About the Network
Web Site: Health Systems Knowledge Network
Organizational Hub: Centre for Health Policy, University of Witwatersrand, South Africa.
Challenging Health Inequity through Health Systems
Author(s): Lucy Gilson, Jane Doherty, Rene Loewenson and Victoria Francis
Published: June 2007
Summary: This report introduces the concept of health systems as social determinants of health, and focuses on how national health systems can address health inequity, primarily in low and middle income countries. The report gives an overview of how health systems are implicated in both health and health equity, and describes some of the equity problems of health systems. It then discusses how inequity can be addressed in health systems through actions across multiple sectors, social empowerment, provision of universal coverage, and focusing on primary health care. Both national and international actions needed for successful health system changes are then discussed. The report includes mention of the Canadian tobacco strategy as an example of how targeted approaches can be successful in focusing efforts on specific issues and populations. The appendices include case studies from both developed and developing countries.
The Role of Civil Society in Building an Equitable Health System
Author(s): R. Vegas-Romero & M. Torres Tovar
Published: June 2007
Summary: This paper is a review of published grey literature about the contribution of civil society to the development of people-oriented systems that deliver equitable health care. The roles of civil society are examined specifically in terms of advocating, promoting and facilitating people-oriented systems, intersectoral action on the social determinants of health, and the development of equitable actions and policies. The report describes people-centred health systems and the provision of health services by civil society organizations. The report then goes on to discuss intercultural approaches to health, participation by civil society in health policy development, the governance of health systems and the importance of local-level input to reduce inequality, and the history of civil society’s participation in health care. A discussion follows of how civil society is involved in various levels of health care, from local to national. It was found that civil society organizations contribute to equitable policies and health systems by advocating against social exclusion and inequitable access to services, and by advocating for community involvement in health care decision-making. The report concludes with discourse on intersectoral action and equity in policy and action.
Crossing Sectors: Experiences in intersectoral action, public policy and health
Author(s): Public Health Agency of Canada
Published: June 2007
Summary: This report provides an overview of intersectoral action for equitable policy and health care at local, national and global levels. It is the first phase of a Canadian project to promote intersectoral health. The report seeks to identify the types of issues that can be addressed with intersectoral action; tools, mechanisms and approaches to and conditions needed for successful intersectoral action; and the roles of the health and other sectors. The report begins with an introduction to terminology. It discusses various approaches to intersectoral action for health, and many of the barriers that exist to successful intersectoral action. A number of approaches are suggested to facilitate intersectoral action. The main findings are that context is important, intersectoral action is useful for a wide variety of health sector issues, intersectoral action is dynamic and resource-intensive, and it is favoured in a more simplistic policy environment.
The experience of the USA: health inequity within a high-income setting
Author(s): Dubowitz T, Anthony R., Bird C., Cohen, D., Lurie, N.
Published: July 2007
Summary: A case study of the extensive health inequalities in one of the wealthiest nations: providing a history of health disparities in the US; an overview of race / ethnicity, gender, socioeconomic position and health; and geographic differences and the role of health. This study also takes a look at federal policy initiatives to address health disparities, reviews a number of social policies (e.g. housing and neighbourhood ‘relocation’), and explores possible future directions.
Proposed areas of investigation for the Knowledge Network: an initial scoping of the literature
Author(s): Lucy Gilson and Jane Doherty
Published: February 2006
Summary: Health Systems Knowledge Network – a framework for understanding the health system as a social determinant, building the national policy space for health policies that seek social justice, work plan for health systems.