Monitoring equity and research policy

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.

No development without research: A challenge for capacity strengthening
Global Forum for Health Research, August 2005

Health research is indispensable for improving health and health equity and contributing to overall development. Many developing countries have made substantial investments in building and enhancing their capacities for research in health and related fields, and these efforts have been supported and extended by programmes of development agencies and research institutions located in high-income countries. Despite decades of such efforts, and notwithstanding some notable examples of success, the overall picture of progress is a mixed one.

Priorities for research to take forward the health equity policy agenda
WHO Task Force on Research Priorities for Equity in Health

Despite impressive improvements in aggregate indicators of health globally over the past few decades, health inequities between and within countries have persisted, and in many regions and countries are widening. We recommend that highest priority be given to research in five general areas: (1) global factors and processes that affect health equity and/or constrain what countries can do to address health inequities within their own borders; (2) societal and political structures and relationships that differentially affect people's chances of being healthy within a given society; (3) interrelationships between factors at the individual level and within the social context that increase or decrease the likelihood of achieving and maintaining good health; (4) characteristics of the health care system that influence health equity and (5) effective policy interventions to reduce health inequity in the first four areas.

Reviewing national priorities for child health research in sub-Saharan Africa
Health Research Policy and Systems 2005, 3:7

There are few systematically developed national research priorities for child health that exist in sub-Saharan Africa. Children's interests may be distorted in prioritisation processes that combine all age groups. Future development of priorities requires a common reporting framework and specific consideration of childhood priorities, according to a review of national priorities for child health research published in Health Research Policy and Systems 2005. The research reviewed existing national child health research priorities in Sub-Saharan Africa, and the processes used to determine them.

Applying policy analysis in tackling implementation gaps
Paper Presented to Forum 9, Global Forum for Health Research, Mumbai, September 12-16th, 2005 pp 1-16

Ultimately any policy or health system change, whether generated from within or outside national environments, has to work through those responsible for service delivery, and their interactions with the intended beneficiaries of those changes. Yet we continue to know too little about the experiences of these groups, including how their words, actions and beliefs shape the practice of implementation. This paper used policy analysis to understand these implementation gaps.

Grading evidence and recommendations for public health interventions
Report by the Health Development Agency, London

This provisional framework provides a practical and transparent method for deriving grades of recommendation for public health interventions, based on a synthesis of all relevant supporting evidence from research.

Applying policy analysis in tackling implementation gaps

Ultimately any policy or health system change, whether generated from within or outside national environments, has to work through those responsible for service delivery, and their interactions with the intended beneficiaries of those changes. Yet we continue to know too little about the experiences of these groups, including how their words, actions and beliefs shape the practice of implementation. This paper used policy analysis to understand these implementation gaps.

Inequalities in health in developing countries: Challenges for public health research
Critical Public Health, Volume 15, Number 1 / March 2005

"Inequalities in health are important for overall well-being even in developing countries. But research into this area has lagged behind developed countries partly because of the lack of routine and longitudinal data. Insights from developed countries have highlighted how risk factors are clustered around poor people and the ways in which pathways of poverty and poor health are formed during their lives. This is being overlaid by the process of globalization that seems to be accentuating these processes. The paucity of reliable routine data should encourage public health researchers in developing countries to stretch their methodological imagination to include qualitative insights in order to facilitate a more probing investigation that moves beyond describing inequalities but begins to describe how they are produced and reproduced."

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