Social determinants of health

The UN Platform on Social Determinants of Health is an informal mechanism to provide coordinated support to Member States with implementation of the Rio Political Declaration on Social Determinants of Health. The Platform also advocate s placing the social determinants of health highly on the global development agenda, and fostering coherent action on the social determinants of health. Currently, the platform involves staff from ILO, UNDP, UNFPA, UNICEF, WHO and UNAIDS.

The School of Public Health at the University of the Western Cape is a WHO Collaborating Centre, and has an international reputation as a leading research and teaching institution in Public Health. Its educational and research activities are wide-ranging, with a special focus on health systems research, primary health care, social determinants of health, priority conditions (including TB/HIV and chronic disease) and the implementation of district health systems. The School’s distance learning postgraduate programme, offered through a range of learning media, is unique in Southern Africa.

From 26-28 April 2012, EQUINET held a regional methods workshop in Cape Town, South Africa. It gathered the lead institutions of country teams in the Equity Watch work, the EQUINET steering committee, regional and international agencies and networks involved in work on health equity. The workshop aimed to: provide training on equity analysis and discuss future approaches to capacity building on equity analysis; review Equity Watch work at country level and the learning and implications from the work for future monitoring of health equity within countries; and review and discuss the draft regional Equity Watch and the follow up and dissemination.

This report was commissioned by the Regional Network for Equity in Health in East and Southern Africa (EQUINET). It highlights areas of concern for gender equity in health in East and Southern Africa (ESA), based on a review of published literature. The report provides examples of key areas of gender equity in health drawn from the literature. It raises dimensions of gender equity in health in relation to the contexts for and social determinants of health; in health outcomes; in health systems and options for acting on gender equity in health. The report does not provide a systematic analysis using household data and is not a comprehensive assessment of all dimensions of gender equity.

Convened by EQUINET, in association with the ECSA Health Community and IDRC Canada, this session presented evidence and experience from work carried out in 2010-2012 in five countries and at regional level in East and Southern Africa to assess progress in key areas of equity in health outcomes, in social determinants of health and in redistributive health systems. The
session reviewed the learning from the work, particularly in relation to monitoring policy commitments to equity in health, and discuss the opportunities and the challenges for institutionalising and using equity analysis within health policy and planning. This report summarises the presentations and issues raised at the session.

Global Health Watch 3 comprises five broad sections. The first section, entitled ‘The global political and economic architecture’, provides an analysis to locate the decisions and choices that impact on health. The second section, ‘Health systems – current issues and debates’, provides a view of current issues and debates on health systems across the world, from which it is possible to draw appropriate lessons and propose concrete actions for promoting health. The third section, ‘Beyond health care’, is a recognition that health encompasses areas beyond the provision of health care.

This report provides evidence that health inequities can and need to be addressed through a holistic approach. Health inequities, and the resulting social injustice are closely linked with other issues such as poverty, gender inequality and human rights violations which in turn, have an impact on education, transport, health, agriculture, and overall well-being. Our 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.

Since 1995, the South African Health Review (SAHR) has been an annual publication of the Health Systems Trust. Viewed as an authoritative and comprehensive publication, the SAHR provides a current and longer-term review of health policy developments and their implementation in South Africa, and monitors changes and challenges in the provision of equitable and accessible health care in the country.