Poverty and social exclusion in the WHO European Region: health systems respond
Edited by Theadora Koller
WHO European Office for Investment for Health and Development
Available online PDF [344p.] at: http://bit.ly/cnZ0xU
“…..Much about poverty is obvious enough, particularly the relationship between poverty and ill health. So evident are the links that extreme poverty is listed in the International Classification of Diseases. Far more controversial are the answers to the following questions:
How is poverty caused? How can it be measured? How can it be tackled?
What are the health status and access to health systems of people experiencing poverty and social exclusion, and how do they compare to people experiencing greater wellbeing and inclusion in society?
What can health systems do to meet the needs of people in poverty and thus ensure the right to health for all?
What can be done at cross-government levels (by the health sector together with others) to address poverty and social exclusion as determinants of health?...”
“…..The authors were asked to consider how multifaceted social exclusion processes render some groups (such as Roma and migrants living in poverty, the under-employed and children living in poverty) particularly vulnerable, as evidenced in multiple national plans for social inclusion and in progress updates on poverty reduction strategies.
They were asked to describe interventions designed to improve the accessibility, availability, acceptability and quality of health services for populations living in poverty and social exclusion.
They were invited to reflect on both the proximate and distal determinants of health, and how the health sector works with other sectors to address them. The authors were also encouraged to explore other aspects of health system strengthening including financing, sustainability, service delivery networks, human resource requirements, community empowerment and political leadership….”
“…..In reading this book, it is opportune to refl ect on the fi ndings of the Commission on Social Determinants of Health. The Commission calls for the universal provision of social protection (which includes health services as well as rights and entitlements to the conditions required for health). It states that targeted measures should only be used for those who fall through the cracks of universal services. In transition and resource-scarce environments, the progressive realization of universal services may be necessary. It recommends public sector leadership in health-care systems financing, ensuring universal coverage of health care regardless of ability to pay, and minimizing out-of-pocket health spending. The Social Exclusion Knowledge Network of the Commission calls for further action to address how exclusion – across the social, cultural, political and economic dimensions – has an impact on health…..”
Part II. Background papers on the health of select groups disproportionately exposed to poverty and social exclusion
23. Roma health
24. Migration and health of migrants
25. Poverty and child health
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