In this blog, the author comments on the May 2013 report by the United Nations High Level Panel (HLP), which is included in this newsletter. He expresses disappointment that universal health coverage (UHC) is not one of the twelve goals outlined in the report, despite overwhelming global consensus for UHC. Whilst the panel acknowledged that universal access to basic healthcare services is required to achieve desired outcomes, the author argues that without setting a target to ensure this is realised different actors will continue operating in silos and vertical interventions that can undermine the national health system. Instead the panel proposes ‘ensuring healthy lives’ as goal four. The author considers this as vague and it appears as a call to business as usual. It lacks the enthusiasm inherent in UHC. And, in many parts of the world that are in dire need of health, especially in Africa, the fourth goal resonates as maintaining status quo. Although UHC is not an end in itself, it is a means to ensure equitable access to quality health services and can guarantee the protection of the right to health and better health outcomes. The author argues that this oversight is a challenge to UHC advocates, who should represent UHC in a more ambitious way drawing lessons from proponents of gender equality. He calls on advocates to promote UHC as the appropriate overarching post 2015 health goal, using the forum of the UN Sustainable Development Goals Open Working Group.
Equity in Health
A focus on social determinants of health provides a welcome alternative to the bio-medical illness paradigm. However, the tendency to concentrate on the influence of risk factors related to living and working conditions of individuals, rather than to more broadly examine dynamics of the social processes that affect population health, has triggered critical reaction not only from the Global North but especially from voices the Global South where there is a long history of addressing questions of health equity. In this article, the authors elaborate on how focusing instead on the language of “social determination of health” has led to application of more equity-sensitive approaches to research and related policy and praxis. The authors briefly explore the epistemological and historical roots of epidemiological approaches to health and health equity that have emerged in Latin America to consider its relevance to global discourse. In this region marked by pronounced inequity, context-sensitive concepts such as “collective health” and “critical epidemiology” have been prominent, albeit with limited acknowledgement by the Global North. The authors illustrate attempts to apply a social determination approach (and the “4 S” elements of bio-Security, Sovereignty, Solidarity and Sustainability) in five projects within their research collaboration linking researchers and knowledge users in Ecuador and Canada, in diverse settings (health of healthcare workers; food systems; antibiotic resistance; vector borne disease [dengue]; and social circus with street youth). The authors argue that the language of social determinants lends itself to research that is more reductionist and beckons the development of different skills than would be applied when adopting the language of social determination. They conclude that this language leads to more direct analysis of the systemic factors that drive, promote and reinforce disparities, while at the same time directly considering the emancipatory forces capable of countering negative health impacts. It follows that “reverse innovation” must not only recognise practical solutions being developed in low and middle income countries, but must also build on the strengths of the theoretical-methodological reasoning that has emerged in the South.
Publish What You Fund is the Global Campaign for Aid Transparency, which brings together leading NGOs and NGO coalitions to draft a first set of consultation materials – the Publish What You Fund principles, which were released in July 2008. These five principles are designed to be signed by all public and private bodies engaged in funding and delivering aid: 1. Information on aid should be published proactively. 2. Everyone can request and receive information on aid processes. 3. Information on aid should be timely and accessible. 4. Information on aid should be comparable. 5. The right of access to information about aid should be promoted. The principles will be reviewed in the run-up to the Accra High Level Forum, following an initial consultation period.
A woman-focused method to prevent HIV/AIDS and other sexually transmitted infections can be available by 2007, according to a series of reports by the Rockefeller Foundation-funded Initia- tive on Microbicides. "We have the science and the road map, now we need the political will to fund this effort," said Geeta Rao Gupta, President of the International Center for Research on Women (ICRW), one of several groups participating in the Initiative.
Despite considerable progress in the past decades, societies continue to fail to meet the health care needs of women at key moments of their lives, particularly in their adolescent years and in older age. These are the key findings of this report. The World Health Organization (WHO) calls for urgent action both within the health sector and beyond to improve the health and lives of girls and women around the world, from birth to older age. The report provides the latest and most comprehensive evidence available to date on women's specific needs and health challenges over their entire life-course. It includes the latest global and regional figures on the health and leading causes of death in women from birth, through childhood, adolescence and adulthood, to older age.
Globally, 12% of women smoke, 22% in developed and 9% in developing countries, according to this article. While smoking has peaked in men and begun a slow decline, it is predicted that by 2025, 20% of women worldwide will be smokers, with so many younger women taking up the habit. Tobacco transnationals minimise the dangers of smoking in powerful advertising that goes round the globe, while health agencies and institutions strive to counter these media messages on shoestring budgets - an astounding asymmetry that endangers the health of millions, the author notes. The author argues that we have to go beyond banning tobacco advertising and ‘demarket’ smoking and counter the positive images that permeate our culture with more sophisticated presentations of the threat to health. Stakeholders also need to create more barriers to tobacco access - in addition to those already banning sales to youngsters and raising cigarette prices - aligning education and legislation for greater effect. And finally, policy makers need to understand more fully the forces that influence people - particularly young women - to start smoking. It is not enough to simply warn people of the dangers of smoking, the article concludes – stronger measures are needed.
According to this editorial from the Bulletin of the World Health Organisation, most of the literature on gender differences in smoking has focused on differences in traditional sex roles. These roles have translated historically into social norms, such as disapproval of female smoking, and gender-specific personal characteristics, such as greater rebelliousness among men, which is linked to higher smoking rates. However, countries can vary widely in their actual experience with the smoking epidemic. For example, smoking levels among Chinese women have always been low and even dropped during the 20th century. In the 21st century, the situation is changing, the author argues, noting that social norms that slowed the diffusion of smoking among women are diminishing in most parts of the developing world, an unintended consequence of gender empowerment and economic growth, which allow women to freely make choices and furnish them with the economic resources to pursue those choices. A clue to the changing demographics of smokers is found in the narrowing gender gap in the rates of smoking experimentation and adoption among teenagers around the world. The author call for more research on how women view triggers that could lead to smoking adoption, such as peer pressure and role models, how addiction develops in female smokers, and how they weigh the costs and benefits of smoking.
About 3,500 advocates, policymakers, development leaders, health care professionals, youth advocates, celebrities and media personnel from 140 countries attended the 2010 Women Deliver Conference, held from 7–9 June in Washington, DC, United States. The conference challenged the international community to dramatically reduce maternal and child mortality by committing US$12 billion in aid. Three messages emerged from the conference. First, maternal and newborn mortality rates are dropping, but the work is far from done. Second, investing in girls and women is not only the right thing to do, but it makes economic sense. Third, although solutions exist to achieve Millennium Development Goal 5, which aims to reduce maternal and infant mortality, what is lacking are the requisite political will and the equitable allocation of resources.
A significant number of displaced women in South Darfur, western Sudan, suffer from depression and experience suicidal thoughts because of largely unaddressed mental-health problems, according to a study by the International Medical Corps (IMC).
Women who suffer physical abuse from intimate partners - the most common form of violence perpetrated against women worldwide - experience serious health consequences, according to a report released in November by the World Health Organization, the AP/Boston Globe reports. The survey of 24,000 women in 10 countries found that women who suffer domestic abuse were twice as likely as other women to suffer health problems, including pain, dizziness, gynecological and mental health problems, which persist after the abuse has stopped, the report says.