tools

8 Generating evidence for policy and practice

8.1 Status of the evidence base on the social determinants of health

8.2 Getting the questions right

8.3 Achieving methodological diversity

8.4 Assessing the quality of the diverse evidence base

8.5 Conclusion

8.6 Illustrative case studies

8.7 Related reading

8.8 Specific tools

9 Evidence synthesis and action

9.1 Synthesizing complex and diverse data

9.2 Producing guidance for action

9.3 Illustrative case studies

9.4 Related reading

9.5 Specific tools

10 Effective implementation and evaluation

10.1 Health equity auditing, needs assessment and impact assessment

10.2 Organizational development and change management

10.3 Readiness for intersectoral action

10.4 Effective ways of involving local communities

10.5 Evaluation

10.6 Illustrative case studies

10.7 Related reading

10.8 Specific tools

CONSTRUCTING THE EVIDENCE BASE ON THE SOCIAL DETERMINANTS OF HEALTH: A GUIDE

11 Learning from practice

12 Monitoring

12.1 Introduction

12.2 Use of data to monitor health inequities

12.3 Sources of health data

12.4 Issues in interpreting key equity stratifiers

12.5 Special issues in low and middle income countries

12.6 Special issues in high income countries

12.7 Improvements in monitoring systems

12.8 Illustrative case studies

12.9 Related reading

13 Further issues for consideration

13.1 Attribution of effects and outcomes

13.2 The challenge of policy

13.3 Hierarchies of evidence

13.4 Equity: relative or absolute?

13.5 Where further research and development is required

14 Conclusion

14.1 Social structure and the operation of the determinants of health inequities

14.2 Towards a causal hypothesis

14.3 A plea for action

15 References


Appendix I – Illustrative case studies

 

Case study 1: United Kingdom – Using evidence to inform health policy: the Acheson Inquiry

Case study 2: Brazil, Peru and United Republic of Tanzania – Failure to equity proof interventions for children in low and middle income countries

Case study 3: Bolivia – Evaluating Bolivia’s Social Investment Fund

Case study 4: Brazil – Use of survey data to determine and refine state-wide policies and programmes; persistent inequities between rich and poor

Case study 5: Canada – A decade of children’s policies based on evidence (1990-2001)

Case study 6: Mexico – Use of evidence to reform national health system

Case study 7: Thailand – Introduction of universal health coverage

Case study 8: Various countries – Linking research and evidence to policy-making

Case study 9: Thailand – Use of locally-defined health determinants to push for change, Mun River dam

Case study 10: Brazil and Chile – Use of national conferences to bring together policy and evidence

Case study 11: Uganda – Community-based monitoring and evaluation of Poverty Action Fund

Case study 12: Various countries – Synthesis of qualitative studies of effectiveness of tuberculosis treatment

Case study 13: Various countries – Synthesis of different types of evidence to assess the impact of school feeding

Case study 14: United Kingdom – Development of evidence based guidance

Case study 15: Slovenia – Health impact assessment of agriculture, food and nutrition policies.

Case study 16: United Kingdom – Health impact assessment of a housing estate regeneration project

Case study 17: Mexico – Use of monitoring and evaluation to continuously improve the Oportunidades programme

Case study 18: Sweden – Use of evidence to develop the intersectoral National Public Health Strategy and the challenges of monitoring its implementation

Case study 19: Bangladesh – Evaluating the Food for Education programme using existing data sources

Case study 20: Kenya – Impact of grassroots involvement in gathering data on successful introduction of change

Case study 21: The Netherlands – Introduction of a multi-level surveillance system for monitoring health inequalities

Appendix II – Low and middle income countries by income group, equity and health indicators, and data sources

Appendix III – Content of standard surveys

Appendix IV – Recommendations from MEKN final report

Appendix V – List of abbreviations.

 

 

  *      *      *     * 

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;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“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”.

---------------------------------------------------------------------------------------------------
PAHO/WHO Website: http://www.paho.org/
EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.  

[EQ] Capacity planning in health care: a review of the international experience

Capacity planning in health care: a review of the international experience

New policy brief on capacity planning

 

Stefanie Ettelt, Ellen Nolte, Sarah Thomson, Nicholas Mays, and the International Healthcare Comparisons Network 

World Health Organization on behalf of the European Observatory on Health Systems and Policies 

Policy Brief No.13, February 2008  

 

Available online PDF file [67p.] at: http://www.euro.who.int/Document/E91193.pdf

 

“…..  This policy brief reviews approaches to capacity planning, a crucial component of health care governance. By concentrating on a selection of countries as diverse as Canada, Denmark, England, Finland, France, Germany, Italy, the Netherlands and New Zealand, it aims to show a range of approaches to health care financing and organization, since both of these factors have an impact on approaches to capacity planning….”

 

Country Lead responsibility for capacity planning

 

Canada Planning is the responsibility of the provinces/territories, guided in some cases by national frameworks, with participation from local authorities

Denmark Regions and municipalities plan different areas of health care autonomously, with some central supervision

England National and regional planning is directed by the central government with the participation of local authorities

Finland Planning is the responsibility of municipalities and hospital districts (formed by municipalities)

France Regional hospital agencies plan hospital care within a centrally determined framework in consultation with regional stakeholders

Germany Länder (state) governments plan hospital capacity on the basis of national and regional legislation in consultation with regional stakeholders

Italy Regional governments plan health care (mainly hospital care), using a national health plan as a guide

Netherlands Regional provider organizations plan acute hospital care (subject to approval from the central government)

New Zealand Responsibility for planning is shared by the central government and the DHBs

 

 

 

  *      *      *     * 

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;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“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”.

---------------------------------------------------------------------------------------------------
PAHO/WHO Website: http://www.paho.org/
EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.