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Promoting health equity in conflict-affected fragile states

Author

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  • Bornemisza, Olga
  • Ranson, M. Kent
  • Poletti, Timothy M.
  • Sondorp, Egbert

Abstract

Issues around health equity in conflict-affected fragile states have received very little analysis to date. This paper examines the main factors that threaten health equity, the populations that are most vulnerable and potential strategies to improve health equity. The methods employed are a review of the published and grey literature, key informant interviews and an analysis of data on social determinants of health indicators. A new conceptual framework was developed outlining types of inequity, factors that influence equity and possible strategies to strengthen equity. Factors that affect equity include displacement, gender and financial barriers. Strategies to strengthen health equity include strengthening pro-equity policy and planning functions; building provider capacity to provide health services; and reducing access and participation barriers for excluded groups. In conclusion, conflict is a key social determinant of health. More data is needed to determine how conflict affects within-country and between-country equity, and better evaluated strategies are needed to reduce inequity.

Suggested Citation

  • Bornemisza, Olga & Ranson, M. Kent & Poletti, Timothy M. & Sondorp, Egbert, 2010. "Promoting health equity in conflict-affected fragile states," Social Science & Medicine, Elsevier, vol. 70(1), pages 80-88, January.
    • Handle: RePEc:eee:socmed:v:70:y:2010:i:1:p:80-88
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    References listed on IDEAS

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    1. Branchflower, Andrew & Hennell, Sarah & Pongracz, Sophie & Smart, Malcolm, 2004. "How Important Are Difficult Environments To Achieving The Mdgs?," PRDE Working Papers 12821, Department for International Development (DFID) (UK).
    2. repec:wbk:wbpubs:6637 is not listed on IDEAS
    3. Berry, Chris & Forder, Ali & Sultan, Sonya & Moreno-Torres, Magui, 2004. "Approaches To Improving The Delivery Of Social Services In Difficult Environments," PRDE Working Papers 12823, Department for International Development (DFID) (UK).
    4. Pia Schneider & Kara Hanson, 2006. "Horizontal equity in utilisation of care and fairness of health financing: a comparison of micro‐health insurance and user fees in Rwanda," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 19-31, January.
    5. Oecd, 2009. "Service delivery in fragile situations: Key concepts, findings and lessons," OECD Journal on Development, OECD Publishing, vol. 9(3), pages 7-60.
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