[EQ] Attacking Inequality in the Health Sector - A Synthesis of Evidence and Tools

Attacking Inequality in the Health Sector - A Synthesis of Evidence and Tools

 

Abdo S. Yazbeck

The International Bank for Reconstruction and Development / The World Bank – 2009

 

Available online as PDF file [336p.] at:
http://siteresources.worldbank.org/INTPAH/Resources/Publications/YazbeckAttackingInequality.pdf

 

“……The overwhelming evidence of inequalities in health outcomes and in the use of health services calculated and disseminated by the World Bank and other development agencies in the last 10 years has energized global efforts to address the needs of the poor and socially vulnerable. These efforts have led to a renewed interest at the global and national levels in both understanding the causes of health sector inequalities and developing policies to tackle them. It is time to synthesize the new knowledge being generated from research and experimentation on addressing inequality.

 

The main purpose of this book is to make available the accumulated knowledge of successful policy and analytical tools in this fight to reverse the vicious circle of income-poverty and ill health. The book presents both a practical set of analytical tools for understanding the causes of inequality in the use of health services and a menu of proven pro-poor policy actions. It is based on the evaluation of 14 successful policy changes in low- and middle-income countries in Africa, Asia, and Latin America, and a review of the published literature on inequality in the health sector.

 

As this book shows, however, policy answers are neither easy nor uniform. We now have ample evidence about the levels of inequality in more than 50 low- and middle-income countries. We know which outcomes and which services show the highest levels of inequality. We have proven analytical tools for understanding the causes of service use inequality.

 

Most important, we have evaluations of experiences from countries designing and implementing pro-poor polices that are having measurable success. This book puts all this knowledge in one place. The next challenge is turning this knowledge into further action in the global effort to reduce poverty….”

 

            Content:

1. An Unacceptable Reality

A Light at the End of the Tunnel: A New Way to Measure Inequalities

Not a Pretty Picture

Health Sector May Exacerbate Inequality

The Misallocation of Public Spending on Health

Presenting Inequality Data

Annex 1.1 Asset Index as a Measure of Relative Wealth

Annex 1.2 Health, Nutrition, and Population Inequality Data

Annex 1.3 Benefit Incidence Analysis

Annex 1.4 Recommendations for Further Reading

Notes

2. Approaching a Complex and Persistent Problem

Pathways to Good Health

The Binding Constraints Faced by the Poor

The Blind Spots of the Health Sector

Health Sector Finance and the Poor

Moving Forward

Annex 2.1 Summary of the Multisectoral Determinants of Health

Annex 2.2 Recommendations for Further Reading

Notes

3. The Importance of “Listening”

The Views of Leaders from Low- and Middle-Income Countries

The Dilemmas Posed by the Long List of Causes

Listening Is Critical

Combining Active and Passive Listening: Immunization in India

Advanced Analytical Techniques

Eight Steps to Effective Use by the Poor

Following the Money: Tools for Analyzing the Role of Resource Allocations and Financing in Inequality

An Analytical Checklist

Annex 3.1 Data Sources and Their Limitations

Annex 3.2 Beneficiary Assessment

Annex 3.3 Recommendations for Further Reading

Notes

4. A Menu of Pro-Poor Policies

Hope

Recurring Themes

Rules of Thumb

Annex 4.1 Accountability Framework

Annex 4.2 Recommendations for Further Reading

Note

5. Brazil, Filling the Cracks in Universal Coverage

6. Cambodia: Contracting with Nongovernmental Organizations to Serve the Poor

 

7. Cambodia: Health Equity Fund for the Poor

 

8. Chile: Integrated Services Program for the Poor

9. Colombia: Expanding Health Insurance for the Poor

10. India: Community-Based Health Care Services

11. Indonesia: Health Cards for the Poor

12. Kenya: Expanding Immunization Reach through Campaigns

13. The Kyrgyz Republic: Health Financing Reform and the Poor

14. Mexico: Paying the Poor to Use Health Services

15. Mexico: Providing Subsidized Health Insurance to the Poor

16. Nepal: Participatory Planning

17. Rwanda: Community-Based Health Insurance

18. Tanzania: Social Marketing for Malaria Prevention

19 Vigilance

What to Monitor

Other Elements of Monitoring Frameworks

Annex 19.1 Recommendations for Further Reading

Note

References

Index

 

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