The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the ninth of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.
Monitoring equity and research policy
Improving the use of research evidence in guideline development: 9. Grading evidence and recommendations
Fretheim A , Schünemann A, Oxman AD: Health Research Policy and Systems 4:21, 5 December 2006
Levels and trends of demographic indices in southern rural Mozambique: evidence from demographic surveillance in Manhiça district
Nhacolo AQ, Nhalungo DA, Sacoor CN, Aponte JJ, Thompson R, Alonso P: BMC Public Health 6: 291, 30 November 2006
In Mozambique most of demographic data are obtained using census or sample survey including indirect estimations. A method of collecting longitudinal demographic data was introduced in southern Mozambique since 1996 (DSS -Demographic Surveillance System in Manhiça district, Maputo province), but the extent to which it yields demographic measures that are typical of southern rural Mozambique has not been evaluated yet.
The meaning and measurement of acute malnutrition in emergencies
Humanitarian Practice Network Paper 56, November 2006
The recent humanitarian reform agenda, which aims to make the humanitarian system more accountable, has led to a surge in interest in acute malnutrition as an indicator of humanitarian crisis. WHO and UNICEF, as UN cluster leads in health and nutrition, have put forward a proposal for a ‘Humanitarian Health and Nutrition Tracking Service’to help track humanitarian outcomes and performance on request from the Inter-Agency Standing Committee. This is not only a technical challenge, but also an institutional one, as it is often institutional constraints that hamper the implementation of, and response to, nutrition surveys. This paper seeks to link the technical issues with a more pragmatic understanding of the institutional constraints to collecting and using information.
Global health inequalities: An international comparison
Ruger JP, Kim H: Journal of Epidemiology and Community Health 60 (11) 928-936, 2006
The objective of this study was to study cross-national inequalities in mortality of adults and of children aged 4 times the rate in countries with low mortality. For child mortality, the worse-off group made slower progress in reducing <5 mortality than the better-off group. The study concludes that inequalities in child and adult mortality are large, are growing, and are related to several economic, social and health sector variables.
The United Nations Process Indicators for emergency obstetric care
Paxton A, Bailey P, Lobis S: International Journal of Gynecology and Obstetrics 95 (2) 192-208, 2006
The paper reviews the experience with the emergency obstetric care (EmOC) process indicators, and evaluates whether the indicators serve the purposes for which they were originally created – to gather and interpret relatively accessible data to design and implement EmOC service programs. The authors conclude that The EmOC process indicators have been used successfully in a wide variety of settings. They describe vital elements of the health system and how well that system is functioning for women at risk of dying from major obstetric complications.
Burden of disease analyses in developing countries: Implications for health system policy, planning and management
Global Health Forum for Health Research
Methods to measure the burden of disease (BOD) on populations have been applied for decades, but have only received increasing attention in the past twenty years. During this period of time, a number of concerns have been raised with the use of summary measures of population health. This report summarises the lessons learned from seven BOD studies funded by the Global Forum for Health Research.
Delivering on the MDGs: Equity and maternal health in Ghana, Ethiopia and Kenya
Wirth M, Delamonica E, Sacks E, et al: World Institute for Development Research (WIDER), 2006
The Millennium Development Goals (MDGs) have put maternal health in the mainstream, but there is a need to go beyond the MDGs to address equity within countries. Maternal health indicators from three countries in sub-Saharan Africa show the continent is lagging far behind other regions on health indicators. In the past decade, maternal mortality has increased in some countries, in large part due to health system collapse, increasing poverty among women, lack of access to skilled care for delivery, weak national human resource management and lack of resources.
Measurement and explanation of inequality in health and health care in low-income settings
Van Doorslaer E, O\\\'Donnell O: World Institute for Development Economic Research (WIDER)
This paper describes approaches to the measurement and explanation of income-related inequality and inequity in health care financing, health care utilisation and health and considers the applicability and the feasibility of these methods in low income countries. Results from a comparative study of fourteen Asian countries are used to illustrate the main issues. The empirical analyses demonstrate that, in low-income countries, the better-off tend to pay more for health care, both absolutely and in relative terms. But they also consume more health care. Assessing the distributional performance of health systems in low income settings therefore requires examination of finance and utilisation simultaneously.
Measuring health inequality and health opportunity
Zheng B: World Institute for Development Economic Research (WIDER)
The paper considers the measurement of health inequality and health opportunity with categorical data of health status. A society’s health opportunity is represented by an income-health matrix that relates socioeconomic class with health status; each row of the matrix corresponds to a socioeconomic class and contains the respective probability distribution of health. The income-health matrix resembles the transition matrix used in measuring income mobility and, hence, approaches developed there can be adapted to measuring health opportunity.
The Biasfree Framework: A practical tool for identifying and eliminating social biases in health research
Global Forum for Health Research, 2006
The BIAS FREE Framework provides a useful tool for the identification and elimination of bias in health research. The utility of The BIAS FREE Framework goes beyond the specific context of health research and extends to human subject research generally and to the policy and law reform contexts as well. The BIAS FREE Framework is posited on the equal entitlement of all people to be treated with dignity and respect and on the inviolability of human rights and it uses a rights-based model of health and well being.