Monday, May 3, 2010

[EQ] Course: Health and Social Justice - June 28 - July 2, 2010 Spain

Course:
Health and Social Justice

June 28 – July 2, 2010

Palacio de la Magdalena, Santander, Spain

Organiser: Universidad Internacional Menéndez Pelayo (UIMP) in cooperation with Ecuela de Salud Pública de Menorca

Jennifer Prah Ruger. - Yale School of Public health. Former Co-Director of the Yale
World Health Organization (WHO) Collaborating Centre for Health Promotion, Policy and Research.

Website: http://www.emsp.cime.es/WebEditor/Pagines/file/Curso%20magistral%20Ruger(1).pdf

Grants available - Deadline for applications: 24 May

Registration at: http://bit.ly/bzr3Gx

“….Health and Social Justice introduces the health capability paradigm, a unique approach, which considers the capability for health to be a moral imperative. There are no guarantees for good health, but society can, if it will, design and build effective institutions and social systems that support all citizens in the pursuit of central health capabilities-- avoiding premature death and escapable morbidity.

The health capability paradigm embodies comprehensive strategies for this vision to become a reality and employs theories and methods from disciplines including philosophy, economics, law, political science, health policy and public health. It argues for a norms-based approach to health promotion, a joint scientific and deliberative approach to efficiently guide allocation decisions, and offers shared health governance to create systems enabling all to be healthy….”

PROGRAMME/CALENDAR

LUNES / MONDAY

Mañana Lección 1ª: Introduction: The health capability paradigm - Summary of theoretical foundations - Overview of components

Tarde Lección 2ª: Part I: The current set of ethical frameworks Approaches to medical and public ethics

MARTES / TUESDAY

Mañana Lección 3ª: Part II: An alternative account – the health capability paradigm Health and human flourishing

Tarde Lección 4ª: Pluralism, incompletely theorized agreements, and public policy

MIÉRCOLES / WENESDAY

Mañana Lección 5ª: Justice, capability, and health policy

Tarde Lección 6ª: Grounding the right to health

JUEVES / THURSDAY

Mañana Lección 7ª: Part III: Domestic health policy applications A health capability account of equal access

Lección 8ª: A health capability account of equitable and efficient health financing and insurance

TardeLección 9ª: Allocating resources: A joint scientific and deliberative approach

VIERNES / FRIDAY

Mañana Lección 10ª Part IV: Domestic health reform Political and moral legitimacy: A normative theory of health policy decision-making

Lección 11ª: Conclusion

INTRODUCCIÓN – RESUMEN / DESCRIPTION

Societies make decisions and take actions that profoundly impact the distribution of health. Why and how should collective choices be made, and policies implemented, to address health inequalities under conditions of resource scarcity? How should societies conceptualize and measure health disparities, and determine whether they've been adequately addressed? Who is responsible for various aspects of this important social problem? In Health and Social Justice, Jennifer Prah Ruger elucidates principles to guide these decisions, the evidence that should inform them, and the policies necessary to build equitable and efficient health systems world-wide. This book weaves together original insights and disparate constructs to produce a foundational new theory, the health capability paradigm.

Ruger's theory takes the ongoing debates about the theoretical underpinnings of national health disparities and systems in striking new directions. It shows the limitations of existing approaches (utilitarian, libertarian, Rawlsian, communitarian), and effectively balances a consequentialist focus on health outcomes and costs with a proceduralist respect for individuals' health agency. Through what Ruger calls shared health governance, it emphasizes responsibility and choice. It allows broader assessment of injustices, including attributes and conditions affecting individuals' "human flourishing," as well as societal structures within which resource distribution occurs. Addressing complex issues at the intersection of philosophy, economics, and politics in health, this fresh perspective bridges the divide between the collective and the individual, between personal freedom and social welfare, equality and efficiency, and science and economics.

Jennifer Prah Ruger, Ph.D.
Associate Professor at Yale University Schools of Public Health, Medicine, Law and the Graduate School of Arts and Sciences. Previous appointments include Assistant Professor at Washington University in St. Louis (2001-2004); Speech Writer to the World Bank President, James D. Wolfensohn (2000-2001), Health Economist in the World Bank Health, Nutrition and Population Sector (1998-2000) and Member of World Health Organization Director-General Gro Harlem Brundtland’s Transition Team, Health and Development Satellite (1998).

EDUCATION

HARVARD UNIVERSITY 1998 Ph.D. Health Policy, Graduate School of Arts and Sciences

OXFORD UNIVERSITY, U.K. 1992 M.Sc. Comparative Social Research

FLETCHER SCHOOL OF LAW AND DIPLOMACY 1991 M.A. International Relations

UNIVERSITY OF CALIFORNIA-BERKELEY 1988 B.A. Political Economy of Industrial Societies

For further information please contact: Secretaría UIMP
Isaac Peral, 23

28040 Madrid Tel.: + 00 34 91 592 06 31 / 91 592 06 33 Fax: + 00 34 91 543 06 40 / 91 543 08 97 alumnos@uimp.es

UNIVERSIDAD INTERNACIONAL MENÉNDEZ PELAYO http://www.uimp.es/

ESCUELA DE SALUD PÚBLICA DE MENORCA http://www.emsp.cime.es/

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[EQ] Worldwide mortality in men and women aged 15-59 years from 1970 to 2010: a systematic analysis

Worldwide mortality in men and women aged 15—59 years from 1970 to 2010:
a systematic analysis

Julie Knoll Rajaratnam PhD a, Jake R Marcus BA a, Alison Levin-Rector BSPH a, Andrew N Chalupka b, Haidong Wang PhD a,
Laura Dwyer BA a, Megan Costa BA a, Prof Alan D Lopez PhD c, Prof Christopher JL Murray MD a
a Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA

b Harvard Medical School, Harvard University, Boston, MA, USA

c School of Population Health, University of Queensland, Brisbane, QLD, Australia

The Lancet , 30 April 2010 doi:10.1016/S0140-6736(10)60517-X

URL: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60517-X/fulltext

Adult deaths are a crucial priority for global health. Causes of adult death are important components of Millennium Development Goals 5 and 6. However, adult mortality has received little policy attention, resources, or monitoring efforts. This study aimed to estimate worldwide mortality in men and women aged 15—59 years.

Methods

We compiled a database of 3889 measurements of adult mortality for 187 countries from 1970 to 2010 using vital registration data and census and survey data for deaths in the household corrected for completeness, and sibling history data from surveys corrected for survival bias. We used Gaussian process regression to generate yearly estimates of the probability of death between the ages of 15 years and 60 years (45q15) for men and women for every country with uncertainty intervals that indicate sampling and non-sampling error. We showed that these analytical methods have good predictive validity for countries with missing data.

Findings

Adult mortality varied substantially across countries and over time. In 2010, the countries with the lowest risk of mortality for men and women are Iceland and Cyprus, respectively. In Iceland, male 45q15 is 65 (uncertainty interval 61—69) per 1000; in Cyprus, female 45q15 is 38 (36—41) per 1000. Highest risk of mortality in 2010 is seen in Swaziland for men (45q15 of 765 [692—845] per 1000) and Zambia for women (606 [518—708] per 1000). Between 1970 and 2010, substantial increases in adult mortality occurred in sub-Saharan Africa because of the HIV epidemic and in countries in or related to the former Soviet Union. Other regional trends were also seen, such as stagnation in the decline of adult mortality for large countries in southeast Asia and a striking decline in female mortality in south Asia.

Interpretation

The prevention of premature adult death is just as important for global health policy as the improvement of child survival. Routine monitoring of adult mortality should be given much greater emphasis.

Funding: Bill & Melinda Gates Foundation





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[EQ] Four social theories for global health

Four social theories for global health

Arthur Kleinman

Harvard University, Department of Anthropology, Cambridge, MA, USA

The Lancet, Volume 375, Issue 9725, Pages 1518 - 1519, 1 May 2010
doi:10.1016/S0140-6736(10)60646-0

URL: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60646-0/fulltext

‘……………Global health, many would agree, is more a bunch of problems than a discipline. As such it lacks theories that can generalise findings—through an iterative process of knowledge construction, empirical testing, critique, new generalisation, and so on—into durable intellectual frameworks that can be applied not only to distinctive health problems, but to different contexts and future scenarios.
This lack may or may not have slowed progress in developing and implementing programmes, but it surely has limited the education of practitioners and the emergence of an intellectually robust field.

There is no contradiction between global health being both evidence-based and theory-oriented. After all, this is what characterises the social sciences and natural sciences, which together create the academic platform for global health, even if the profession of medicine, another core component, has not been a theory-rich field…..”

“….The first social theory of global health is the unintended consequences of purposive (or social) action. Introduced by the sociologist Robert Merton, this theory holds that all social interventions have unintended consequences, some of which can be foreseen and prevented, whereas others cannot be predicted…

“….Second, is the social construction of reality, as introduced by Peter Berger and Thomas Luckmann in the 1960s, that has become foundational in the social sciences. This theory holds that the real world, no matter its material basis, is also made over into socially and culturally legitimated ideas, practices, and things….’”

“….The third social theory is that of social suffering, which provides a framework that holds four potentially useful implications for global health….

“….Fourth, we draw on the concept of biopower, a term coined by Michel Foucault to model the way political governance increasingly exerted its effects via the control of bodies and populations….”





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[EQ] Retaining health workers in remote and rural areas

This issue:
Addresses the special theme of retaining health workers in remote and rural areas

index.html

Chile; Combined incentives work; Cuba; Calling all doctors; Ghana; Incentives for medical students; Kenya, South Africa & Thailand; Attracting nurses to rural areas; Norway; Dealing with doctor shortages; Ethiopia and Rwanda ; Who wants a rural health post? ; Nigeria; Pilot insurance plan; Rising to the challenge; Senegal; Solving regional differences; Global; Where have all the nurses gone?; Decentralized health financing; Does compulsory service work?; Getting staff to stay in rural areas; The role of medical schools;Where do we stand on the Millennium Development Goals?
Full article text [HTML]

EDITORIALS

One piece of the puzzle to solve the human resources for health crisis
- Manuel M Dayrit et al. doi: 10.2471/BLT.10.078485
Full article text [HTML]

Striking the right balance: health workforce retention in remote and rural areas
- Lincoln C Chen doi: 10.2471/BLT.10.078477
Full article text [HTML]

Five years to go and counting: progress towards the Millennium Development Goals
- Carla AbouZahr & Ties Boerma doi: 10.2471/BLT.10.078451
Full article text [HTML]

RESEARCH

Rural practice preferences among medical students in Ghana: a discrete choice experiment
- Margaret E Kruk et al. doi: 10.2471/BLT.09.072892 Full article text [HTML]

Who wants to work in a rural health post? The role of intrinsic motivation, rural background and faith-based institutions in Ethiopia and Rwanda
- Pieter Serneels et al. doi: 10.2471/BLT.09.072728 Full article text [HTML]

Policy interventions that attract nurses to rural areas: a multicountry discrete choice experiment
- D Blaauw et al. doi: 10.2471/BLT.09.072918 Full article text [HTML]

POLICY AND PRACTICE

Increasing access to health workers in underserved areas: a conceptual framework for measuring results
- Luis Huicho et al. doi: 10.2471/BLT.09.070920 Full article text [HTML]

Compulsory service programmes for recruiting health workers in remote and rural areas: do they work?
- Seble Frehywot et al. doi: 10.2471/BLT.09.071605 Full article text [HTML]

The Chilean Rural Practitioner Programme: a multidimensional strategy to attract and retain doctors in rural areas
- Sebastian Peña et al. doi: 10.2471/BLT.09.072769 Full article text [HTML]

Evaluated strategies to increase attraction and retention of health workers in remote and rural areas
- Carmen Dolea et al. doi: 10.2471/BLT.09.070607 Full article text [HTML]

LESSONS FROM THE FIELD

How to recruit and retain health workers in underserved areas: the Senegalese experience
- Pascal Zurn et al. doi: 10.2471/BLT.09.070730 Full article text [HTML]

Effective physician retention strategies in Norway’s northernmost county
- Karin Straume & Daniel MP Shaw doi: 10.2471/BLT.09.072686 Full article text [HTML] |

PERSPECTIVES

How can medical schools contribute to the education, recruitment and retention of rural physicians in their region?
- James Rourke doi: 10.2471/BLT.09.073072 Full article text [HTML] |

Emerging opportunities for recruiting and retaining a rural health workforce through decentralized health financing systems
- Mahjabeen Haji et al. doi: 10.2471/BLT.09.072827 Full article text [HTML]

BOOKS & ELECTRONIC MEDIA

Working in health: financing and managing the public sector health workforce
- Gilles Dussault doi: 10.2471/BLT.10.076190 Full article text [HTML]





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