[EQ] Attacking Inequality in the Health Sector - A Synthesis of Evidence and Tools

de: Ruggiero, Mrs. Ana Lucia (WDC) - ruglucia@paho.org
para: EQUIDAD@listserv.paho.org
fecha: 26 de junio de 2009 08:36
asunto: [EQ] Attacking Inequality in the Health Sector - A Synthesis of Evidence and Tools

Attacking Inequality in the Health Sector - A Synthesis of Evidence and Tools



Abdo S. Yazbeck
The International Bank for Reconstruction and Development / The World Bank – 2009



Available online as PDF file [336p.] at:
http://siteresources.worldbank.org/INTPAH/Resources/Publications/YazbeckAttackingInequality.pdf



“……The overwhelming evidence of inequalities in health outcomes and in the use of health services calculated and disseminated by the World Bank and other development agencies in the last 10 years has energized global efforts to address the needs of the poor and socially vulnerable. These efforts have led to a renewed interest at the global and national levels in both understanding the causes of health sector inequalities and developing policies to tackle them. It is time to synthesize the new knowledge being generated from research and experimentation on addressing inequality.

The main purpose of this book is to make available the accumulated knowledge of successful policy and analytical tools in this fight to reverse the vicious circle of income-poverty and ill health. The book presents both a practical set of analytical tools for understanding the causes of inequality in the use of health services and a menu of proven pro-poor policy actions. It is based on the evaluation of 14 successful policy changes in low- and middle-income countries in Africa, Asia, and Latin America, and a review of the published literature on inequality in the health sector.

As this book shows, however, policy answers are neither easy nor uniform. We now have ample evidence about the levels of inequality in more than 50 low- and middle-income countries. We know which outcomes and which services show the highest levels of inequality. We have proven analytical tools for understanding the causes of service use inequality.

Most important, we have evaluations of experiences from countries designing and implementing pro-poor polices that are having measurable success. This book puts all this knowledge in one place. The next challenge is turning this knowledge into further action in the global effort to reduce poverty….”



Content:
1. An Unacceptable Reality
A Light at the End of the Tunnel: A New Way to Measure Inequalities
Not a Pretty Picture
Health Sector May Exacerbate Inequality
The Misallocation of Public Spending on Health
Presenting Inequality Data
Annex 1.1 Asset Index as a Measure of Relative Wealth
Annex 1.2 Health, Nutrition, and Population Inequality Data
Annex 1.3 Benefit Incidence Analysis
Annex 1.4 Recommendations for Further Reading
Notes
2. Approaching a Complex and Persistent Problem
Pathways to Good Health
The Binding Constraints Faced by the Poor
The Blind Spots of the Health Sector
Health Sector Finance and the Poor
Moving Forward
Annex 2.1 Summary of the Multisectoral Determinants of Health
Annex 2.2 Recommendations for Further Reading
Notes
3. The Importance of “Listening”
The Views of Leaders from Low- and Middle-Income Countries
The Dilemmas Posed by the Long List of Causes
Listening Is Critical
Combining Active and Passive Listening: Immunization in India
Advanced Analytical Techniques
Eight Steps to Effective Use by the Poor
Following the Money: Tools for Analyzing the Role of Resource Allocations and Financing in Inequality
An Analytical Checklist
Annex 3.1 Data Sources and Their Limitations
Annex 3.2 Beneficiary Assessment
Annex 3.3 Recommendations for Further Reading
Notes
4. A Menu of Pro-Poor Policies
Hope
Recurring Themes
Rules of Thumb
Annex 4.1 Accountability Framework
Annex 4.2 Recommendations for Further Reading
Note
5. Brazil, Filling the Cracks in Universal Coverage


6. Cambodia: Contracting with Nongovernmental Organizations to Serve the Poor

7. Cambodia: Health Equity Fund for the Poor

8. Chile: Integrated Services Program for the Poor


9. Colombia: Expanding Health Insurance for the Poor


10. India: Community-Based Health Care Services


11. Indonesia: Health Cards for the Poor


12. Kenya: Expanding Immunization Reach through Campaigns


13. The Kyrgyz Republic: Health Financing Reform and the Poor


14. Mexico: Paying the Poor to Use Health Services


15. Mexico: Providing Subsidized Health Insurance to the Poor


16. Nepal: Participatory Planning


17. Rwanda: Community-Based Health Insurance


18. Tanzania: Social Marketing for Malaria Prevention


19 Vigilance
What to Monitor
Other Elements of Monitoring Frameworks
Annex 19.1 Recommendations for Further Reading
Note
References
Index