As part of its contribution to closing the ‘10/90 gap’, the GFHR conducts studies of the flows of financial resources for health research and the extent to which these address the health needs of the poor and marginalized. This new volume of Monitoring Financial Flows for Health Research looks behind the global totals and examines several facets of the overall picture. The report highlights the revolution of a much broader and more holistic definition of health and the need for a wider and more multisectoral approach to understanding the determinants of health.
Monitoring equity and research policy
Monitoring financial flows for health research
Global Forum for Health Research
Contact: info@globalforumhealth.org
Scaling up health interventions in resource-poor countries: What role for research in stated-preference frameworks?
Health Research Policy and Systems 4 (4): Pokhrel S
Despite improved supply of health care services in low-income countries in the recent past, their uptake continues to be lower than anticipated. This has made it difficult to scale-up those interventions which are not only cost-effective from supply perspectives but that might have substantial impacts on improving the health status of these countries. Understanding demand-side barriers is therefore critically important. This commentary argues that more research on demand-side barriers needs to be carried out and that the stated-preference (SP) approach to such research might be helpful.
Applying clinical epidemiological methods to health equity: the equity effectiveness loop
Tugwell P, deSavigny D, Hawker G: British Medical Journal 2006, 332:358-361
We propose the "equity effectiveness loop" framework (fig 1) to highlight equity issues inherent in assessing health needs, effectiveness, and cost effectiveness of interventions, and the development and evaluation of evidence based health policy. This framework provides a method to calculate the "equity effectiveness ratio," which assesses the impact of various factors on the gap in the effectiveness of interventions across socioeconomic gradients.
Methodological and data challenges to identifying the impacts of globalisation and liberalisation on inequality
Berry A: United Nations Research Institute for Social Development (UNRISD), 2005
Globalisation and liberalisation (G&L) are two of the defining features of the last couple of decades. Both have given rise to contentious debate, with views ranging from the most optimistic to the most sceptical. This paper reviews the evidence on how the two trends have affected inequality - and thus poverty - at both the global and domestic levels. The absence of consensus on these effects reflects both the dearth of adequate quantitative information and the lack of and difficulty in the analysis of the causal links among the issues.
Validating a work group climate assessment tool for improving the performance of public health organizations
Perry C, LeMay N, Rodway G, Tracy A, Galer J: Human Resources for Health 2005, 3:10
This article describes the validation of an instrument to measure work group climate in public health organizations in developing countries. The instrument, the Work Group Climate Assessment Tool (WCA), was applied in Brazil, Mozambique, and Guinea to assess the intermediate outcomes of a program to develop leadership for performance improvement. Findings discussed include how the WCA is useful for comparing the climates of different work groups, tracking the changes in climate in a single work group over time, or examining differences among individuals' perceptions of their work group climate.
Health Disparities And Health Equity: Concepts and Measurement
Annual Review of Public Health
There is little consensus about the meaning of the terms "health disparities," "health inequalities," or "health equity." The definitions can have important practical consequences, determining the measurements that are monitored by governments and international agencies and the activities given resource-support to address health disparities/inequalities or health equity. This paper aims to clarify the concepts of health disparities/inequalities and health equity, focusing on the implications of different definitions for measurement and hence for accountability.
Integrating gender, rights, and sexuality into sexual and reproductive health systems: A quality improvement approach
Eldis health policy reporter. Via WHO (Mozambique)
This document contains guidelines for assessing the integration of gender, rights and sexuality (GRS) issues into sexual and reproductive health services. The guidelines include a self-assessment GRS questionnaire designed to guide discussions among staff with the aim of producing concrete solutions to improve the integration of GRS issues. The questionnaire is divided into two sections: the needs of staff providers and the needs of clients.
Poverty, Equity & Health Research
The report stresses that reducing inequities in health requires political will, increased resources and enhanced effort to organize and deliver health products and services effectively. It also needs research – whether biomedical research to create the needed drugs, vaccines, diagnostics and medical appliances; health policy and systems research to understand and improve the organization and functioning of the health sector; social sciences and behavioural research to increase understanding of the factors that determine health and affect health-seeking behaviour; or operational research to examine how effectively systems and interventions are working on the ground and how they can be improved.
Stigma and global health: developing a research agenda
The Lancet, Volume 367, Number 9509
Stigma is a pervasive influence on disease and responses of nations, communities, families, and individuals to illness. Too little research has been done in recent years to better understand the pathogenesis and implications of stigma, how beliefs are generated, perpetuated, and translated into behaviours, and the cost of stigma to individuals, families, communities, and nations. The sense that legislation and education against stigma is sufficient may explain the shortage of interest in research in this field.
Bringing them on board: putting health policy into practice in South Africa
Wits Institute for Social and Economic Research
The successful implementation of health policy requires the backing of health care practitioners, managers, and patients. In South Africa, the introduction of free health care, although supported in principal by nurses and health facility managers, faced resistance as workloads increased and staff felt excluded from a centrally prescribed policy. Proponents of a 'street-level bureaucracy' approach to policy implementation acknowledge the day-to-day methods to cope with pressures that are adopted by frontline health care providers in the face of high demand for their services. It is these mechanisms, they argue, that effectively become public policy, rather than the decisions taken by central government.