Health Equity: 07/27/11

Wednesday, July 27, 2011

[EQ] The wider determinants of inequalities in health: A decomposition analysis

The wider determinants of inequalities in health: A decomposition analysis

Leonie Sundmacher, David Scheller-Kreinsen and Reinhard Busse

Department of Health Care Management, Berlin University of Technology, Berlin

International Journal for Equity in Health - 26 July 2011 doi:10.1186/1475-9276-10-30

Available online PDF [35p.] at: http://bit.ly/oopiHT

Background: The common starting point of many studies scrutinizing the factors underlying health inequalities is that material, cultural-behavioural, and psycho-social factors affect the distribution of health systematically through income, education, occupation, wealth or similar indicators of socioeconomic structure. However, little is known regarding if and to what extent these factors can assert systematic influence on the distribution of health of a population independent of the effects channelled through income, education, or wealth.

Methods: Using representative data from the German Socioeconomic Panel, we apply Fields’ regression based decomposition techniques to decompose variations in health into its sources. Controlling for income, education, occupation, and wealth, we assess the relative importance of the explanatory factors over and above their effect on the variation in health channelled through the commonly applied measures of socioeconomic status.

Results: The analysis suggests that three main factors persistently contribute to variance in health:
- the capability score,
- cultural-behavioural variables and to a lower extent,
- the materialist approach.

Of the three, the capability score illustrates the explanatory power of interaction and compound effects as it captures the individual’s socioeconomic, social, and psychological resources in relation to his/her exposure to life challenges.

Conclusion: Models that take a reductionist perspective and do not allow for the possibility that health inequalities are generated by factors over and above their effect on the variation in health channelled through one of the socioeconomic measures are underspecified and may fail to capture the determinants of health inequalities.

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[EQ] Global Public-Private Health Partnerships: lessons learned from ten years of experience and evaluation

Global Public-Private Health Partnerships:
lessons learned from ten years of experience and evaluation

Kent Buse and Sonja Tanaka

UNAIDS, Geneva
International Dental Journal 2011; 61 (Suppl. 2): 2–10 doi: 10.1111/j.1875-595X.2011.00034.x

Available online PDF [9p.] at: http://bit.ly/nX7tmk

“…….Global Health Partnerships (GHPs) have contributed significantly to improved global health outcomes as well as the manner in which global health is governed. Yet in a context of an increasingly complex global health landscape, resource scarcity and a shift from disease-specific to systems strengthening approaches, it is important to continually enhance and apply our understanding of how to improve GHP performance.

The authors reviewed and synthesised findings from eight independent evaluations of Global Health Partnerships GHPs as well as research projects conducted by the authors over the past several years, the most recent of which involved semi-structured discussions with 20 ‘partnership pioneers’.

This paper presents the major drivers of the Global Health Partnerships GHP trend, briefly reviews the significant contributions of GHPs to global health and sets out common findings from evaluations of these global health governance instruments.

The paper answers the question of how to improve GHP performance with reference to a series of lessons emerging from the past ten years of experience.
These lessons cover the following areas:

• Value-added and niche orientation

• Adequate resourcing of secretariats

• Management practices

• Governance practices

• Ensuring divergent interests are met

• Systems strengthening

• Continuous self-improvement.

These and other critical reflections inform the ‘what’s next’ agenda for Global Health Partnerships development….”

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