 |
 |
For information. Paul Paul Bywaters Emeritus Professor of Social Work Faculty of Health and Life Sciences Coventry University Priory Street Coventry CV1 5FB Tel.: 02476 795945 or 795384 ________________________________ From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Claudio Schuftan Sent: 10 March 2008 18:07 To: [log in to unmask] Subject: PHA-Exch> Constructing the evidence base on the social determinantsof health: A guide .From: Ruggiero, Mrs. Ana Lucia (WDC) <[log in to unmask]> .crossposted from: [log in to unmask] Constructing the evidence base on the social determinants of health: A guide Josiane Bonnefoy, Antony Morgan, Michael P. Kelly, Jennifer Butt, Vivian Bergman With Peter Tugwell, Vivian Robinson, Mark Exworthy, Johan Mackenbach, Jennie Popay, Catherine Pope, Thelma Narayan, Landon Myer, Sarah Simpson, Tanja Houweling, Liliana Jadue The Measurement and Evidence Knowledge Network (MEKN) of the WHO Commission on Social Determinants of Health November 2007 Available online as PDF file [337p.] at: http://whqlibdoc.who.int/hq/2007/a91145.pdf <http://whqlibdoc.who.int/hq/2007/a91145.pdf> "......This guide is designed for practitioners interested in developing and implementing policies and programmes to tackle the social determinants of health inequities. It sets out state of the art recommendations on how best to measure the social determinants of health and the most effective ways of constructing an evidence base which provides the basis for translating evidence into political action... The guide is divided into two parts: I Issues and principles II Tools and techniques..." Table of contents Introduction PART I - ISSUES AND PRINCIPLES 1 The challenge of measurement and evidence about the social determinants of health 1.1 Conceptual and theoretical issues 1.2 Eight principles for developing the evidence base 1.3 Conclusion 2 Taking an evidence based approach 2.1 Lessons from evidence based medicine 2.2 Applying the evidence based approach to the social determinants of health 2.3 Building an integrated evidence base for the social determinants of health 2.4 'Equity proofing' 2.5 Illustrative case studies 3 Gaps and gradients 3.1 The pioneering work of Antonovsky and Victora 3.2 Health gaps 3.3 Health gradients 3.4 Shape of health gradients 3.5 Illustrative case study 3.6 Remainder of this guide PART II - TOOLS AND TECHNIQUES 4 Framework for policy development, implementation, monitoring and evaluation 5 Getting social determinants on the policy agenda - understanding the policymaking process 5.1 Introduction 5.2 Understanding policy-making 5.3 SDH and the policy-making process 5.4 Policy-making in context 5.5 Models to inform policy-making 5.6 Conclusions 5.7 Illustrative case studies CONSTRUCTING THE EVIDENCE BASE ON THE SOCIAL DETERMINANTS OF HEALTH: A GUIDE 6 Getting social determinants on the policy agenda - making the case for change 7 Getting social determinants on the policy agenda - equity proofing 7.1 Equity filter/ lens 7.2 Equity audits/ health equity audits 7.3 Equity-effectiveness loop 7.4 Equity gauge 7.5 Equity-focused health impact assessment 7.6 Conclusion 7.7 Illustrative case studies 7.8 Specific tools 8 Generating evidence for policy and practice 8.1 Status of the evidence base on the social determinants of health 8.2 Getting the questions right 8.3 Achieving methodological diversity 8.4 Assessing the quality of the diverse evidence base 8.5 Conclusion 8.6 Illustrative case studies 8.7 Related reading 8.8 Specific tools 9 Evidence synthesis and action 9.1 Synthesizing complex and diverse data 9.2 Producing guidance for action 9.3 Illustrative case studies 9.4 Related reading 9.5 Specific tools 10 Effective implementation and evaluation 10.1 Health equity auditing, needs assessment and impact assessment 10.2 Organizational development and change management 10.3 Readiness for intersectoral action 10.4 Effective ways of involving local communities 10.5 Evaluation 10.6 Illustrative case studies 10.7 Related reading 10.8 Specific tools CONSTRUCTING THE EVIDENCE BASE ON THE SOCIAL DETERMINANTS OF HEALTH: A GUIDE 11 Learning from practice 12 Monitoring 12.1 Introduction 12.2 Use of data to monitor health inequities 12.3 Sources of health data 12.4 Issues in interpreting key equity stratifiers 12.5 Special issues in low and middle income countries 12.6 Special issues in high income countries 12.7 Improvements in monitoring systems 12.8 Illustrative case studies 12.9 Related reading 13 Further issues for consideration 13.1 Attribution of effects and outcomes 13.2 The challenge of policy 13.3 Hierarchies of evidence 13.4 Equity: relative or absolute? 13.5 Where further research and development is required 14 Conclusion 14.1 Social structure and the operation of the determinants of health inequities 14.2 Towards a causal hypothesis 14.3 A plea for action 15 References Appendix I - Illustrative case studies Case study 1: United Kingdom - Using evidence to inform health policy: the Acheson Inquiry Case study 2: Brazil, Peru and United Republic of Tanzania - Failure to equity proof interventions for children in low and middle income countries Case study 3: Bolivia - Evaluating Bolivia's Social Investment Fund Case study 4: Brazil - Use of survey data to determine and refine state-wide policies and programmes; persistent inequities between rich and poor Case study 5: Canada - A decade of children's policies based on evidence (1990-2001) Case study 6: Mexico - Use of evidence to reform national health system Case study 7: Thailand - Introduction of universal health coverage Case study 8: Various countries - Linking research and evidence to policy-making Case study 9: Thailand - Use of locally-defined health determinants to push for change, Mun River dam Case study 10: Brazil and Chile - Use of national conferences to bring together policy and evidence Case study 11: Uganda - Community-based monitoring and evaluation of Poverty Action Fund Case study 12: Various countries - Synthesis of qualitative studies of effectiveness of tuberculosis treatment Case study 13: Various countries - Synthesis of different types of evidence to assess the impact of school feeding Case study 14: United Kingdom - Development of evidence based guidance Case study 15: Slovenia - Health impact assessment of agriculture, food and nutrition policies. Case study 16: United Kingdom - Health impact assessment of a housing estate regeneration project Case study 17: Mexico - Use of monitoring and evaluation to continuously improve the Oportunidades programme Case study 18: Sweden - Use of evidence to develop the intersectoral National Public Health Strategy and the challenges of monitoring its implementation Case study 19: Bangladesh - Evaluating the Food for Education programme using existing data sources Case study 20: Kenya - Impact of grassroots involvement in gathering data on successful introduction of change Case study 21: The Netherlands - Introduction of a multi-level surveillance system for monitoring health inequalities Appendix II - Low and middle income countries by income group, equity and health indicators, and data sources Appendix III - Content of standard surveys Appendix IV - Recommendations from MEKN final report Appendix V - List of abbreviations. -------------------------------------------------------- NOTICE This message and any files transmitted with it is intended for the addressee only and may contain information that is confidential or privileged. Unauthorised use is strictly prohibited. If you are not the addressee, you should not read, copy, disclose or otherwise use this message, except for the purpose of delivery to the addressee. Any views or opinions expressed within this e-mail are those of the author and do not necessarily represent those of Coventry University.