Health Equity: 2009

Friday, December 11, 2009

[EQ] Public stewardship of private providers in mixed health systems

Public stewardship of private providers in mixed health systems

Synthesis report from the Rockefeller Foundation—sponsored initiative on the role of the private sector in health systems

Lagomarsino Gina, Stefan Nachuk, and Sapna Singh Kundra. 2009.

Washington, DC: Results for Development Institute. ISBN 978-0-9788790-8-2

Available online PDF [74p.] at: http://bit.ly/1gpmsq

“……..This report summarizes the findings from research commissioned in 2008 by the Rockefeller Foundation, in collaboration with the Results for Development Institute and the Thai Ministry of Public Health’s International Health Policy Program. This research—resulting in 14 papers by various institutions, examining the role of the private sector in health systems in developing countries— draws on multiple data sources, including, a global survey of countries’ regulatory models, a scan of innovative private sector financing and delivery models, a survey of attitudes toward the private health sector, and evidence on where people receive health services.

The Foundation sponsored this work as part of broader repositioning of its health strategy to address the emerging challenges of the 21st century. The repositioning led, in late 2008, to adoption of a new Foundation initiative on Transforming Health Systems to achieve high-quality, accessible, and affordable health coverage for all.

One key theme emerging from this analysis is the importance of public stewardship of the nonstate sector (that is, the private sector, broadly defined). Effective government stewardship is crucial for achieving broader health objectives, given the reality that many countries already have large, complex markets for healthcare, presenting major challenges and significant opportunities.

A second key theme is that many governments are not performing that stewardship role particularly well at present. Policy dialogue and decisionmaking—within government and with donors— are often not well informed about the huge scale and diversity of health services that exist beyond government-run facilities. Those in the public sector who should be overseeing the entire health system—state and nonstate—are not monitoring what is happening in the nonstate sector and have imperfect understanding of the forces at work in the health system in its entirety. Nor is there adequate appreciation of the fact that private out-of-pocket payments by households account for a large proportion of total health spending.

Compounding these problems are severe limitations in the data available on the nonstate sector. Basic information on what kinds of services the private sector provides, to whom, and with what results is not readily at hand for policymakers…..”

Table of contents

Executive summary

Chapter 1 The context: Country health systems include much more than government-run services

A varied mix of service providers

Is the private sector growing or shrinking?

Complexity of mixed public-private systems

Why do health markets persist?

Challenges for health markets

Chapter 2 The challenge: Developing effective stewardship

The regulatory mechanism

The financing mechanism

The purchasing mechanism

Limited stewardship of health markets in the developing world

Systemic barriers to stewardship in mixed health systems

Chapter 3 Ideas for accelerating progress toward better stewardship of mixed health systems

Invest in information about health markets

Support innovative models that can serve as “stepping stones” to broader reforms

Develop a roadmap for mixed health system stewardship

In conclusion

Notes

Partner papers and references

Health Sector Governance and Implications for the Private Sector

Innovative Health Service Delivery Models for Low and Middle Income Countries

Innovative Pro-Poor Healthcare Financing and Delivery Models

Making Health Markets Work for the Poor: Improving Provider Performance

Overcoming the Challenges of Scaling Voluntary Risk Pools in Low-Income Settings

Performance Incentives in Provider Purchasing and Contracting Arrangements: Rationale and Experiences

Private Sector Role in Health Supply Chains:
Review of the Role and Potential for Private Sector Engagement in Developing Country Health Supply Chains

Private-public mix in woman and child health in low-income countries: an analysis of demographic and health surveys

Provider Purchasing and Contracting for Health Services: The Case of Zambia

Provider Purchasing and Contracting Mechanisms

Regulation of Health Service Delivery in the Private Sector: Challenges and Opportunities

The role of the private sector in health:
a landscape analysis of global players’ attitudes toward the private sector in health systems and policy levers that influence these attitudes

Toward a New Paradigm for Health Sector Development

* * *
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/ KMC 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
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho

    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] Methodological Toolbox on the Right to Food

Methodological Toolbox on the Right to Food

Economic and Social Department
The Food and Agriculture Organization of the United Nations 2009

Website: http://www.fao.org/righttofood/publi_02_en.htm

The purpose of the Methodological Toolbox is to provide a practical aid for the implementation of the Right to Food Guidelines.

It contains a series of analytical, educational and normative tools that offer guidance and hands-on advice on the practical aspects of the right to food. It covers a wide range of topics such as assessment, legislation, education, budgeting and monitoring. It emphasises the operational aspects of the right to food and contributes to strengthening in-country capacity to implement this right.

Download the pdf publications:

1. Guide on legislating for the right to food (4 MB)
2. Methods to monitor the human right to adequate food - Vol I (565 KB)
2. Methods to monitor the human right to adequate food - Vol II (1,2 MB)
3. Guide to conducting a right to food assessment (1.7 MB)
4. Right to food curriculum outline (2.3 MB)
5. Budget work to advance the right to food (3.9 MB)

1. GUIDE ON LEGISLATING - FOR THE RIGHT TO FOOD

Contents

Foreword

Acknowledgements

Acronyms and abbreviations

Introduction and purpose of this guide

PART ONE – Background: the right to food in international law

PART TWO – Constitutional recognition

PART THREE – Framework law

PART FOUR – Sectoral compatibility review

Conclusion

Annex.

Checklist for framework law on the right to food

References

2. METHODS TO MONITOR THE HUMAN RIGHT TO ADEQUATE FOOD - Vol I

Contents

1. Monitoring the human right to food – an overview

2. The meaning and application of rights-focused and rights-based monitoring

3. Putting rights-focused and rights-based monitoring of the right to adequate food into

4. Defining analytical and methodological agendas

5. Legal and institutional settings for monitoring the right to food

6. Getting started

Annex 1. Clarification of relevant and commonly used terms

Annex 2. What can be learned so far from country experiences?

2. METHODS TO MONITOR THE HUMAN RIGHT TO ADEQUATE FOOD - Vol II

Contents

1. Introduction

2. A Monitoring Framework for the Right to Adequate Food

3. Indicators to Measure the Progressive Realization of the Right to Adequate Food

4. Monitoring Implementation Processes through Rights Focused Assessments

5. Monitoring Impacts on the Realization of the Right to Adequate Food

6. Community Level Monitoring of the Right to Adequate Food

7. Assessing Existing Information Systems and Information Needs: Information Gap Analysis

8. Information Gathering Methods to Monitor the Right to Adequate Food

9. Sharing Monitoring Information on the Right to Adequate Food

Annex 1. Clarification of Relevant and Commonly Used Terms

Annex 2. Database Inventories

Annex 3. Dietary Assessment Methods

Annex 4. An Example: Rights-Focused Assessment and Monitoring of School Feeding Programmes

Annex 5. Maps as Presentational Tools in Monitoring the Human Right to Adequate Food

Annex 6. Preparing Monitoring Reports for International Human Rights Bodies

3. GUIDE TO CONDUCTING - A RIGHT TO FOOD ASSESSMENT

Contents

1. Introduction

2. A human rights-based approach to food and nutrition security

3. Assessing trends and causes of food and nutrition insecurity

4. Assessing the environment for the right to adequate food

5. Relevant analytical methods

6. Final remarks

References

Annex 1: sources of assessment information

Annex 2. Indicators for the right to adequate food assessment

Annex 3. Vulnerable group profiling

Annex 4. General data on relevant programmes and other actions

Annex 5. Assessing institutional motivation, capacity and performance

4. RIGHT TO FOOD - CURRICULUM OUTLINE

Contents

PART ONE – PREAMBLE

1. Introduction

2. The role of academic institutions

3. Notes for the users of the curriculum outline

4. Target learner groups

5. The structure of the curriculum outline and how to use the document

PART TWO – Thematic units

Thematic Unit A: Introduction to the Right to Adequate Food

Thematic Unit B: Role s an d Right to Adequate Food Tasks

Thematic Unit C: Assessing The Realization of the Right to Adequate Food

Thematic Unit D: Formulation, Implementation and Monitoring of National Laws, Policies and Programmes

Thematic Unit E: Public Budget Planning, Implementation and Monitoring

Thematic Unit F: Institution Building and Capacity Strengthening

Thematic Unit G: Human Rights Monitoring and International Reporting on Progress

Thematic Unit H: Public Information, Education and Advocacy

Thematic Unit I: Enforceability of, and Access to, Judicial, Quasi-judicial and Administrative Recourse Systems

Thematic Unit J: Policy Assistance and Advice by International Agencies

Thematic Unit K: Respect for and protection of human rights advocates, activists and workers

Thematic Unit L: Multilateral Negotiations on the Right to Adequate Food

PART THREE – Learning Paths

Annex 1. Task and learning content analysis

5. BUDGET WORK TO ADVANCE - THE RIGHT TO FOOD

Contents

Introduction

PART ONE

1. Building a right to food case

2. Analyzing the government’s budget

3. Presenting a claim

PART TWO

4. Approaching a right to food budget

References

Annex 1. Governments’ international human rights obligations and the Right to Food Guidelines

Annex 2. Budget classifications, budget calculations and costing

    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.

Thursday, December 10, 2009

[EQ] Message from the Director of the Pan American Health Organization








Message from the Director of the Pan American Health Organization Mensaje de la Directora de la Organización Panamericana de la Salud Mensagem da diretora da Organização Pan-Americana da Saúde Message de la directrice de l'Organisation Panaméricaine de la Santé

PAHO/WHO Website
Twitter http://twitter.com/eqpaho
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] How Can We Support the Use of Systematic Reviews in Policymaking?

How Can We Support the Use of Systematic Reviews in Policymaking?

John N. Lavis

1 McMaster Health Forum, McMaster University, Hamilton, Ontario, Canada,
2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada,
3 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada,
4 Department of Political Science, McMaster University, Hamilton, Ontario, Canada

PLoS Medicine | www.plosmedicine.org -- November 2009 | Volume 6 | Issue 11 | e1000141

Available online OPDF file [6p.] at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777391/pdf/pmed.1000141.pdf

“…….In the last few years the landscape has changed dramatically for policymakers seeking to use research evidence in the policymaking process.
The landscape has also changed for the many stakeholders seeking to use research evidence to influence the policymaking process. The task once seemed overwhelming given the dearth of synthesized research evidence on the ‘‘big’’, typically multifaceted, questions that matter to policymakers and stakeholders [1,2]. Now it isn’t uncommon for these groups to find dozens of systematic reviews that address the governance, financial, and delivery arrangements within health systems that can determine whether a cost-effective program, service, or drug reaches those who need it…..”

Summary Points

· Policymakers need many types of research evidence—synthesized and packaged for them—and the use of this evidence supported in multiple complementary ways. Stakeholders who seek to influence the policymaking process have the same requirements.

· Policymakers and stakeholders need many types of systematic reviews. For example, reviews of qualitative studies can help to identify alternative framings of the problem, to understand how or why a policy or program option works, and to appreciate stakeholders’ perspectives on particular options.

· Policymakers and stakeholders now have access to many review-derived products:
(1) summaries of systematic reviews highlighting decision-relevant information;
(2) overviews of systematic reviews providing a ‘‘map’’ of the policy questions addressed by systematic reviews and the insights derived from them; and
(3) policy briefs drawing on many systematic reviews to characterize a problem, policy or program options to address the problem, and implementation strategies.

· A range of activities are being undertaken to support the use of reviews and review-derived products in policymaking, all of which warrant rigorous evaluation.

· Future challenges include:
(1) examining whether and when any apparent duplication of efforts occurs in the production of review-derived products at the international level; and
(2) scaling up activities that are found to be effective in supporting the use of reviews and review-derived products in policymaking

    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] Call for Papers: Public Health Reports Supplement on Data Systems and Social Determinants of Health

Call for Papers:
Supplement Social Determinants of Health and Data Systems

Public Health Reports (PHR) is inviting papers for a Supplement on Social Determinants of Health and Data Systems.

Deadline for submission: June 1, 2010.
The anticipated publication date for the PHR Supplement is Fall 2011.

Journal website -author guidelines at www.publichealthreports.org

The Guest Editors for this Supplement are :
Kathleen McDavid Harrison, Associate Director for Health Equity and
Hazel D. Dean, Deputy Director, both with the United States Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The Editors seek manuscripts that advance the scientific knowledge and public health research, practice, and policy on data systems related to addressing social determinants of health (SDH). Manuscripts may be analytic or descriptive in format and may propose models for new/enhanced data systems, evaluate existing data systems, or use data from current systems to illustrate how gaps can be addressed.

Manuscripts may examine policy, program, disease surveillance, or other appropriate data systems and novel ways to use them to monitor indicators of health equity.

Manuscripts addressing the following broad range of topics will be sought:
• Studies focusing on developing and identifying key metrics that might be used to better measure and monitor the impact of SDH;
• Studies that are multidisciplinary; that analyze or compare rather than merely describe; and that are not limited to one measure of social determinants or health outcomes, one age group, or one population subgroup;
• Mathematical models of social determinants of human immunodeficiency virus, viral hepatitis, sexually transmitted diseases, and tuberculosis outcomes;
• Studies that examine or use SDH analytic methods (e.g., individual-level, multilevel, and mixed-level analyses) that take into account

The uniqueness of the data being used;
• Evidence of linkage with policy or other constituencies that influence equity outcomes;
• Application of innovative analytic methods for studying and monitoring influences on health equity;
• Analyses to support the design and evaluation of policies, services, and interventions that enhance equity in health;
• Analyses or meta-analyses of available data on legal and health policies; and
• Use of evidence toward enhanced public accountability in and social action for health equity.

Manuscript requirements: Articles in PHR are typically 3,000–4,000 words in length.
All manuscripts will be reviewed by the PHR Special Editorial Committee (SEC) for this Supplement.
The SEC determines which manuscripts are sent for external peer review and which manuscripts are published in the Supplement.

Submit manuscripts to: manuscripts@publichealthreports.org.
Please include “Attention Social Determinants of Health and Data Systems” in the subject line of the e-mail.

If you have any questions about this Supplement, please contact
Dr. Kathleen McDavid Harrison (404-639-8000; KMcDavidHarrison@cdc.gov) or
Dr. Hazel D. Dean (404-639-8000; HDean@cdc.gov).

If you have any questions about PHR, please contact the Acting Editor, Laurence Reed, at 513-636-0257; Laurence.Reed@cchmc.org.
Public Health Reports is a peer-reviewed journal of the U.S. Public Health Service and the U.S. Surgeon General.
It is published in collaboration with the Association of Schools of Public Health. PHR is the oldest journal of public health in the U.S. and has published since 1878.
The journal is widely distributed internationally, and is indexed by MEDLINE/Index Medicus, Current Contents, EMBASE/Excerpta Medica, Pais International, and LexisNexis.

* * *
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/ KMC Area]

    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] PAHO/WHO Consultancy on the Social Determinants of Neglected and Other Poverty-Related Diseases

Consultancy on the Social Determinants of Neglected
and Other Poverty-Related Diseases

Call for Expression of Interest in a Consultancy on the Social Determinants of Neglected and Other Poverty-Related Diseases in Latin America and the Caribbean

Health Surveillance and Disease Prevention and Control Area, Communicable Disease Project
Pan American Health Organization PAHO/WHO

Deadline for submission of applications: 15 January 2010

Website English::
http://new.paho.org/hq/index.php?option=com_content&task=view&id=1508&Itemid=259&en

Website Spanish:
http://new.paho.org/hq/index.php?option=com_content&task=view&id=1508&Itemid=259&es

Purpose: To conduct qualitative studies to identify, in two specific communities, neglected infectious diseases (NIDs) affecting them, the social determinants of health (SDH), and to establish their relationship.

The aim: To address the social determinants of NIDs in a multisectoral and integrated approach to reduce the risk and burden of the NIDs. These two communities with overlapping of NIDs will be identified in agreement with PAHO. Possible sites include Brazil and Mexico.

Objectives

To identify, at the local level, the NIDs and their social determinants perceived by the members of the two selected communities and by relevant stakeholders and actors, including the health system, in two selected communities, and the importance given to both the NIDs and the social determinants.
Analyze—involving community members and relevant stakeholders and actors in the process— the role of the social determinants associated with the perceived NIDs, within the Framework of Social Determinants of Health as defined by the WHO Commission on Social Determinants of Health (CSDH).
Identify—involving community participation and relevant stakeholders and actors— priorities, mechanisms and key interventions and present specific recommendations to address the Social Determinants of Health that could be used to develop a comprehensive, integrated and multi-sectoral approach in the selected communities to reduce the risk of NIDs as well as their burden.

Terms of reference:
http://new.paho.org/hq/index.php?option=com_docman&task=doc_download&gid=2006&Itemid=

    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.