Human rights approaches to health have been criticized as antithetical to equity, principally because they are seen to prioritise rights of individuals at the expense of the interests of groups, a core tenet of public health. The objective of this study was to identify how human rights approaches can promote health equity. The paper argues that Where it is clear that rights approaches are predicated upon understanding the need to prioritize vulnerable groups and where the way rights are operationalised recognizes the role of agency on the part of those most affected in realising their socio-economic rights, human rights
approaches appear to offer powerful tools to support social justice and health equity.
Latest Equinet Updates
Issues of equity are also issues of rights: Lessons from experiences in Southern Africa
London, L. BMC Public Health 7 :4 pp 1-10
Knowledge and attitudes of intern doctors at rural and urban hospitals in Uganda regarding the migration of health workers
Lwamafa DK, Nabitaka MV, Opio KC
This student capacity building project aimed at comparing information on the knowledge and attitudes of intern doctors at two urban hospitals and three rural hospitals in Uganda regarding international migration. The key informant interviews suggested that the search for better pay is the most significant push factor for migration; while the most significant retention factor is feeling indebted to the government and family who sponsor their education. The respondents from both settings think that the workload and working conditions will affect their eventual specialty and location of practice.
Building equitable, people-centred national health systems: The role of parliament and parliamentary committees on health in east and southern Africa
Musuka G, Chingombe I
The Health Systems Knowledge Network of the WHO Commission on the Social Determinants of Health in co-operation with the Regional Network for Equity in Health in east and southern Africa (EQUINET) commissioned a desk review of the role of parliaments and parliamentary portfolio committees on health in building equitable and people centered national health systems. This review presents evidence from published literature, and other secondary evidence in the east and southern African regions.
The dispossession of African wealth at the cost of African health
Bond P
This article synthesises data reported in EQUINET discussion paper 30 about the outflow of Africa’s wealth, to reveal structural factors behind the continent’s ongoing underdevelopment. The flow of wealth out of sub-Saharan Africa to the North occurs primarily through exploitative debt and finance, phantom aid, capital flight, unfair trade, and distorted investment. Although the resource drain from Africa dates back many centuries—beginning with unfair terms of trade, amplified through slavery, colonialism, and neocolonialism—today, neoliberal (free market) policies are the most direct causes of inequality and poverty. They tend to amplify preexisting class, race, gender, and regional disparities and to exacerbate ecological degradation. Reversing this outflow is just one challenge in the struggle for policy measures to establish a stronger funding base for the health sector.
Country health equity analysis: Malawi
Banda HTR, Bongololo G, Ng'ombe J, Makwiza I (2007)
This report explores the health equity issues in Malawi, as a country equity analysis and contribution to the regional picture. It explores the current equity situation in Malawi through a review of literature and a meeting of local institutions, and proposes areas of focus for future work. It addresses the potential to promote equity in health through a strong network of equity actors whose voice would advocate for equitable access to basic quality health care in Malawi.
Discussion Paper 34: Distribution of public sector health workers in Zimbabwe: A challenge for equity in health
Mudyarabikwa O, Mbengwa A
Zimbabwe, like many other countries in the region, is badly affected by a shortage of health workers. Many of the health indicator improvements achieved during the first ten years of independence are on the decline and a major reason for this is shortage of skilled and experienced health workers at a time when demand for services is increasing due to a growing population and the challenges posed by HIV and AIDS. The public sector provides as much as 65% of health care services in the country, so a shortage of public sector health workers affects the majority of the population. Against a background of increasing shortages, the report argues for improved management practices and better distribution of human resources in health care systems. This study presents evidence on the distribution of public sector health workers in Zimbabwe and the impacts on equity objectives in health care.
Discussion paper 40: A literature review of district health systems in east and southern Africa: Facilitators and barriers to participation in health
Lopez-Levers L, Magweva FI, Mpofu E
This study reviewed the available published and grey literature, with a focus on primary health care and the district health systems in sub-Saharan Africa, in order to explore the facilitators and barriers to community participation. Six African countries were selected for deeper review and analysis: Botswana, Lesotho, Namibia, Rwanda, Swaziland and Tanzania. The work signals a need for more culturally informed interventions that draw from indigenous knowledge bases, with evidence-based data that is culturally relevant, and that contextualises poverty, health risks and systems in sub-Saharan Africa. The review identifies a number of challenges, not the least of which is the prevailing perspective of the citizen as an object of health rather than as an active subject.
Discussion paper 43: Zimbabwe National Health Sector Budget Analysis and Equity Issues
Zimbabwe Economic Policy Analysis and Research Unit (ZEPARU), Training and Research Support Centre (TARSC)
This study was implemented to identify trends in the health budget in Zimbabwe 2001-2006, assess the equity oriented nature of these trends and make recommendations to strengthen pro-equity dimensions of the health budget. The review examines the budget in three major respects: how far the opportunities for equity in revenue mobilization are being tapped; how far the allocation and expenditure patterns are promoting policy targets, particularly equity; and how far incentives and investments are levering health promoting investments (and penalizing those that undermine health). The study drew evidence from secondary data and national surveys, from reported Ministry of Finance estimates and from the reported budget allocations provided by government, with a focus on the years 2000-2006.
Implications of the GATS and TRIPS agreements for the Right to Health in Malawi
Mabika AH, London L (2007)
This report prepared under a capacity building programme analyses the relevant provisions of the World Trade Organisation (WTO) Trade Related Aspects of Intellectual Property Rights (TRIPs) and the General Agreement of Trade in Services (GATS) agreements with respect to the provision and accessibility of health services in Malawi. The paper explores the manner in which Malawi's legal and institutional systems are able to ensure access to essential medicines under TRIPS and the implications of GATS for essential health care services and for meeting health obligations.
Zambia: The right to health and international trade agreements
Mabika AH, London L
This report prepared in capacity building programme analyses the relevant provisions of the World Trade Organisation (WTO) Trade Related Aspects of Intellectual Property Rights (TRIPs) and the General Agreement of Trade in Services (GATS) agreements with respect to the provision and accessibility of health services and essential medicines in Zambia.