Health Equity: 05/25/10

Tuesday, May 25, 2010

[EQ] Strong Ministries for Strong Health Systems

Strong Ministries for Strong Health Systems

Francis Omaswa, Executive Director The African Center for Global Health and Social Transformation (ACHEST)

Jo Ivey Boufford, President The New York Academy of Medicine
Support from The Rockefeller Foundation - January 2010

Available online PDF [32p.] at: http://bit.ly/bRzkGN

"……Strengthening health systems is a major priority of the Rockefeller Foundation. They support better health and financial protection for poor and vulnerable people through improved health systems performance and progressive adoption of universal health coverage.

While health systems have received worldwide attention, little has been done to strengthen ministries of health, the central institutions responsible for stewardship of health systems at the country level. This report addresses the gaps in our understanding of the roles ministries play, their needs and the challenges they face, so that we can take effective action to fortify them…."

Report Highlights

• "………….Strengthening health systems has emerged as a priority in global and national health policy and practice.

• A health system is defined for the purposes of this report as consisting of four core elements: personal health care services, public or population health services, health research systems, and health in all policies. Effective health systems strengthening requires attention to all four of these elements.

• Governments are stewards, or protectors, of the public interest and have the ultimate responsibility for assuring conditions that allow people to be as healthy as they can be. Ministries of health and the ministers who lead them must be able to perform a set of core stewardship functions within the ministry and across government. Stewardship is one of the central building blocks of an effective health system.

• Health ministries must also work effectively with an increasing number of non-governmental partners who bring important knowledge, expertise, and advocacy to help them meet their responsibilities (e.g. universities, professional associations, academies of medicine and science, business, civil society). Governance is the alignment of multiple actors and interests, such as these, to promote collective action towards an agreed upon goal, in this case, to assure the best use of resources for health.

• Despite the central role ministers and ministries of health play in these processes, they are currently overlooked when investments are being made and initiatives are being designed to strengthen health systems.

• Among the ministers and stakeholders interviewed, there was significant support for the specific proposals for an executive leadership development program for new ministers, leadership support for sitting ministers, and the establishment of a virtual information resource center on health systems stewardship and governance.

• There is a need to build awareness among politicians, policy makers, and the public, of the importance of stewardship and governance in strengthening health systems, and the critical role of ministers and ministries of health.

• Based on data from minister and stakeholder interviews and supporting research and consultation activities, this report offers seven action items geared toward building a systematic and sustained program of support for health ministries. Recommendations and proposals provided address:

− Capacity assessment tools

− Leveraging existing management development resources

− Mapping country networks of expertise

− Regional networks to support health systems stewardship and governance

− A knowledge network for ministers of health

− Executive leadership development

− Advocacy for strengthening health ministries

• Collective action on these proposals is needed to strengthen health ministries, enhance the leadership capabilities of ministers, and assure their full ability to serve as effective stewards of health resources in the drive to achieve national, regional, and global health objectives…."

* * *
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 dispose of and delete this transmission. 

Thank you.

[EQ] The Buzz about the Upcoming G8 Summit and Global Health

The Buzz about the Upcoming G8 Summit and Global Health

Jennifer Zelmer Editor-in-chief Healthcare Policy, 5(4) 2010: 10-14
Website: http://bit.ly/bWSOTi

G8 summit on June 25-26 in Canada’s Muskoka region: http://g8.gc.ca/g8-summit/

“………G8 watchers have been speculating about the blackflies in Muskoka for months, but it is mosquitoes that will feature in formal discussions at the upcoming Summit. As host of the G8, Prime Minister Stephen Harper has announced that he will ask his colleagues to focus on the extent to which countries have met previous G8 commitments (Office of the Prime Minister 2010). Among them was a pledge in 1998 to support the global "Roll Back Malaria" initiative, with the goal of significantly reducing the death rate from the disease by 2010.

G8 watchers have been speculating about the blackflies in Muskoka for months, but it is mosquitoes that will feature in formal discussions at the upcoming Summit. As host of the G8, Prime Minister Stephen Harper has announced that he will ask his colleagues to focus on the extent to which countries have met previous G8 commitments (Office of the Prime Minister 2010). Among them was a pledge in 1998 to support the global "Roll Back Malaria" initiative, with the goal of significantly reducing the death rate from the disease by 2010.

Canada will also be championing a global agenda for improving maternal and child health at the Summit. With only five years left until the 2015 deadline, much progress still needs to be made to achieve the Millennium Development Goals (Secretary General to the United Nations 2010). One of those goals is to reduce the under-five mortality rate by two-thirds between 1990 and 2015. The United Nations reports that child mortality in developing countries fell from 99 deaths per 1,000 live births at the beginning of this period to 72 in 2008. With a goal of 33 deaths per 1,000 live births by 2015, there is still much to do.

Can it be done? Historical analysis by Hans Rosling (2009) from Sweden's Karolinska Institute demonstrates that significant progress is possible…..

References

Bourbeau, R., J. Légaré and V. Émond. 1997. "New Birth Cohort Life Tables for Canada and Québec, 1801–1991." Current Demographic Analysis, Demographic Document No. 3 (Statistics Canada Catalogue no. 91F00115MPE). Ottawa: Statistics Canada.

Office of the Prime Minister. 2010. Canada's G8 Priorities. Retrieved April 12, 2010. http://pm.gc.ca/eng/media.asp?id=3093

Rosling, H. 2009. Yes They Can. Stockholm: Gapminder Foundation. Retrieved April 12, 2010. <http://www.gapminder.org/videos/yes-they-can/

Secretary General to the United Nations. 2010. Keeping the Promise: A Forward-Looking Review to Promote an Agreed Action Agenda to Achieve the Millennium Development Goals by 2015. New York: Report of the Secretary General to the Sixty-Fourth Session of the United Nations General Assembly. Retrieved April 12, 2010. http://www.un.org/ga/search/view_doc.asp?symbol=A/64/665

Statistics Canada. 2010. "Table 102-0506 – Infant Deaths and Mortality Rates, by Age Group and Sex, Canada, Annual." CANSIM (database). Retrieved April 12, 2010. http://cansim2.statcan.gc.ca/cgi-win/cnsmcgi.exe?Lang=E&CNSM-Fi=CII/CII_1-eng.htm

United Nations Children's Fund (UNICEF). 2010. "Table 1: Basic Indicators: The State of the World's Children." Downloadable Statistical Indicators. Retrieved April 12, 2010. http://www.unicef.org/rightsite/sowc/pdfs/statistics/SOWC%20Table%201%20Basic%20indicator_111109.xls

“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 dispose of and delete this transmission. 

Thank you.

[EQ] The Lancet: Child mortality and MDG4

Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries,
1970—2010: a systematic analysis of progress towards Millennium Development Goal

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

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

The Lancet, Early Online Publication, 24 May 2010 -- doi:10.1016/S0140-6736(10)60703-9

Website: http://bit.ly/cAXevh

“….Previous assessments have highlighted that less than a quarter of countries are on track to achieve Millennium Development Goal 4 (MDG 4), which calls for a two-thirds reduction in mortality in children younger than 5 years between 1990 and 2015. In view of policy initiatives and investments made since 2000, it is important to see if there is acceleration towards the MDG 4 target. We assessed levels and trends in child mortality for 187 countries from 1970 to 2010.

Methods

We compiled a database of 16 174 measurements of mortality in children younger than 5 years for 187 countries from 1970 to 2009, by use of data from all available sources, including vital registration systems, summary birth histories in censuses and surveys, and complete birth histories. We used Gaussian process regression to generate estimates of the probability of death between birth and age 5 years. This is the first study that uses Gaussian process regression to estimate child mortality, and this technique has better out-of-sample predictive validity than do previous methods and captures uncertainty caused by sampling and non-sampling error across data types. Neonatal, postneonatal, and childhood mortality was estimated from mortality in children younger than 5 years by use of the 1760 measurements from vital registration systems and complete birth histories that contained specific information about neonatal and postneonatal mortality.

Findings

Worldwide mortality in children younger than 5 years has dropped from 11·9 million deaths in 1990 to 7·7 million deaths in 2010, consisting of 3·1 million neonatal deaths, 2·3 million postneonatal deaths, and 2·3 million childhood deaths (deaths in children aged 1—4 years). 33·0% of deaths in children younger than 5 years occur in south Asia and 49·6% occur in sub-Saharan Africa, with less than 1% of deaths occurring in high-income countries. Across 21 regions of the world, rates of neonatal, postneonatal, and childhood mortality are declining. The global decline from 1990 to 2010 is 2·1% per year for neonatal mortality, 2·3% for postneonatal mortality, and 2·2% for childhood mortality. In 13 regions of the world, including all regions in sub-Saharan Africa, there is evidence of accelerating declines from 2000 to 2010 compared with 1990 to 2000. Within sub-Saharan Africa, rates of decline have increased by more than 1% in Angola, Botswana, Cameroon, Congo, Democratic Republic of the Congo, Kenya, Lesotho, Liberia, Rwanda, Senegal, Sierra Leone, Swaziland, and The Gambia.

Interpretation

Robust measurement of mortality in children younger than 5 years shows that accelerating declines are occurring in several low-income countries. These positive developments deserve attention and might need enhanced policy attention and resources.

Funding Bill & Melinda Gates Foundation.

Supplementary webappendix

PDF (4163K)





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 dispose of and delete this transmission. 

Thank you.

[EQ] Conference: Achieving Health Equity in the Era of Health Care Reform

Academy for Health Equity Conference Announcement:

Theme of the conference:
Achieving Health Equity in the Era of Health Care Reform

August 18 - 20, 2010 - Littleton, Colorado USA

Website: http://bit.ly/d1QSD8

“…..The meeting is critical to developing the knowledge-base for those engaged in health disparity activities by facilitating trans-disciplinary exchanges of the latest research and practical applications by:

•increasing the capacity of researchers, practitioners, policymakers and communities to address complex health systems change, delivery of services, new models of medical care and public health, policies that facilitate access to health, and new methods of measurement for preventable diseases in underserved, poorly served and never served populations;

•promoting the application of evidence-based, theory-driven findings of disease prevention and health promotion for the elimination racial and ethnic health disparities;

•identifying gaps in knowledge and data of the broad spectrum of causal factors of health disparities and bringing together inter-disciplinary, trans-disciplinary and community-based approaches to achieve equity in health;

•exploring effective trans-disciplinary approaches to identify and address the social determinants of health related to health disparities; and,

•applying the latest theories, principles, programs, and practices to improving health literacy, cultural competency, and health communications programs to promote health and prevent disease among individuals living in communities characterized by poverty and health disparities.

CALL FOR ABSTRACTS

All abstracts are due by Sunday, May 30, 2010 at 11:59 p.m. Eastern time.

Authors are encouraged to submit abstracts on topics related to the conference theme,
as well as current and emerging issues related to health disparities and health equity.
More information about the abstract submission process can be found at:
https://cmt.research.microsoft.com/AHEC2010/Default.aspx.

Instructions:

Authors should indicate if they would like their abstract considered for oral or poster presentation or both.

To facilitate the review process, authors should choose an appropriate subject area and identify keywords for the abstract.

Authors will copy and paste their abstract to the appropriate section as well as upload a .doc, .docx, or .pdf file with the title, authors, abstract, keywords, and learning objectives. Files are limited to 5000 characters total, including title, authors, abstract, keywords, and learning objectives.

Melva Thompson-Robinson, Dr.PH Associate Professor Director, Center for Health Disparities Research
School of Community Health Sciences
University of Nevada, Las Vegas
4505 S. Maryland Parkway, Box 453050 Las Vegas, NV 89154-3050
Phone: 702-895-1127 Fax: 702-895-3979 Email: melva.thompson-robinson@unlv.edu
https://cmt.research.microsoft.com/AHEC2010/Default.aspx





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 dispose of and delete this transmission. 

Thank you.