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.
Monitoring equity and research policy
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)
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.
Scaling up health interventions in resource-poor countries: What role does research in stated-preference framework play?
Pokhrel S: Health Research Policy and Systems 4:4, 30 March 2006
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.
The state of international collaboration for health systems research: What do publications tell?
González Block MA: Health Research Policy and Systems 4:7, 23 August 2006
International collaboration for health system development has been identified as a critical input to meet pressing global health needs. North-South collaboration has the potential to benefit both parties, while South-South collaboration offers promise to strengthen capacity rapidly and efficiently across developing countries. There is an emerging trend to analyze the fruits of such collaboration. This paper builds on this trend by applying an innovative concept-based bibliometric method to identify the international scope of collaboration within the field of health policy and systems research. Two key questions are addressed: to what extent are papers comparing developing countries as against reporting on single country studies? To what extent are papers in either case being produced by researchers within their respective countries or through North-South or South-South collaboration?
UNGASS reporting and implementation on national monitoring and evaluation systems: Lessons from 4 countries
Kusek JZ, Delay P, Rao KS, Osindo B: The Sixteenth International AIDS Conference, August 2006
As clearly shown in the 2005 UNGASS Country Progress Reports, AIDS resources have grown rapidly in recent years from US$300 million in 1996 to US$8 billion in 2005. One critical need is to ensure that available resources are used effectively, which requires that countries must invest in a sound monitoring and evaluation system to help provide feedback on whether projects, programs, and policies are achieving (or not) their expected results. A major emphasis has been put on integrating the various M&E efforts in support of the three ones principle of “One National Monitoring and Evaluation System”. Four countries were invited to participate in a feedback session, including Botswana of Southern Africa.
Using Geographic Information System applications to improve coverage, access and targeting of HIV/AIDS interventions
Taruberekera N, Chieza F, Madan Y: The Sixteenth International AIDS Conference, August 2006
Zimbabwe is in the mature stage of a generalised HIV/AIDS epidemic. However, HIV prevalence is unevenly distributed with respect to age, gender and locality. The objective of the mapping exercise was to focus limited project resources for improving linkages and ensuring maximum impact of prevention interventions. Use of GIS systems helped improve linkages between communication activities and product delivery to create informed demand and improve off-take of male and female condoms.
Creating windows of opportunity for policy change: Incorporating evidence into decentralized planning in Kenya
Ashford LS, Smith RR, De Souza RM, Fikree FF, Yinger NV: WHO Bulletin 84, August 2006
Because researchers and policy-makers work in different spheres, policy decisions in the health arena are often not based on available scientific evidence.This paper describes a model that illustrates the policy process and how to work strategically to translate knowledge into policy actions. Activities were undertaken as part of the Kenyan Ministry of Health’s new decentralised planning-process.
Using knowledge brokering to promote evidence-based policy-making: The need for support structures
van Kammen J, de Savigny D, Sewankambo N: WHO Bulletin 84, August 2006
Knowledge brokering is a promising strategy to close the “know–do gap” and foster greater use of research findings and evidence in policy-making. It focuses on organising the interactive process between the producers and users of knowledge so that they can co-produce feasible and research-informed policy options. This paper describes a recent successful experience with this novel approach in the Netherlands and also discusses the potential of this approach to assist health policy development in low-income countries based on the experience of developing the Regional East-African Health (REACH)- Policy Initiative.
Setting the stage for equity-sensitive monitoring of the maternal and child health MDGs
e-Civicus, 7 July 2006
This analysis seeks to set the stage for equity-sensitive monitoring of the health-related Millennium Development Goals (MDGs). The MDGs and other development initiatives must become more comprehensive and explicit in their analysis and tracking of inequities, and the design of policies to narrow health gaps must take into account country-specific inequities.