11 January 2012

Eliminating Health Inequities: every woman and every child counts

This International Federation of Red Cross and Red Crescent Societies (IFRC) report uses a human rights framework to tackle health inequities. It provides key evidence on how health inequities can and should be addressed through a holistic approach.

It argues that health inequities, and the resulting social injustice, are closely linked with poverty, gender inequality and human rights violations which in turn, have an impact on education, transport, health, agriculture, and overall well-being.

Interventions should therefore be multi-sectoral, going beyond health to address social and economic determinants – malnutrition, alcohol abuse, poor housing, indoor air pollution and poverty, among others.

There are some nice case studies from Egypt, Bangladesh, Malawi, Ecuador, Afghanistan, Cameroon, Democratic Republic of Congo, Austria, Democratic People's Republic of Korea, and Eritrea.

Click here to download the report.

Key recommendations:

Governments:   take the lead in prioritizing equity
  • Ensure universal access
    Governments should ensure universal access to evidence-based public health interventions for all and allocate health resources according to need.
  • Enable informed decision-making
    Governments should make accurate health information available to all so that everyone, particularly the most vulnerable, can make informed deci- sions about their health.
  • Take a holistic approach
    Governments should promote equality, solidarity, participation, non-discrim- ination and non-violence in all aspects of society, not just health, because tackling health inequities means tackling inequities in society in general.
  • Harness the power of a volunteer network
    Governments should make the most of Red Cross Red Crescent volunteers, who form part of the world’s largest humanitarian network, to eliminate health inequities. Volunteers are uniquely capable of reaching the most marginalized groups. Some volunteers are themselves members of these and, therefore, are an entry point for reaching those whom the formal health sector fails to reach.

National Societies:   scale up efforts
  • Reach the unreached
    Through their extensive volunteer networks, National Societies need to scale up their activities to bring prevention, treatment, care and support to those who are left out of the formal health system – the women and children who have the least access to appropriate health services. National Societies should expand their reach by encouraging health-seeking behaviours, as well as fostering social inclusion and peace.
  • Encourage prioritization and informed decision-making
    National Societies should use their status as auxiliaries to government to engage decision-makers to prioritize health equity and equity in all aspects of society and to hold authorities accountable.
  • Develop powerful partnerships
    In order to eliminate health inequities as quickly and effectively as possible, National Societies should engage in meaningful dialogue with key stakehold- ers and form strategic partnerships to increase the effectiveness of advocacy.

Donors:   create an enabling environment
  • Maintain and increase funding levels
    Given the current global economic crisis, any cuts in healthcare funding for mother-and-child programmes will have a devastating effect on the target groups – many will be exposed to even greater health risks and deeper lev- els of poverty. Peer pressure has meant that some donors have maintained their levels of funding, despite difficult economic circumstances in their own countries.
  • Align commitments with identified gaps
    Encourage skilled and adapted human resources for health, the coverage of essential mother, child and youth health interventions, and integration with other Millennium Development Goals (MDGs). Donors must ensure a well-balanced, effective and adapted response to bridge the gaps in the health of woman, child and young people.
  • Remember spending on health makes good economic and social sense
    Health spending is an investment that yields returns in individual and population health, education, and economic growth.
  • Continue to innovate in health financing
    In order to increase and improve health services in the world’s poorest countries, innovative funding mechanisms are necessary, which require the participation of a range of actors.
  • Start with the person, not the project or programme
    Investment in a comprehensive, multi-sectoral, integrated health approach is the only way forward. Standalone projects do have an impact, but the impact is limited. If a child is immunized but the mother dies in childbirth because of health service failures, the child’s welfare could hardly be con- sidered to have improved.

National Societies together with civil society:   help broker effective support
  • Become a responsible stakeholder for development
    Representatives from civil society organizations, the private sector and academia should play a greater role in helping their governments broker an international commitment that puts health inequity issues high on the development agenda. They should also ensure they commit to supporting countries in implementing effective measures to reduce the health gap, particularly for mothers and children. Civil society has a key role to play in being the voice of the voiceless.
  • Hold policy-makers to account
    Ensure that parliamentarians represent all their constituents, and take the right legislative and budgetary decisions. Ensure they hold themselves, and their executives, to account.

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