The last 10 years have seen a resurgence in interest and research around inequalities in the health sector. While a disproportionate share of the new research has focused on measuring inequality in the health sector, work is emerging on how to understand the causes of inequality and on identifying successful approaches for tackling the problem. This book summarizes the operational lessons emerging from this new focus. It is intended to be an operational resource for change agents within and outside government in low and middle countries committed to improve access and use of critical health services to income poor and social vulnerable populations.
Have gaps in health outcomes between the poor and better off grown? Are they larger in one country than another? Are health sector subsidies more equally distributed in some countries than others? Are health care payments more progressive in one health care financing system than another? What are catastrophic payments and how can they be measured? How far do health care payments impoverish households? Answering questions such as these requires quantitative analysis. This in turn depends on a clear understanding of how to measure key variables in the analysis, such as health outcomes, health expenditures, need, and living standards. It also requires set quantitative methods for measuring inequality and inequity, progressivity, catastrophic expenditures, poverty impact, and so on. This book provides an overview of the key issues that arise in the measurement of health variables and living standards, outlines and explains essential tools and methods for distributional analysis, and, using worked examples, shows how these tools and methods can be applied in the health sector. The book seeks to provide the reader with both a solid grasp of the principles underpinning distributional analysis, while at the same time offering hands-on guidance on how to move from principles to practice.
At the start of each decade the World Development Report focuses on poverty reduction. The World Development Report, now in its twenty-third edition, proposes an empowerment-security-opportunity framework of action to reduce poverty in the first decades of the twenty-first century. It views poverty as a multidimensional phenonmenon arising out of complex interactions between assets, markets, and institutions. This Report shows how the experience of poverty reduction in the last fifteen years has been remarkably diverse and how this experience has provided useful lessons as well as warnings against simplistic universal policies and interventions. It shows how current global trends present extraordinary opportunities for poverty reduction but also cause extraordinary risks, including growing inequality, marginalization, and social explosions. The World Development Report 2000/2001 explores the challenge of managing these risks in order to make the most of the opportunities for poverty reduction.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Guangdong, a province of over 93 million residents, is located on the southern coast of China, boarding with Hong Kong, China. As China s powerhouse for economic growth and a pioneer of reform and opening up, Guangdong has maintained an annual average GDP growth rate of 13.7 percent over the past three decades. Its historical achievements notwithstanding, Guangdong witnessed increased inequality and regional disparity. To assist the authority in developing a strategy for the new phase of reforms that promotes more inclusive and sustainable growth, Reducing Inequality for Shared Growth in Guangdong Province recommends a three-pillar approach: eliminating absolute poverty, reducing inequality in opportunities, and containing inequality in outcomes. The book also proposes a range of policy actions in these three broad areas. First, to further develop the social assistance program (i.e. the minimum living allowance program ) to address the issue of absolute poverty; Second, to improve income opportunities of the rural poor by better facilitating rural labor migration to non-farming jobs and urban labor markets, deepening rural finance reform, and providing better protection of their rights over land. Third, to invest in people through more equitable access to and financing of social services such as basic education, skills development, and health care. Further reform of the intergovernmental fiscal system is essential to the success of these efforts. This report will be of interest to central and sub-national policy makers, policy implementing agencies, researchers, development partners, and others working on economic and social development in China and in other countries. Guangdong s experience will offer great value to the rest of China and to other countries that are grappling with similar development challenges.
This book provides an engaging, comprehensive review of health economics, with a focus on policy implications in the developed and developing world. Authoritative, but non-technical, it stresses the wide reach of the discipline - across nations, health systems, and areas within health and medical care.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.
Two key policy goals in the health sector are equity and financial protection. New methods, data and powerful computers have led to a surge of interest in quantitative analysis that permits monitoring progress toward these objectives, and comparisons across countries. ADePT is a new computer program that streamlines and automates such work, ensuring that results are genuinely comparable and allowing them to be produced with a minimum of programming skills. This book provides a step-by-step guide to the use of ADePT for quantitative analysis of equity and financial protection in the health sect
This book builds on the lessons of the most recent global financial crisis, especially in Europe and Central Asia and proposes a more effective role for the health sector as part of a safety net function and as a stabilizer for the population during a crisis.
