Understanding HIV disease progression is critical for planning healthcare strategies in developing countries. What is the best way to monitor disease progression in the absence of laboratory tests? How does HIV/AIDS in sub-Saharan Africa differ from developed regions? A study by the Liverpool School of Tropical Medicine and the Uganda Virus Research Institute addressed these issues.
Monitoring equity and research policy
On measuring inequalities in health
Michael Wolfson, Assistant Chief Statistician, Statistics Canada and Geoff Rowe, Senior Analyst, Socioeconomic Modelling Group, Statistics Ottawa, Canada. Bulletin of the World Health Organization, June 2001, 79(6): 553-560
In a recent series of papers, Murray et al. have put forward a number of important ideas regarding the measurement of inequalities in health. In this paper we agree with some of these ideas but draw attention to one key aspect of their approach -measuring inequalities on the basis of small area data -which is flawed. A numerical example is presented to illustrate the problem. An alternative approach drawing on longitudinal data is outlined, which preserves and enhances the most desirable aspects of their proposal. These include the use of a life course perspective, and the consideration of non-fatal health outcomes as well as the more usual information on mortality patterns.
Equity and Health: Views from the Pan American Sanitary Bureau
2001, 169p., ISBN 92 75 12288 1
The concept of equity has emerged as a primary guiding for the work of the Pan American Sanitary Bureau. The Bureau has been gathering information on and examining issues related to disparities in health in the Americas, especially as they relate to socioeconomic factors. The articles gathered in this publication represent an important step toward a more equitable distribution of health conditions and health related services, insofar as they represent the status of the issues and dilemmas faced by that Bureau in making equity an operational concept for its work in the Region. The authors have attempted to show how equity and the insights it yields into the distribution of health-dependent as this is on differences in education, income, class, ethnicity and race, geographic location, gender, and other distinctions-can underpin the Bureau's work at the operational level and be incorporated into technical cooperation activities.
Global health fund debated
A new global fund to combat HIV/AIDS, tuberculosis and malaria will be administered by the World Bank in collaboration with WHO and UNAIDS. Officially announced by UN secretary general Kofi Annan in May, discussions have so far focused on raising the US$10 billion experts say is needed. Less clear are details on how it will fit into national processes and poverty reduction strategies. Some NGOs, academics and officials are worried the fund reflects donors' priorities and the desire to apply "quick fixes" to complex problems. Welcoming the fund in principle, Save the Children, UK, and MEDACT warn in a joint report that lessons of the past 30 years must be taken into account or "billions of dollars could be wasted". "Donor led programmes that focus on specific diseases rather than taking a holistic approach to building services and resources have contributed to the collapse of developing countries' health systems," comments Regina Keith, health adviser to Save the Children, UK. The report The Bitterest Pill of All: The Collapse of Africa's Health System, argues that a significant amount of any new global health fund should be dedicated to the long term strengthening of health systems. European Commissioner for Development Poul Nielson also warns that, without efficient delivery systems, "there is a big risk of this whole discussion being hijacked by PR-politics in rich countries".
Challenging Inequities in Health: from ethics to action
Edited by Timothy Evans, Margaret Whitehead, Finn Diderichsen, Abbas Bhuiya and Meg Wirth.
Challenging Inequities in Health: From Ethics to Action provides new perspectives on the idea of health equity, the scale of the inequalities and the ways in which gender, social context and globalization impact the health of populations in thirteen countries. The studies seek to expose health disparities within countries, revealing stark social inequalities in life expectancy and health status.
Female Circumcision in Sudan:
Future Prospects and Strategies for Eradication
Female circumcision--also known as female genital mutilation--is widely practiced in some parts of Sudan. Information about attitudes toward the practice, the reasons why women support it and the social and demographic predictors associated with support for it are needed for development of eradication strategies.
Gender and Health Equity Resource Guide
by Elaine Baume, Mercedes Juarez, Hilary Standing,
Institute of Development Studies at the University of Sussex, April 2001
A resource from the Gender and Health Equity Network, a partner of the Health and Social Change Programme at IDS. The purpose of this resource guide is to give an overview of gender sensitive interventions and initiatives directly or indirectly related to health that have been tried at macro and micro levels. Through mapping different experiences, the guide provides information on lessons learned, results achieved, and the challenges that have emerged in promoting gender and health equity. It includes information on gender-sensitive approaches, working methods, practical methodologies and tools which can be incorporated into policies and programmes. In pulling these resources together our aim is to create a practical reference mechanism for those involved in implementing programmes and policies worldwide. We felt that a guide to existing resources that could be periodically updated and reviewed would be more useful than commissioning more exhaustive but perhaps less accessible review papers.
JHPIEGO: Work In Policy: A Comprehensive Review
Changes in policy at all levels of a healthcare system are often necessary to achieve program objectives and secure the success of performance improvement activities. In the course of our work, JHPIEGO has helped to develop, implement and evaluate policy in many countries and at a variety of levels. The latest technical report, "JHPIEGO's Work In Policy: A Comprehensive Review", documents JHPIEGO's efforts in policy development (particularly through the Training in Reproductive Health Project), and reveals a scope that was underestimated even by many JHPIEGO staff. To obtain a copy of the technical report, please contact Kathleen Hines.
Contact: khines@jhpiego.org