Rashad Hoda, Khadr Zeinab
The Social Research Center, The American University in Cairo, Cairo, Egypt.
The Social Research Center, The American University in Cairo, Cairo, Egypt Department of Statistics, Faculty of Economics and Political Science, Cairo, Egypt.
Health Promot Int. 2014 Jun;29 Suppl 1:i68-82. doi: 10.1093/heapro/dau045.
This paper proposes measurement tracks of health equity (HE) and presents practical illustrations to influence, inform and guide the uptake of equity-sensitive policies. It discusses the basic requirements that allow the effective use of the proposed measurement tracks. Egypt is used as a demonstration of this practice. The paper differentiates between the policy needs of two groups of countries. The first set of measurement tracks are specifically tailored to countries at the early stages of considering health equity, requiring support in placing HE on the policy agenda. Key messages for this group of countries are that the policy influence of measurement can be strengthened through the implementation of four self-reinforcing tracks that recognize the need to effectively use the available current databases prior to engaging in new data collection, emphasize the importance of a social justice reframing of the documented health inequities, present health inequity facts in simple visual messages and move beyond the why to what needs to be done and how. The tracks also recognizes that placing an issue on the policy agenda is a complex matter requiring reinforcement from many actors and navigation among competing forces and policy circles. For the second group of countries the paper discusses the monitoring framework. The key messages include the importance of moving toward a more comprehensive system that sustains the monitoring system which is embedded within affective participatory accountability mechanisms. The paper discusses the basic requirements and the institutional, financial, technical and human capacity-building considerations for implementing the proposed measurement tracks.
本文提出了健康公平性(HE)的衡量路径,并给出了实际示例,以影响、告知和指导对公平性敏感政策的采用。它讨论了有效使用所提出的衡量路径的基本要求。以埃及为例展示了这种做法。本文区分了两类国家的政策需求。第一组衡量路径是专门为处于考虑健康公平性早期阶段的国家量身定制的,这些国家在将健康公平性纳入政策议程方面需要支持。针对这类国家的关键信息是,通过实施四条相互强化的路径可以增强衡量对政策的影响力,这四条路径分别是:认识到在进行新的数据收集之前有效利用现有数据库的必要性;强调从社会正义角度重新审视已记录的健康不平等现象的重要性;以简单直观的信息呈现健康不平等事实;从关注“为什么”转向关注“需要做什么”以及“如何做”。这些路径还认识到,将一个问题纳入政策议程是一件复杂的事情,需要众多行为体的支持,以及在相互竞争的力量和政策圈子之间进行权衡。对于第二类国家,本文讨论了监测框架。关键信息包括朝着一个更全面的系统发展的重要性,该系统要维持嵌入有效参与式问责机制的监测系统。本文讨论了实施所提出的衡量路径的基本要求以及机构、财政、技术和人力能力建设方面的考虑因素。