Health system resilience and capacity for emergency risk management are critical to effective disaster management supporting sustainability goals. That is one of the key messages emerging from this paper by the World Health Organisation (WHO). WHO also found that monitoring and reporting on the human health aspects of disasters are important for strengthening disaster risk management, and should be included in government measures to improve risk assessment, prevention, preparedness response and recovery from disasters. This will help reduce health impacts, particularly the loss of human lives, WHO argues. Building health system resilience and capacity for emergency risk management, particularly at a community level, is also critical to effective disaster management, which also supports wider sustainability objectives. Indicators of health system resilience to natural disasters include the proportion of health facilities, new and improved, to withstand hazards, including access to reliable clean energy and water supplies, daily and in emergencies.
Monitoring equity and research policy
Many food-related diseases and conditions – including undernutrition, micronutrient deficiency, and obesity as well as food safety risks and farmworker health – are interlinked, according to this report. Sustainable food policies that place the promotion and protection of health at the core of strategies from the farm field to the dinner plate can help advance the provision of sustainable, quality foods for all, across the supply chain and the human life-cycle, the World Health Organisation (WHO) argues. WHO offers three health indicators that can be used to monitor progress. 1. Health outcomes: prevalence of anaemia in women of reproductive age; prevalence of stunting in children under 5 years; and prevalence of obesity in children under five and in adults. 2. Food access and dietary quality in association with sustainable foods production: adequate access to protein supply; excessive adult saturated fat consumption; household dietary diversity; and prevalence/incidence of foodborne disease outbreaks. 3. Food market/trade policies supporting health and sustainability: foods that comply with international food safety standards, including hormone, pesticides and antibiotic residues; number of countries that have phased out use of antibiotics as growth promoters; and assessment of health and sustainability impacts in agricultural trade negotiations, policies and plans.
Increased urbanisation means there are an estimated 800 million slum-dwellers globally, according to World Health Organisation (WHO), who face increased health hazards and risks. Health is an important benchmark of sustainability of urban policies, WHO argues. It proposes health indicators that reflect progress on the social equity, environment and development dimensions of sustainable cities. WHO calls for slum housing improvements that benefit health, as assessed by well-defined measures for safe, resilient, and climate-adapted structures that also have access to clean energy and basic utilities. Urban air quality must be monitored in terms of particulate pollution with respect to WHO air quality guidelines. Healthy, efficient transport in urban areas must be promoted and violence reduced in terms of intentional homicides. Governance indicators can assess how cities account for health in urban planning and building codes, and in monitoring air/water quality and sanitation risks. WHO argues that indicators should include access to urban services, which is essential to public health and sustainable cities, and suggests indicators for health care services, green spaces, fresh food markets and waste management.
Health offers a universal indicator of progress in attaining the United Nations Secretary General's goals for sustainable energy for all, argues the World Health Organisation (WHO) in this report. Citing estimates of close to 1.3 million deaths annually due to urban air pollution and 2 million death to household air pollution, WHO notes that this health burden could be avoided with more efficient, better used and better distributed energy technologies. WHO puts forward some key health-relevant indicators of progress on sustainable energy, including: household access to modern, low-emission heating/cooking technologies; energy access at community health facilities, particularly for reliable electricity; health burden from air pollution-related diseases and injuries; health equity impacts of energy policies including access by poor and vulnerable populations; clean electricity generation across the energy supply chain in terms of reduced pollution; and greater efficiencies and reliance on renewable energy sources.
In this brief prepared for Rio+20 in June 2012, the world Health Organisation (WHO) argues that a healthy workforce is a prerequisite for social and economic development, and fair terms of employment and decent working conditions are critical to the health of the working-age population. Yet global occupational health statistics from 2011 reveal that an estimated 2.3 million people died from work related injuries, illnesses, and accidents. WHO calls for more systematic measurement and reporting of workers' health to help reduce work-related injuries, illnesses and deaths. Compliance with basic national occupational safety and health standards, at country level and by sector, can support improved workers' health, including in the transition to a green economy. Monitoring progress on the ratification and implementation of core international labour conventions covering occupational safety and health policies and occupational health services is a third measure supporting improved workers' health and safety.
Measurement of access to safe and climate resilient drinking-water resources, as well as sanitation, is increasingly critical in an era of continued population growth and climate change. Therefore ensuring access to safe, resilient and sustainable water and sanitation will accelerate attainment of multiple environment and health-related goals for sustainable development, according to this brief by the world Health Organisation. Indicators of access to safe drinking water require greater refinement to reflect the large, continuing gaps in access to safe drinking water among the world's poorest populations, and measure progress towards attainment of the universal right to water. Monitoring access to adequate climate-resilient water and sanitation systems is particularly critical in light of the increasing impacts of temperature change and extreme weather on water sources, sanitation systems and human health. WHO calls on public health agencies to embrace Integrated Water Resource Management, an approach that provides a comprehensive and multisectoral approach for the identification and management of water-related health risks.
This paper uses available data to describe health inequalities experienced by diverse Aboriginal peoples in Canada. Its method is useful for those working on indigenous people's health in other regions. The data are organized around social determinants of health across the life course and provide evidence that not only demonstrates important health disparities within Aboriginal groups and compared to non-Aboriginal people, but also links social determinants, at proximal, intermediate and distal levels, to health inequalities. The Integrated Life Course and Social Determinants Model of Aboriginal Health is introduced as a promising conceptual framework for understanding the relationships between social determinants and various health dimensions, as well as examining potential trajectories of health across the life course. Data from diverse and often limited literature is provided to support claims made by the authors of this paper and others about health disparities among Aboriginal peoples and the degree to which inequalities in the social determinants of health act as barriers to addressing health disparities.
In this study, the authors outline some of the challenges faced when carrying out a financing incidence analysis (FIA) in Ghana, Tanzania and South Africa and illustrate how innovative techniques were used to overcome data weaknesses in these settings. They conducted a FIA for tax, insurance and out-of-pocket payments, drawing data from the Living Standards Measurement Surveys (LSMSs) and household surveys conducted in each of the countries. They found that LSMSs are likely to underestimate financial contributions to health care by individuals. For tax incidence analysis, reported income tax payments from secondary sources were severely under-reported. Income tax payers and shareholders could not be reliably identified. The use of income or consumption expenditure to estimate income tax contributions was found to be a more reliable method of estimating income tax incidence. Assumptions regarding corporate tax incidence had a huge effect on the progressivity of corporate tax and on overall tax progressivity. In terms of policy development, the authors show how data constraints can be overcome for FIA in lower-income countries and provide recommendations for future studies.
In this study researchers aimed to identify priority policy issues in access to medicines (ATM) relevant for low- and middle-income countries, to identify research questions that would help address these policy issues, and to prioritise these research questions in a health policy and systems research (HPSR) agenda. The study involved i) country- and regional-level priority-setting exercises performed in 17 countries across five regions, with a desk review of relevant grey and published literature combined with mapping and interviews of stakeholders. A list of 18 research questions was formulated according to four ranking criteria (innovation, impact on health and health systems, equity, and lack of research). The top three research questions were: i) In risk protection schemes, which innovations and policies improve equitable access to and appropriate use of medicines, sustainability of the insurance system, and financial impact on the insured? ii) How can stakeholders use the information available in the system, e.g., price, availability, quality, utilisation, registration, procurement, in a transparent way towards improving access and use of medicines? and iii) How do policies and other interventions into private markets, such as information, subsidies, price controls, donation, regulatory mechanisms, promotion practices, etc., impact on access to and appropriate use of medicines? The HPSR agenda discussed here adopts a health systems perspective and will guide relevant, innovative research, likely to bear an impact on health, health systems and equity.
Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio.