Health Equity: 07/01/08

Tuesday, July 1, 2008

[EQ] The Right to Health

The Right to Health

Fact Sheet No. 31 - 2008

Joint publication by the UN Office of the High Commissioner for Human Rights (OHCHR) and the World Health Organization (WHO)

Available online PDF [52p.] at: http://www.ohchr.org/Documents/Publications/Factsheet31.pdf

“…..This fact sheet aims to shed light on the right to health in international human rights law as it currently stands, amidst the plethora of initiatives and proposals as to what the right to health may or should be. Consequently, it does not purport to provide an exhaustive list of relevant issues or to identify specific standards in relation to them.

The fact sheet starts by explaining what the right to health is and illustrating its implications for specific individuals and groups, and then elaborates upon States' obligations with respect to the right. It ends with an overview of national, regional and international accountability and monitoring mechanisms….”

Content:

Introduction

I. WHAT IS THE RIGHT TO HEALTH?

A. Key aspects of the right to health

B. Common misconceptions about the right to health

C. The link between the right to health and other human rights

D. How does the principle of non-discrimination apply to the right to health?

E. The right to health in international human rights law

II. HOW DOES THE RIGHT TO HEALTH APPLY TO SPECIFIC GROUPS?

A. Women

B. Children and adolescents

C. Persons with disabilities

D. Migrants

E. Persons living with HIV/AIDS

III. OBLIGATIONS ON STATES AND RESPONSIBILITIES OF OTHERS TOWARDS THE RIGHT TO HEALTH

A. General obligations

Progressive realization

Taking steps to realize the right to health

Core minimum obligation

B. Three types of obligations

The obligation to respect

The obligation to protect

The obligation to fulfill

C. Do others have responsibilities too?

United Nations bodies and specialized agencies

The private sector

IV. MONITORING THE RIGHT TO HEALTH AND HOLDING STATES ACCOUNTABLE

A. Accountability and monitoring at the national level

B. Accountability at the regional level

C. International monitoring

Annex: Selected international instruments and other documents related to the right to health

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[EQ] Measuring maternal mortality: An overview of opportunities and options for developing countries

Measuring maternal mortality: An overview of opportunities and options for developing countries

WJ Graham1,2 , S Ahmed3 , C Stanton3 , CL Abou-Zahr4 and OMR Campbell5

¹Department of Obstetrics and Gynaecology, University of Aberdeen, UK

²Immpact, University of Aberdeen, UK

³Department of Population, Family and Reproductive Health, The Johns Hopkins Bloomberg Shool of Public Health, Baltimore, MD, USA

⁴Health Metrics Network, World Health Organization, Geneva, Switzerland

⁵Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

BMC Medicine 2008, 6:12doi:10.1186/1741-7015-6-12

Available online at: http://www.biomedcentral.com/1741-7015/6/12

“….There is currently an unprecedented expressed need and demand for estimates of maternal mortality in developing countries. This has been stimulated in part by the creation of a Millennium Development Goal that will be judged partly on the basis of reductions in maternal mortality by 2015. Since the launch of the Safe Motherhood Initiative in 1987, new opportunities for data capture have arisen and new methods have been developed, tested and used.

This paper provides a pragmatic overview of these methods and the optimal measurement strategies for different developing country contexts. There are significant recent advances in the measurement of maternal mortality, yet also room for further improvement, particularly in assessing the magnitude and direction of biases and their implications for different data uses.

Some of the innovations in measurement provide efficient mechanisms for gathering the requisite primary data at a reasonably low cost. No method, however, has zero costs. Investment is needed in measurement strategies for maternal mortality suited to the needs and resources of a country, and which also strengthen the technical capacity to generate and use credible estimates. Ownership of information is necessary for it to be acted upon: what you count is what you do. Difficulties with measurement must not be allowed to discourage efforts to reduce maternal mortality. Countries must be encouraged and enabled to count maternal deaths and act….”

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[EQ] Equity in Health Care Financing: The Case of Malaysia

Equity in Health Care Financing: The Case of Malaysia

Chai Ping Yu¹, David K Whynes², Tracey H Sach³

¹ Health Economics Research Group, Brunel University, Uxbridge, United Kingdom.

² School of Economics, University of Nottingham, United Kingdom.

³ School of Chemical Sciences and Pharmacy, and Health Economics Group, University of East Anglia, Norwich, United Kingdom.

International Journal for Equity in Health June 2008, 7:15 doi:10.1186/1475-9276-7-15

Available online PDF [49p.] at: http://www.equityhealthj.com/content/pdf/1475-9276-7-15.pdf

Background: Equitable financing is a key objective of health care systems. Its importance is evidenced in policy documents, policy statements, the work of health economists and policy analysts. The conventional categorisations of finance sources for health care are taxation, social health insurance, private health insurance and out-of-pocket payments. There are nonetheless increasing variations in the finance sources used to fund health care. An understanding of the equity implications would help policy makers in achieving equitable financing.

Objective: The primary purpose of this paper was to comprehensively assess the equity of health care financing in Malaysia, which represents a new country context for the quantitative techniques used. The paper evaluated each of the five financing sources (direct taxes, indirect taxes, contributions to Employee Provident Fund and Social Security Organization, private insurance and out-of-pocket payments) independently, and subsequently by combined the financing sources to evaluate the whole financing system.

Methods: Cross-sectional analyses were performed on the Household Expenditure Survey Malaysia 1998/99, using Stata statistical software package. In order to assess inequality, progressivity of each finance sources and the whole financing system was measured by Kakwani’s progressivity index.

Results: Results showed that Malaysia’s predominantly tax-financed system was slightly progressive with a Kakwani’s progressivity index of 0.186. The net progressive effect was produced by four progressive finance sources (in the decreasing order of direct taxes, private insurance premiums, out-of-pocket payments, contributions to EPF and SOCSO) and a regressive finance source (indirect taxes).

Conclusions: Malaysia’s two tier health system, of a heavily subsidised public sector and a user charged private sector, has produced a progressive health financing system. The case of Malaysia exemplifies that policy makers can gain an in depth understanding of the equity impact, in order to help shape health financing strategies for the nation.

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[EQ] Health system snapshots: perspectives from six countries

Health system snapshots: perspectives from six countries

Eurohealth Vol 14 No 1 - 2008
LSE Health, London School of Economics and Political Science - London, United Kingdom

Available online PDF [52p.] at: http://www.lse.ac.uk/collections/LSEHealth/pdf/eurohealth/vol14no1.pdf

‘…..We hear a lot about the soaring price of commodities such as oil and gas. The global energy crisis will not be resolved through further exploration for fossil fuels. Instead, that most precious of commodities, knowledge, can help find innovative ways of harnessing new sources of energy.

Knowledge is also priceless for health policy. Intelligence on the state of health systems is vital, yet it can be difficult to keep up with the rapid pace of

change. In this issue of Eurohealth we include snapshots on six countries. Originally commissioned and funded by the New York based Commonwealth

Fund, and prepared in a common format, they provide an opportunity to reflect on approaches to efficiency and quality improvement.

We are also delighted to include a contribution from historian Louis Galambos, who highlights challenges for the global vaccine industry and how these parallel

past events. In an economic downturn, cost pressures may first be felt in areas viewed as low priorities. All too often public health research can suffer. As well as

the potential lost health benefits, the economic consequences of reduced investment into vaccine research and development may be substantial: Europe

currently produces around 90% of the world’s vaccines. Professor Galambos argues that we should focus on the long-term benefits of vaccines to society,

rather than just being mindful of short-term budgetary requirements.

We also feature two articles looking at how knowledge can better inform policy making. Hans Stein looks at the role of international organisations in public health

research across the EU. He calls for more emphasis on ensuring that research is feasible, policy relevant and linked to the policy making process. Philipa

Mladovsky and colleagues, meantime, argue that we are losing an opportunity to make use of much existing knowledge….”

The health system in England

Seán Boyle

The health system in France

Isabelle Durand-Zaleski

The health system in Germany

Reinhard Busse

The health system in Denmark

Karsten Vrangbæk

The health system in the Netherlands

Niek Klazinga

The health system in Sweden

Anders Anell

Public Health Perspectives

What are the prospects for a new golden era in vaccines?

Louis Galambos

Access to research data in Europe

Philipa Mladovsky, Elias Mossialos and Martin McKee

Supporting and using policy-oriented public health research at the European level

Hans Stein

Health Policy Developments

Celtic Tiger, Health Care Dragon: Fiery debates in the Irish private health insurance market

Brian Turner

Governance in the pharmaceutical sector

Armin Fidler and Wezi Msisha

Pharmaceutical policy challenges in Central and Eastern Europe

Andreas Seiter

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