Health Equity: March 2012

Friday, March 30, 2012

[EQ] UN World Water Development Report - Managing Water under Uncertainty and Risk

The 4th edition of the UN World Water Development Report (WWDR4)

Managing Water under Uncertainty and Risk

United Nations Educational, Scientific and Cultural Organization

UNESCO Paris, France, 2012

Volume 1: Managing Water under Uncertainty and Risk

PDF file [407 p.] at: http://bit.ly/H3IX6p

Volume 2: Knowledge Base

PDF file [406p.] at: http://bit.ly/HoL47Y

Volume 3: Facing the Challenges

PDF file [98p.] at: http://bit.ly/HunpzD

“……Managing Water under Uncertainty and Risk’ was recently launched at the 6th World Water Forum in Marseille by Irina Bokova, UNESCO Director General, and Michel Jarraud, UN-Water Chair.

The WWDR4 is a comprehensive review of the world's freshwater resources and seeks to demonstrate, among other messages, that water underpins all aspects of development, and that a coordinated approach to managing and allocating water is critical.

The Report underlines that in order to meet multiple goals water needs to be an intrinsic element in decision-making across the whole development spectrum

The WWDR4 aims to encourage all stakeholders both in and out of the ‘water box’ - water managers, leaders in government, civil society and businesses – to engage early in decision making processes to improve the quality and acceptance of decisions and the probability of successful implementation. It highlights that more responsible action by all water users has enormous potential to lead to better outcomes - but requires political, social, economic and technical responses at all levels of government, businesses and communities, from local to international.

While providing a comprehensive assessment of the world’s water resources it also introduces a strong thematic element. Building on the WWDR3 in the recognition of the externalities, the WWDR4 elaborates on the interactions between water and the drivers of change.

The WWDR4 describes the major changes, uncertainties, and risks taking place in the world and their links to water resources. It gives account of the status and the trends related to water supplies, uses, management, institutions and financing; highlights regional hotspots, and addresses issues such as gender equality, water-related disasters, health and the role of ecosystems. ….”

Content:

Volume 1

Introduction

What’s WDR4

Chapter 1. Recognizing the centrality of water and its global dimensions TRENDS AND CHALLENGES

Chapter 2. Water demand: What drives consumption?

Chapter 3. The water resource: Variability, vulnerability and uncertainty

Chapter 4. Beyond demand: Water’s social and environmental benefits

Chapter 5. Water management, institutions and capacity development

Chapter 6. From raw data to informed decisions

Chapter 7. Regional challenges, global impacts

Chapter 8. Working under uncertainty and managing risk

Chapter 9. Understanding uncertainty and risks associated with key drivers

Chapter 10. Unvalued water leads to an uncertain future

Chapter 11. Transforming water management institutions to deal with change

Chapter 12. Investment and financing in water for a more sustainable future

Chapter 13. Responses to risk and uncertainty from a water management perspective

Chapter 14. Responses to risks and uncertainties from out of the water box

Conclusion

Volume 2 Knowledge Base

Chapter 15. State of the Resource: Quantity

Chapter 16. State of the Resource: Quality

Chapter 17. Human Settlements

Chapter 18. Managing water along the livestock value chain

Chapter 19. The global nexus of energy and water

Chapter 20. Freshwater for industry

Chapter 21. Ecosystems

Chapter 22. Allocating water

Chapter 23. Valuing water

Chapter 24. Investing in water infrastructure, its operation and its maintenance 550

Chapter 25. Water and institutional change: Responding to present and future uncertainty

Chapter 26. Developing knowledge and capacity

Chapter 27. Water-related disasters

Chapter 28. Desertification, land degradation and drought and their impacts on water resources in the dry lands

REGIONAL REPORTS

Conclusion

Volume 3: Facing the Challenges

Foreword by Olcay Ünver, Coordinator, United Nations World Water Assessment Programme

Summary

Case study development process and highlights of the findings

AFRICA

Chapter 37. Ghana

Chapter 38. Mara River basin, Kenya and Tanzania

ARAB STATES

Chapter 39. Jordan

Chapter 40. Morocco

ASIA AND THE PACIFIC

Chapter 41. Murray-Darling basin, Australia

Chapter 42. Yellow River basin, China

Chapter 43. Jeju Island, Korea

Chapter 44. Pakistan, with special reference to the Indus River basin

EUROPE AND NORTH AMERICA

Chapter 45. Czech Republic

Chapter 46. Marseille Provence Métropole Urban Community, France

Chapter 47. Tiber River basin, Italy

Chapter 48. Tagus River basin, Portugal

Chapter 49. St Johns River basin, Florida, United States of America

LATIN AMERICA AND THE CARIBBEAN

Chapter 50. Costa Rica

Chapter 51. Lerma-Chapala basin, Mexico

Boxes, tables, figures and maps

KMC/2012/HSD
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[EQ] The voice and experience of the Caribbean Islands towards sustainable development - 4 April 2012 - PAHO/WHO Rio+20

SDE Seminar Series towards Rio+20
Sustainable Development and Environmental Health – SDE - PAHO/WHO

The voice and experience of the Caribbean Islands towards sustainable development

Ninth Seminar: 4 April 2012 – PAHO/WHO Rio+20

Time: 12:00 pm - 1:00 pm - Eastern Standard Time (Washington DC USA)

To check local time in WDC against your time zone, see the World Clock at:
http://www.timeanddate.com/worldclock/meeting.html

Website PAHO/WHO Rio+20 at: http://bit.ly/oxoRdS

“The picture of the Caribbean as an idyllic paradise is an appropriate one for promoting the area to the outside world and one that most nationals in the diaspora retain with fondness and nostalgia. The physical attributes often shown are real, but they sometimes hide the struggle that many citizens must make to acquire the necessities for a decent living against the background of the reality”.

(From Report of the Caribbean commission on health and development, CARICOM and PAHO, 2006)EMCONET

We all know that a healthy population is an essential prerequisite for economic growth and stability of the Caribbean and we recall the Nassau Declaration (2001), which underscored the importance of health to development which states that “Health of a Nation is the wealth of a Nation”.

Additionally challenges specific to the Caribbean and Small Island States call for a constant attention to preserving the gains made through sustainable development. In the Caribbean, specific vulnerabilities exist such as size (while the problems are not less than in larger countries, the opportunities from economies of scale are not there) and fragility of the economic base, with tourism being the main source of income and employment in most of the islands. Furthermore, potential outbreaks, emerging and reemerging infectious diseases, and natural hazards such as hurricanes, now aggravated by the impact of climate change, are accentuating the vulnerability for the Region.

Sustainable tourism -tourism attempting to make a low impact on the environment and local culture, while helping to generate future employment for local people and aiming to ensure that development brings a positive experience for local people, tourism companies and the tourists themselves- is an imperative for the Caribbean countries. Any ecological or environmental crisis, be it an oil spill, a cholera outbreak or a leak of pesticides, can have a devastating effect for the environment, the inhabitants of the islands and the economy.

Finally, the speed of demographic transition in the Caribbean is unprecedented. By 2030, in many countries in the Caribbean the number of persons aged 60 or over will be 2.5 to 3.5 times as large as it was in 2000. As things stand, for the next three to five decades the speed of ageing in the region will continue on a singularly rapid course, a result of the momentum of demographic forces set in motion long ago. The other aspect of demographic transition is the rapid decline of fertility rates which leads to a decrease in the younger population and a trend towards an increased population of older age groups. This phenomenon is further aggravated by the migration dynamics within and outside the region and will have major implications for pension schemes and social protection interventions among others.

The Caribbean has often been in the forefront in leading innovative and important processes, as recently proven again when the Region was operational in motivating the High Level UN NCD summit. It is now time to examine where the Caribbean health movement stands when it comes to sustainable development in the light of the Rio+20 Summit.

Agenda

12:00 Welcome and introduction: Gerry Eijkemans, PAHO/WHO Representative in The Bahamas and Turks and Caicos

12:05 The experience of the Caribbean in the lead up to Rio+20 and the involvement of health; Looking back and looking forward:
Henriette Elizabeth Thompson, Executive Coordinator for Rio+20 Conference

12:20 Comments

Patrick Martin, Chief Medical Officer, St Kitts and Nevis

Hugh Sealy, St George’s University

Rudy Cummings, Head of Health Desk, CARICOM

12:35 Questions and Answers

1:00 Closing remarks and conclusions.

Moderator: Gerry Eijkemans, PAHO/WHO Representative in The Bahamas and Turks and Caicos

How to participate:

In person:
PAHO/WHO
525 23^rd ST NW
Washington DC, 20037 Room 812 – 12h to 13h Eastern Time (WDC)

Online: via Elluminate link:

- Spanish room: www.paho.org/virtual/SeminariosSDE

- English room www.paho.org/virtual/SDESeminars

SDE Seminar Series towards Rio+20

"Human beings are at the centre of concerns for sustainable development.
They are entitled to a healthy and productive life in harmony with nature" - Principle 1 of the Rio…..” Declaration on Environment and Development, 1992.

The Rio Declaration of 1992 recognizes that healthy populations are central to human progress and sustainable development, and remains equally true today. However, the economic pillar has been prioritized at the expense of the social and environmental pillars of sustainable development over the last few decades, becoming itself a source of volatility and destabilization.

The United Nations Conference on Sustainable Development, Rio+20, now offers an opportunity to re-examine the relationship between health and sustainable development. The proposed SDE Seminar series towards Rio+20 aim at contributing to this important debate by bringing different themes of relevance to sustainable development and health to inform all areas of the Pan American Organization about the themes under discussion in the Rio Conference, but also to inform public health stakeholders and other decision makers in the health sector, to better take part in the debate.

The SDE Seminar series will happen every Wednesday from 12 to 1pm (Washington time), from February 8 to June 13th.

All Seminars will be life-streamed, and opened for participation in person at the PAHO/WHO HQ, or via Elluminate.
Some of the Seminars will be in English, others in Spanish.

For those who cannot follow the seminar alive, they will be available later at PAHO Rio+20 Toolkit at: http://bit.ly/oxoRdS

Twitter http://twitter.com/eqpaho

Short Bio participants

Ms. H. Elizabeth Thompson, a former Minister for Energy and Environment of Barbados, was appointed by the Secretary-General of the United Nations as Executive Coordinator for the UNCSD Rio + 20 Conference and assumed her duties in 7 December 2010. Ms. Thompson also served as Minister for Physical Development and Minister for Health. Ms. Thompson was appointed to the Barbados Senate and was a practicing attorney as well as a journalist. In addition, she was a lecturer in ecology, economy, energy and politics. Ms. Thompson graduated from the University of the West Indies and obtained an MBA, with distinction, from the University of Liverpool and a Master of Laws from Robert Gordon University, Scotland.

Dr. Patrick Martin, a USA Certified Paediatrician (ABP) and Physician Executive (ACPE), is the Chief Medical Officer of St Kitts and Nevis having assumed that role in October 2004.He is a graduate of the University of the Virgin islands and Howard University college of Medicine. At the regional and international levels, Dr. Martin represents St Kitts and Nevis in matters relating to public health and its interface with sustainable development.

Dr. Hugh Sealy, a chemical engineer with a MSc in Environmental Pollution Science and PhD in Environmental Science is a consultant with over 25 years of experience as a project manager, a professional engineer, an environmental scientist and a university lecturer. He was the Chairman of the Barbados National Energy Policy Committee and the Chairman of the National Commission on Sustainable Development for the Government of Barbados. In January 2008, Dr. Sealy was elected as a Member of the Executive Board of the Clean Development Mechanism (CDM) under the UNFCCC. In December 2011 Dr. Sealy was reelected to the Executive Board of the CDM to serve as the Member for the Alliance of Small Island States (AOSIS). Currently, Dr. Sealy is an Associate Professor in the Department of Public Health and Preventive Medicine in the School of Medicine at St. George’s University in Grenada.

Dr. Rudolph Cummings MD, MPH, is Health Sector Development Programme Manager in the Directorate of Human and Social Development, CARICOM Secretariat, Guyana. Formerly Chief Medical Officer in the Ministry of Health of Guyana, Dr. Cummings assumed office in 2007. In this post he is responsible for the co-ordination of regional health policy (CCHIII) across the English-speaking Caribbean, Surinam and Haiti (20 states). He is also Principal Health Officer of the Community Secretariat, providing policy guidance to the Secretary General and technical and policy support to the Ministerial Council on Human and Social Development. He also participates in the interdisciplinary agenda of the Secretariat.

Dr. Gerry Eijkemans is currently PAHO/WHO Representative in The Bahamas and Turks and Caicos Islands. Previously, Dr. Eijkemans was PWR for Suriname. She has 20 years of working experience at country level, regional level and global level at PAHO, WHO and ILO in the areas of occupational and environmental health.

KMC/2012/HSD
Twitter http://twitter.com/eqpaho

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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]
Washington DC USA

Thank you.

Thursday, March 29, 2012

[EQ] Primary Care and Public Health: Promoting Integration to Improve Population Health

Primary Care and Public Health:
Promoting Integration to Improve Population Health

Board on Population Health and Public Health Practice (BPH)
US National Academy of Sciences 2012

Available online at: http://t.co/NC3ckflo

“…………Primary care and public health have critical roles in providing for the health and well-being of communities across the nation. Although they each share a common goal, historically they have operated independently of each other.
However, new opportunities are emerging that could bring the two sectors together in ways that will yield substantial and lasting improvements in the health of individuals, communities, and populations. Because of this potential, the Centers for Disease Control and Prevention and the Health Resources and Services Administration asked the IOM to examine the integration of primary care and public health.
The interactions between the two sectors are so varied that it is not possible to prescribe a specific model or template for how integration should look. Instead, the IOM identifies a set of core principles derived from successful integration efforts – including a common goal of improving population health, as well as involving the community in defining and addressing its needs.

The time is right for action, and the principles provided in this report can serve as a roadmap to move the nation toward a more efficient health system. The challenges in integrating primary care and public health are great – but so are the opportunities and rewards….”

The review informed the development of a set of principles that the committee believes are essential for successful integration of primary care and public health:

- a shared goal of population health improvement;

- community engagement in defining and addressing population health needs;

- aligned leadership that

— bridges disciplines, programs, and jurisdictions to reduce fragmentation and foster continuity,

— clarifies roles and ensures accountability,

— develops and supports appropriate incentives, and

— has the capacity to manage change;

- sustainability, key to which is the establishment of a shared infrastructure and building for enduring value and impact; and

- the sharing and collaborative use of data and analysis.

KMC/2012/HSS
Twitter http://twitter.com/eqpaho

* * *
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]
Washington DC USA

Thank you.

[EQ] Monitoring Inequalities in the Health Workforce: The Case Study of Brazil

Monitoring Inequalities in the Health Workforce:
The Case Study of Brazil 1991–2005

Angelica Sousa1,2*, Mario R. Dal Poz1,3, Cristiana Leite Carvalho4

1 Department for Health Systems Policies and Workforce, World Health Organization, Geneva, Switzerland,
2 Center for Population and Development Studies, Harvard School of Public Health, Boston, Massachusetts, United States of America,
3 Institute of Social Medicine, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil,

4 Dental School, Pontifical Catholic University, Minas Gerais, Brazil

PLoS ONE 7(3): e33399. March 27, 2012

Available online at: http://bit.ly/GVD1vg

Both the quantity and the distribution of health workers in a country are fundamental for assuring equitable access to health services. Using the case of Brazil, we measure changes in inequalities in the distribution of the health workforce and account for the sources of inequalities at sub-national level to identify whether policies have been effective in decreasing inequalities and increasing the density of health workers in the poorest areas between 1991 and 2005.

Methods:
With data from Datasus 2005 and the 1991 and 2000 Census we measure the Gini and the Theil T across the 4,267 Brazilian Minimum Comparable Areas (MCA) for 1991, 2000 and 2005 to investigate changes in inequalities in the densities

of physicians; nurse professionals; nurse associates; and community health workers by states, poverty quintiles and urban-rural

stratum to account for the sources of inequalities.

Results:
We find that inequalities have increased over time and that physicians and nurse professionals are the categories of health workers, which are more unequally distributed across MCA. The poorest states experience the highest shortage of health workers (below the national average) and have the highest inequalities in the distribution of physicians plus nurse professionals (above the national average) in the three years. Most of the staff in poor areas are unskilled health workers.

Most of the overall inequalities in the distribution of health workers across MCA are due to inequalities within states, poverty quintiles and rural-urban stratum.

Discussion:
This study highlights some critical issues in terms of the geographical distribution of health workers, which are accessible to the poor and the new methods have given new insights to identify critical geographical areas in Brazil. Eliminating the gap in the health workforce would require policies and interventions to be conducted at the state level focused in poor and rural areas….”

KMC/2012/SDE
Twitter http://twitter.com/eqpaho

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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]
Washington DC USA

Thank you.

Wednesday, March 28, 2012

[EQ] Migration and health in the European Union

Migration and health in the European Union

Editors

Bernd Rechel, Philipa Mladovsky, Walter Devillé, Barbara Rijks, Roumyana Petrova-Benedict, Martin McKee
World Health Organization 2011 on behalf of the European Observatory on Health Systems and Policies

Available online PDF [282p.] at: http://bit.ly/HlLJl1

“…..The increasing diversity of populations in Europe, including a growing proportion of migrants, creates new challenges for health systems, which have to adapt in order to remain responsive.

This book explores the overall context of migration and health in the European Union, addresses the rights of migrants to health and looks at problems in their access to health services, explores the challenges and opportunities in monitoring migrant health, reviews the health issues faced by migrants in Europe, discusses the policy response so far and the need for culturally responsive health services, provides examples of best practice, and looks at the policy implications of the findings presented…..”

Section I Introduction

one Migration and health in the European Union

Section II Context

two Trends in Europe’s international migration

three Asylum, residency and citizenship policies and models of migrant incorporation

Section III Access to health services

four The right to health of migrants in Europe

fi ve Migrants’ access to health services

Section IV Monitoring migrant health six Monitoring the health of migrants

Section V Selected areas of migrant health

seven Non-communicable diseases

eight Communicable diseases

nine Maternal and child health – from conception to fi rst birthday

ten Occupational health

eleven Mental health of refugees and asylum-seekers

Section VI Policy response

twelve Migrant health policies in Europe

thirteen Differences in language, religious beliefs and culture: the need for culturally responsive health services

fourteen Good practice in emergency care: views from practitioners

fi fteen Good practice in health service provision for migrants

Section VII Conclusions

sixteen The future of migrant health in Europe

The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Offi ce for Europe, the Governments of Belgium, Finland, Ireland, the Netherlands, Norway, Slovenia, Spain, Sweden and the Veneto Region of Italy, the European Commission, the European Investment Bank, the World Bank, UNCAM (French National Union of Health Insurance Funds), the London School of Economics and Political Science and the London School of Hygiene & Tropical Medicine.

KMC/2012/SDE
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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]
Washington DC USA

Thank you.