Review of the Equity Watch work in East and 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. Equity Watch presentations were delivered at the meeting for five of the countries in east, central and southern Africa included in the EQUINET network, namely Kenya, Uganda, Zambia, Zimbabwe and Mozambique. Results were mixed from the various countries, indicating success in improved aggregate health in most countries, some closing of rural-urban disparities in health, but widening social and economic inequalities in health and the social determinants of health. Delegates argued that aggregated data obscured inequities in health in the region. They identified decreases in public health spending as a major problem in giving ministries the leverage over other sources of spending on health. They also called for ‘mainstreaming’ health equity into the national and regional health agendas, as well as for the dissemination of the Equity Watch results at country and regional level to all stakeholders, identifying champions who will take Equity Watch forward, putting effective monitoring and evaluation in place to measure progress in health equity in the region, and conducting district-level analysis (so far Equity Watch analysis has been on regional and national levels only). Presentations were also given on various aspects of equity analysis, such as disaggregating health expenditure, analysing the social determinants of health equity and universal health coverage and linking equity analysis to the Millennium Development Goals.