[VNPH Family] PHA-Exch> Constructing the evidence base on the social determinants of health: A guide
Claudio Schuftan
.crossposted from: EQU...@listserv.paho.org
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
"……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.