Conceptualizing and researching health equity in Africa through a political economy of health lens – Rwanda in perspective

Research on promoting health equity by reducing health inequalities in Africa presents an emerging research frontier. Concepts from the political economy of health literature such as decommodification, stratification, class mobilization, and the relative responsibility ascribed to the state, marketplace, and family in defining the quality and distribution of economic and social resources, i.e., the social determinants of health, have relevance for the African health scene. We use Rwanda as an example to show how these considerations can inform research and policy action to promote health equity in Africa. Based on evidence of Rwanda’s generally better health and narrower health inequalities than other sub-Saharan African nations, we explore some of the political, economic, and social forces promoting health equity in Rwanda. We conclude that Rwandan actions are consistent with movement towards a welfare state that acts in the service of promoting health equity.