Displaying all 14 publications

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  1. Khosla R, McCoy D, Marriot A
    Lancet, 2023 Jun 17;401(10393):2019-2021.
    PMID: 37271154 DOI: 10.1016/S0140-6736(23)01118-2
    Matched MeSH terms: Health Equity*
  2. Reidpath D, Khosla R, Gruskin S, Dakessian A, Allotey P
    BMJ Glob Health, 2023 Oct;8(10).
    PMID: 37903566 DOI: 10.1136/bmjgh-2023-013274
    Matched MeSH terms: Health Equity*
  3. Sreekumar S, Ravindran TKS
    Health Policy Plan, 2023 Sep 18;38(8):949-959.
    PMID: 37354455 DOI: 10.1093/heapol/czad041
    In 2017, the State of Kerala in India, launched the 'Aardram' mission for health. One of the aims of the mission was to enhance the primary health care (PHC) provisioning in the state through the family health centre (FHC) initiative. This was envisaged through a comprehensive PHC approach that prioritized preventive, promotive, curative, rehabilitative and palliative services, and social determinants of health. Given this backdrop, the study aimed to examine the renewed policy commitment towards comprehensive PHC and the extent to which it remains true to the globally accepted ideals of PHC. This was undertaken using a critical discourse analysis (CDA) of the policy discourse on PHC. This included examining the policy documents related to FHC and Aardram as well as the narratives of policy-level actors on PHC and innovations for them. Through CDA we examined the discursive representation of PHC and innovations for improving it at the level of local governments in the state. Though the mission envisaged a shift from the influence of market-driven ideas of health, analysis of the current policy discourse on PHC suggested otherwise. The discourse continues to carry a curative care bias within its ideas of PHC. The disproportionate emphasis on strategies for early detection, treatment and infrastructural improvements meant limited space for preventive, protective and promotive dimensions, thus digressing from the gatekeeping role of PHC. The reduced emphasis on preventive and promotive dimensions and depoliticization of social determinants of health within the PHC discourse indicates that, in the long run, the mission puts at risk its stated goals of social justice and health equity envisioned in the FHC initiative.
    Matched MeSH terms: Health Equity*
  4. Chhibber A, Kharat A, Kneale D, Welch V, Bangpan M, Chaiyakunapruk N
    BMC Public Health, 2021 Sep 16;21(1):1682.
    PMID: 34525995 DOI: 10.1186/s12889-021-11688-7
    INTRODUCTION: There is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE).

    METHODS: A systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as 'PROGRESS-Plus': Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized.

    RESULTS: This review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on "occupation" component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on "workers" such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to "worker focused" policy documents, most of the 'whole population focused' policy documents didn't have a PROGRESS-plus equity component rendering them equity limiting for the society.

    CONCLUSION: Our review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.

    Matched MeSH terms: Health Equity*
  5. Dewidar O, Kawala BA, Antequera A, Tricco AC, Tovey D, Straus S, et al.
    J Clin Epidemiol, 2022 Oct;150:142-153.
    PMID: 35863618 DOI: 10.1016/j.jclinepi.2022.07.007
    OBJECTIVES: We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews.

    STUDY DESIGN AND SETTING: This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for equity-focused systematic reviews (PRISMA-Equity) guideline. We identified Exemplar rapid reviews by searching COVID-19 databases and requesting examples from our team.

    RESULTS: We proposed the following key steps: 1. involve relevant stakeholders with lived experience in the conduct and design of the review; 2. reflect on equity, inclusion and privilege in team values and composition; 3. develop research question to assess health inequities; 4. conduct searches in relevant disciplinary databases; 5. collect data and critically appraise recruitment, retention and attrition for populations experiencing inequities; 6. analyse evidence on equity; 7. evaluate the applicability of findings to populations experiencing inequities; and 8. adhere to reporting guidelines for communicating review findings. We illustrated these methods through rapid review examples.

    CONCLUSION: Implementing this guidance could contribute to improving equity considerations in rapid reviews produced in public health emergencies, and help policymakers better understand the distributional impact of diseases on the population.

    Matched MeSH terms: Health Equity*
  6. Besar Sa'aid H, Mathew S, Richardson M, Bielecki JM, Sander B
    Syst Rev, 2020 01 08;9(1):6.
    PMID: 31915067 DOI: 10.1186/s13643-019-1257-4
    BACKGROUND: Equity in health has become an important policy agenda around the world, prompting health economists to advance methods to enable the inclusion of equity in economic evaluations. Among the methods that have been proposed to explicitly include equity are the weighting analysis, equity impact analysis, and equity trade-off analysis. This is a new development and a comprehensive overview of trends and concepts of health equity in economic evaluations is lacking. Thus, our objective is to map the current state of the literature with respect to how health equity is considered in economic evaluations of health interventions reported in the academic and gray literature.

    METHODS: We will conduct a scoping review to identify and map evidence on how health equity is considered in economic evaluations of health interventions. We will search relevant electronic, gray literature and key journals. We developed a search strategy using text words and Medical Subject Headings terms related to health equity and economic evaluations of health interventions. Articles retrieved will be uploaded to reference manager software for screening and data extraction. Two reviewers will independently screen the articles based on their titles and abstracts for inclusion, and then will independently screen a full text to ascertain final inclusion. A simple numerical count will be used to quantify the data and a content analysis will be conducted to present the narrative; that is, a thematic summary of the data collected.

    DISCUSSION: The results of this scoping review will provide a comprehensive overview of the current evidence on how health equity is considered in economic evaluations of health interventions and its research gaps. It will also provide key information to decision-makers and policy-makers to understand ways to include health equity into the prioritization of health interventions when aiming for a more equitable distribution of health resources.

    SYSTEMATIC REVIEW REGISTRATION: This protocol was registered with Open Science Framework (OSF) Registry on August 14, 2019 (https://osf.io/9my2z/registrations).

    Matched MeSH terms: Health Equity*
  7. Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G
    Bull World Health Organ, 2014 Aug 01;92(8):618-20.
    PMID: 25197149 DOI: 10.2471/BLT.13.132795
    Matched MeSH terms: Health Equity*
  8. Hosseinpoor AR, Nambiar D, Schlotheuber A, Reidpath D, Ross Z
    BMC Med Res Methodol, 2016 10 19;16(1):141.
    PMID: 27760520
    BACKGROUND: It is widely recognised that the pursuit of sustainable development cannot be accomplished without addressing inequality, or observed differences between subgroups of a population. Monitoring health inequalities allows for the identification of health topics where major group differences exist, dimensions of inequality that must be prioritised to effect improvements in multiple health domains, and also population subgroups that are multiply disadvantaged. While availability of data to monitor health inequalities is gradually improving, there is a commensurate need to increase, within countries, the technical capacity for analysis of these data and interpretation of results for decision-making. Prior efforts to build capacity have yielded demand for a toolkit with the computational ability to display disaggregated data and summary measures of inequality in an interactive and customisable fashion that would facilitate interpretation and reporting of health inequality in a given country.

    METHODS: To answer this demand, the Health Equity Assessment Toolkit (HEAT), was developed between 2014 and 2016. The software, which contains the World Health Organization's Health Equity Monitor database, allows the assessment of inequalities within a country using over 30 reproductive, maternal, newborn and child health indicators and five dimensions of inequality (economic status, education, place of residence, subnational region and child's sex, where applicable).

    RESULTS/CONCLUSION: HEAT was beta-tested in 2015 as part of ongoing capacity building workshops on health inequality monitoring. This is the first and only application of its kind; further developments are proposed to introduce an upload data feature, translate it into different languages and increase interactivity of the software. This article will present the main features and functionalities of HEAT and discuss its relevance and use for health inequality monitoring.

    Matched MeSH terms: Health Equity/standards; Health Equity/statistics & numerical data
  9. Garland SM, Stanley MA, Giuliano AR, Moscicki AB, Kaufmann A, Bhatla N, et al.
    Papillomavirus Res, 2020 Jun;9:100195.
    PMID: 32205196 DOI: 10.1016/j.pvr.2020.100195
    Matched MeSH terms: Health Equity/organization & administration; Health Equity/standards*
  10. Vijayasingham L, Govender V, Witter S, Remme M
    BMJ, 2020 10 27;371:m3384.
    PMID: 33109510 DOI: 10.1136/bmj.m3384
    Matched MeSH terms: Health Equity/economics*
  11. Ramsay R, Nashat NH, Thuraisingham C, Andrades M, Ng V, Cabezas-Escobar CE, et al.
    Educ Prim Care, 2021 01;32(1):2-5.
    PMID: 33295252 DOI: 10.1080/14739879.2020.1851147
    This article sets out to highlight the challenges and opportunities for medical education in primary care realised during the COVID-19 pandemic and now being enacted globally. The themes were originally presented during a webinar involving educationalists from around the world and are subsequently discussed by members of the WONCA working party for education. The article recognises the importance of utilising diversity, addressing inequity and responding to the priority health needs of the community through socially accountable practice. The well-being of educators and learners is identified as priority in response to the ongoing global pandemic. Finally, we imagine a new era for medical education drawing on global connection and shared resources to create a strong community of practice.
    Matched MeSH terms: Health Equity/organization & administration
  12. Thomson DR, Linard C, Vanhuysse S, Steele JE, Shimoni M, Siri J, et al.
    J Urban Health, 2019 08;96(4):514-536.
    PMID: 31214975 DOI: 10.1007/s11524-019-00363-3
    Area-level indicators of the determinants of health are vital to plan and monitor progress toward targets such as the Sustainable Development Goals (SDGs). Tools such as the Urban Health Equity Assessment and Response Tool (Urban HEART) and UN-Habitat Urban Inequities Surveys identify dozens of area-level health determinant indicators that decision-makers can use to track and attempt to address population health burdens and inequalities. However, questions remain as to how such indicators can be measured in a cost-effective way. Area-level health determinants reflect the physical, ecological, and social environments that influence health outcomes at community and societal levels, and include, among others, access to quality health facilities, safe parks, and other urban services, traffic density, level of informality, level of air pollution, degree of social exclusion, and extent of social networks. The identification and disaggregation of indicators is necessarily constrained by which datasets are available. Typically, these include household- and individual-level survey, census, administrative, and health system data. However, continued advancements in earth observation (EO), geographical information system (GIS), and mobile technologies mean that new sources of area-level health determinant indicators derived from satellite imagery, aggregated anonymized mobile phone data, and other sources are also becoming available at granular geographic scale. Not only can these data be used to directly calculate neighborhood- and city-level indicators, they can be combined with survey, census, administrative and health system data to model household- and individual-level outcomes (e.g., population density, household wealth) with tremendous detail and accuracy. WorldPop and the Demographic and Health Surveys (DHS) have already modeled dozens of household survey indicators at country or continental scales at resolutions of 1 × 1 km or even smaller. This paper aims to broaden perceptions about which types of datasets are available for health and development decision-making. For data scientists, we flag area-level indicators at city and sub-city scales identified by health decision-makers in the SDGs, Urban HEART, and other initiatives. For local health decision-makers, we summarize a menu of new datasets that can be feasibly generated from EO, mobile phone, and other spatial data-ideally to be made free and publicly available-and offer lay descriptions of some of the difficulties in generating such data products.
    Matched MeSH terms: Health Equity*
  13. Diez Roux AV, Slesinski SC, Alazraqui M, Caiaffa WT, Frenz P, Jordán Fuchs R, et al.
    Glob Chall, 2019 Apr;3(4):1800013.
    PMID: 31565372 DOI: 10.1002/gch2.201800013
    This article describes the origins and characteristics of an interdisciplinary multinational collaboration aimed at promoting and disseminating actionable evidence on the drivers of health in cities in Latin America and the Caribbean: The Network for Urban Health in Latin America and the Caribbean and the Wellcome Trust funded SALURBAL (Salud Urbana en América Latina, or Urban Health in Latin America) Project. Both initiatives have the goals of supporting urban policies that promote health and health equity in cities of the region while at the same time generating generalizable knowledge for urban areas across the globe. The processes, challenges, as well as the lessons learned to date in launching and implementing these collaborations, are described. By leveraging the unique features of the Latin American region (one of the most urbanized areas of the world with some of the most innovative urban policies), the aim is to produce generalizable knowledge about the links between urbanization, health, and environments and to identify effective ways to organize, design, and govern cities to improve health, reduce health inequalities, and maximize environmental sustainability in cities all over the world.
    Matched MeSH terms: Health Equity
  14. Thant, Z., Than, Mt, Shamsul, B.S., Wai, P.W., Htun, H.N.
    MyJurnal
    With economic growth and significant technological advances in the health sector, many countries have developed aggregate outcomes in terms of both health services and individual well-being. Life expectancy has seen a remarkable increase of more than fifty per cent between 1950 and 2009. Achievement is uneven, however, and some groups are better able to access health services than others. In our review, we explore the need and how to maximize health equity, efficiency and effectiveness. Methodology is the review and web surfing on public health, social science, humanity and development literature. The increasing gap in health inequality, however, calls for further reform of the health system to achieve both equity and efficiency. Health is essential for survival and human capability. Good health enables people to participate in society. A new approach to efficient and cost-effective health service provision is community participation in health development. Participation can increase the skills and knowledge of local people, thus providing opportunities to improve their lives (empowerment). Analysis suggests four functional changes to achieve equity and efficiency in maximizing health outputs: reforms targeting universal coverage to achieve universal access to health; people-centred service delivery through concentrating on health services based on need; public policy change targeting integrated and multi-system health planning; and collective health system and community response to achieve health for all.
    Matched MeSH terms: Health Equity
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