St.

Paul's Hospital Millennium Medical College, department of public health Masters

in General Epidemiology Weekend Epidemiology Program

Health Service Management Group Assignment on

Health Equity
Group Members
1. Abowak Ulfata ID No: GSW/001/15
2. Akele Kubi ID No: GSW/002/15
3. Awole Adeba No: GSW/002/15
4. Mebratu Tareke No: GSW/025/15
5. Mohamed Fufa No: GSW/002/15
6. Muluken Desalegn No: GSW/002/15
7. Yain Desalegn No: GSW/002/15
Date of Submission March/2023
Health Equity

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 CONTENT
• Introduction
• Global & Country context of Health Equity
• List Health Equity Stratifies
• Core interventions to address Health inequity
• Conclusion
• Recommendation
What is health?
“Health is a state of complete
physical, social and mental well-
being, and not merely the absence
of disease or infirmity.”
World Health Organization 1948
Public Health
“Public health is what we, as a
society, do collectively to assure the
conditions in which (all) people can
be healthy.”
Institute of Medicine (1988), Future of Public Health
Factors that determine health

Tarlov AR. Public policy frameworks for improving population health.

Ann N Y Acad Sci 1999; 896: 281-93.
 Introduction
Health Equity
World Health Organization define health equity as “the absence of avoidable, unfair, or
remediable differences among groups of people, whether those groups are defined:

• Socially,
• Economically,
• Demographically,
• Geographically, special need population group or by other means of stratification” such
as disability status.

• The term health equity implies that every person no matter their status:-
• should have a fair and
• equal opportunity to attain their full health potential

(WHO, 2021) 7
Introduction…conti..
• It is not equity to simply provide every individual with the same
resources;
• if one population dies younger than another because of genetic
differences, a non-remediable/controllable factor, -health inequality.
• lower life expectancy due to lack of access to medications, the situation
would be classified as a health inequity.
• in order to achieve health equity, resources must be allocated based on
an individual need-based principle.

(Kawachi I, etc(September 2002). "A glossary for health inequalities")

Graphic Depicting Equality and Equity
 Historical perspective, Health Equity
05
2015 -2030 SDG
2000 E.C – 2015 MDG
04

1978, Primary Health Care in

Alma-Ata 03

The launch of “Health for All” campaign ,

implicitly made health equity a priority for

all countries
1948
02
United Nations adopted the Universal Declaration of
1946 Human Rights (UDHR)
1946 WHO Constitution stated …

“The highest standards of health should
be within reach of all…without
distinction of race, religion,
and political belief, economic or social
condition””
“everyone has the right to a standard of living adequate
for the health and well-being of himself and of his
01 family”
Global & Country context of Health Equity

• Globally, so many articles, even most developed countries have base

line health equity data
• Health Equity hottest research area
• Health equity are determined by the conditions in which people are
born, grow, live, work, play and age, as well as biological
determinants.
• Progressively realizing the right to health means systematically
identifying and eliminating inequities resulting from differences in
health and in overall living conditions.
 WHO, Commission on social determinants of health
In 2005, picked on the below focus areas:-
• Improve daily living conditions,

• Tackle inequality in the distribution of resources and power,

• Understand and measure the extent of health inequity and take action

In turning to policy action on SDH inequities, Three broad approaches to reducing health inequities

identified:-
(1) Targeted programmes for disadvantaged populations

(2) Closing health gaps between worse-off and better-off groups and

(3) Addressing the social health gradient across the whole population
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(WHO 2021)
Country context
to address
Health Equity

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 Cont…
Although Ethiopia’s health care is grounded in equity principles and health
outcomes have shown considerable improvements during the past 20 years,
substantial challenges persist.

Indeed, though equal access to essential health services for those in equal

need has been largely ensured, equal utilization of health care for them and
equal health outcomes have not been attained yet.

(Kawachi et al., 2002).

Country context

• Health is Human & Constitutional right

• HSTP I, Equity is one of the transformation agenda

• Equity Plan of Action (2016-2020) developed & implemented in four

developing regions & 7 low performing regions due to resource shortage
• During HSTP II, Equity continues as one of the transformation agenda

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Country context (2)

• National Health Equity Strategy(NHES) will cover all regions and city administration

• Considers major health inequity stratifiers

• Geography
• Demographic profile
• Gender Disparity
• Socio Economic Disparity
• People with Special needs

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Country context (3)

NHES is committed to working across three broad dimensions of health equity in Ethiopia:

• Access to healthcare

• Uptake of healthcare service

• Difference in health status (or outcomes)

(FMoH, 2015).

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 Health Equity Stratifiers
Geography Disparity
Demographic Disparity
Gender Disparity
Socio Economic Disparity
People with special needs

(Goldberg J, etc(November 2004). Understanding Health Disparities.)

interventions to address Health inequity

I Geographic Disparities

Improve accessibility of essential health service

Promoting healthy lifestyle

Healthy City Programme
Demographic Disparities

Implement RH strategy

Adolescent and youth health strategy
1. prove accessibility of essential health service
interventions to address Health inequity

IDisparity due to Socio economic status

Community Based Health Insurance
Implement Family health team in urban setting
Improve household income level through multi sectoral approach
eGender disparities
 Empowering women to leadership
 legislation that promotes gender equity and avoids discrimination
 Increase investment in reproductive health services and programmes
Conclusion Recommendation

• Conclusion
H. equity studies in Ethiopia, had limited scopes and had tended to focus on
only a few health indicators
narrow view of health inequalities that may underestimate overall health
inequality.
we do not have base line health equity data

• Recommendation;
 to MOH & EPHI; base line National health equity survey
Stronger implementation National Health Equity Strategic Plan
Thank You.

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