The State of the World's Children 2008 provides a wide-ranging assessment of the current state of child survival and primary health care for mothers, newborns and children. The report argues that these issues serve as sensitive barometers of a country's development and wellbeing and as evidence of its priorities and values, and states that investing in the health of children and their mothers is a human rights imperative and one of the surest ways for a country to set its course towards a better future. The report identifies six pivotal actions at the macro level that urgently require unified engagement to intensify efforts for maternal, newborn and child survival and fulfil the right of women and children to health and well-being.
Equity in Health
The state of the worlds children 2008: Child survival
United Nations [UN] Children's Fund , 2008
WHO Commission on Social Determinants of Health: Final reports of the Knowledge Networks
WHO Commission on Social Determinants of Health (CSDH)
The Knowledge Networks of the Commission in different regions have completed their reports. These reports will inform the Commission's interim statement to be published later this year for broader consultation. They are available on the Commission website and cover areas of Early childhood development; Globalisation; Health Systems; Employment; Women and Gender equity; Urban Settings and Measurement and Evidence.
Early child development: strategies to ensure children achieve their potential
Engle PL: The Lancet 369 (9557): 229-242, 2007
Over 200 million children under five years old in developing countries do not reach their development potential. Whilst risks such as stunting, iodine-deficiency, anaemia and inadequate cognitive stimulation are known, evidence suggests that maternal depression, exposure to violence, environmental contamination and malaria are further potential risk factors. The researchers identify factors that are consistently associated with effective programmes and identify a need to establish globally accepted monitoring indicators for child development and for more evaluation. Despite the evidence that comprehensive early development programmes are effective in increasing disadvantaged children’s chances of success, government investment remains low. At the current rate of progress, the disparity between rich and poor countries in pre-school attendance will increase.
Make medicines child size
World Health Organisation
Launched on 6 December 2007, 'make medicines child size' is a global campaign spearheaded by WHO to raise awareness and accelerate action to address the need for improved availability and access to safe child specific medicines for all children under 15. To achieve this goal, more research is needed, more medicines need to be developed, and improved access measures are essential. At present, many medicines are not developed for children or available in suitable dosages or formats; and when they are they are not reaching the children who need them most. The 'make medicines child size' campaign is an effort to change that reality.
The Malawi National Tuberculosis programme: an equity analysis
Simwaka B, Bello G, Banda H, Chimzizi R, Squire BSB and Theobald SJ: International Journal for Equity and Health 6(24), 31 December 2007
This article synthesises what is known on equity and tuberculosis (TB) in Malawi and highlights areas for further action and advocacy. Based on a range of published and unpublished reports and analysis of routine data on access to TB services, the authors find that TB cases have increased rapidly from 5,334 in 1985 to 28,000 in 2006. This increase has been attributed to HIV/AIDS; 77 per cent of TB patients are HIV positive. Poor people’s ability to access TB diagnosis services is reduced by the need for repeated visits, long queues and delays in sending results. The costs of seeking care for these people can be up to 240 per cent of monthly income. The paper concludes that the government’s policies to address TB, which are being delivered through the Sector Wide Approach, provide a good opportunity to enhance equity and pro-poor health services. The major challenge is to increase case detection especially amongst poor people. In addition, the Programme needs a prevalence survey which will enable equity monitoring and the development of responsive interventions to promote service access to people with undiagnosed TB.
Developing countries and neglected diseases: challenges and perspectives
Boutayeb A: International Journal for Equity in Health 6(20), 26 November 2007
It is now commonly admitted that the so-called (most) neglected tropical diseases have been given little attention. According to World Health Organization, neglected diseases are hidden diseases as they affect almost exclusively extremely poor populations living in remote areas beyond the reach of health service. The European Parliament recognised that Neglected Diseases have not received the attention they deserve from EU actions or in the Millennium Development Goals. Investing in drugs for these diseases is thought to be not marketable or profitable. However, despite their low mortality, neglected diseases are causing severe and permanent disabilities and deformities affecting approximately 1 billion people in the world, yielding more than 20 millions of Disability Adjusted Life Years (56.6 million according to Lancet's revised estimates) and important socio-economic losses. Urgent pragmatic and efficient measures are needed both at international and national levels.
Theorising inequalities in the experience and management of chronic illness: Bringing social networks and social capital back in (critically)
Sanders C and Rogers A: Research in the Sociology of Health Care 25: 15-24, 15 December 2007
Social networks have been a central focus of sociological research on inequalities but less has focused specifically on chronic illness and disability despite a policy emphasis on resources necessary to support self-management. This seeks to unpack overlaps and distinctions between social network approaches and research on the experience and management of chronic illness. It outlines four main areas viewed as central in articulating the potential for future work consistent with a critical realist perspective: (1) body–society connections and realist/relativist tensions; (2) the controversy of ‘variables’ and accounting for social and cultural context in studying networks for chronic illness support; (3) conceptualising social support, network ties and the significance of organizations and technology; and (4) translating theory into method.
Income redistribution is not enough: income inequality, social welfare programs, and achieving equity in health
Starfield B, Birn AE: Journal of Epidemiology and Community Health 61:1038-1041, 2007
Income inequality is widely assumed to be a major contributor to poorer health at national and subnational levels. According to this assumption, the most appropriate policy strategy to improve equity in health is income redistribution. This paper considers reasons why tackling income inequality alone could be an inadequate approach to reducing differences in health across social classes and other population subgroups, and makes the case that universal social programs are critical to reducing inequities in health. A health system oriented around a strong primary care base is an example of such a strategy.
Malawi Health Equity Network National Health Forum
MHEN, 22-23 November 2007
MHEN held a National Forum on 22nd and 23rd November 2007 at Lilongwe Hotel. It brought together a network of policy makers and practitioners who work in the field of health services delivery. The forum explored the challenges in health services delivery in a non-industrialised country with limited resources.
Further details: /newsletter/id/32725
Shaping the world to illustrate inequalities in health
Dorling D, Barford A: Bulletin of the World Health Organisation 85(11): 821-900, November 2007
Visualizing inequalities in health at the world scale is not easily achieved from tables of mortality rates. Maps that show rates using a colour scale often are less informative than many map-readers realize. For instance, a country with a very small land area receives less attention, whereas a large, sparsely populated area on a map is more obvious. Furthermore, unlike our visual ability to compare the lengths of bars in a chart, we do not have a natural aptitude for translating different colours or shades to the magnitudes they represent. Here we introduce another approach to mapping the world that can be useful for illustrating inequalities in health. This article looks at various ways of mapping and visualising global health statistics.