Social determinants of health
The theme of this 13th edition of the Review, launched in December 2008, is Primary Health Care in South Africa: A review of 30 years since Alma Ata. The SAHR 2008 chapters focus on critical issues in Primary Health Care. The Review includes a national and international perspective of Primary Health Care, and focuses on areas such as policy and legislation, determinants of health, lifestyle, infectious diseases, mental health, maternal and child health, nutrition and environmental health. The SAHR reviews issues around human resources, finance, and information. It also looks at research on health systems, the role of the private and non-governmental organisations in Primary Health Care, and ends with the relevant health and related indicators chapter.
Action on the social determinants of health (SDH) is relevant for reducing health inequalities. This is particularly the case for South Africa (SA) with its very high level of income inequality and inequalities in health and health outcomes. This paper provides evidence on the key SDH for reducing health inequalities in the country using a framework initially developed by the World Health Organization.
Conceptual frameworks in a public health context shall in the best of worlds serve two equally important purposes: guide empirical work to enhance our understanding of determinants and mechanisms and guide policy-making to illuminate entry points for interventions and policies. Effects of social determinants on population health and on health inequalities are characterized by working through long causal chains of mediating factors. Many of these factors tend to cluster among individuals living in underprivileged conditions and to interact with each other. Epidemiology and biostatistics are therefore facing several new challenges of how to estimate these mechanisms.
This report examines the case for greater involvement by public health agencies in cash transfer schemes, a form of welfare assistance. It seeks to identify opportunities, obstacles and actions that might support greater involvement.
The issue arises because cash transfer schemes are an increasingly common form of welfare assistance across the world. Health gain is an explicit objective of such schemes, yet the public health community to date have largely been passive observers rather than active participants.
Health in All Policies (HiAP) is an approach to policies that systematically takes into account the health and health-system implications of decisions, seeks synergies, and avoids harmful health impacts to improve population health and health equity. It is founded on health-related rights and obligations and has great potential to improve population health and equity.
However, incorporating health into policies across sectors is often challenging and even when decisions are made, implementation may only be partial or unsustainable.
The Discussion Paper Series on Social Determinants of Health provides a forum for sharing knowledge on how to tackle the social determinants of health to improve health equity. Papers explore themes related to questions of strategy, governance, tools, and capacity building. They aim to review country experiences with an eye to understanding practice, innovations, and encouraging frank debate on the connections between health and the broader policy environment. Papers are all peer-reviewed.
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.