Equity Gauge An approach to Monitoring Equity in Health and 股本规方法来监测健康公平和.pptVIP

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2018-04-13 发布于江西
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Equity Gauge An approach to Monitoring Equity in Health and 股本规方法来监测健康公平和.ppt

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Equity Gauge An approach to Monitoring Equity in Health and 股本规方法来监测健康公平和.ppt

The Equity Gauge: An approach to Monitoring Equity in Health and Health Care in Developing CountriesInternational Meeting August 17-20 What do we mean by health equity? A world in which any group of individuals defined by age, gender, race-ethnicity, class or residence can achieve its full health potential What do we mean by health equity? ‘health inclusion’: continued improvements in health for all but bringing the bottom up at the same rate or faster than the top ‘tolerable’ vs ‘intolerable’ inequalities: in the context of rapid change What are the dimensions of inequity in health? Equity strata: sex, race, ethnicity, region, education, occupation, place Dimensions of health status across which inequities exist: risk, disease, death, social consequences of illness Health care inequities: access, quality cost of treatment Health Disparities Between Selected Countries Health Status of Poor Versus Non-poor in Selected Countries (1990) Gender and Socioeconomic Inequality in CMR, Matlab 1982 Inverse Care Laws Rich consume more hospital and public health care than the poor (Hart 1971) Immunization coverage strongly correlated with socioeconomic status (Gwatkin et al. 1999) poor with illness don’t access care: 2x more likely to self treat; 10x more likely to do nothing (Uganda, HH Survey, 1994/5). poor that access health care risk medical impoverishment (Liu and Hsiao, 1997; WB, Voices of the Poor, 2000) Smoking is more common among the less educated in India(Men, Chennai) Inverse Care in Public Health Benchmarks of Fairness Evaluating fairness of health systems reform nine benchmarks covering risks to health such as education, safe water and barriers to access both financial and non-financial etc. must develop capacity to monitor health status inequities benchmark encourage “debate” on reform World Health Report 2000 Equity Gauge: South Africa Health equity explicit goal of government policy Problem: how to monitor progress? Partnership: parliamentarians,