Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil
Background: The importance of the social determinants of health (SDH) and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC) in Brazil and other developing countries. Objective: To evaluate...
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doaj-937c3165e8f74eae962ab3e0032e31b72020-11-24T22:11:21ZengTaylor & Francis GroupGlobal Health Action1654-98802016-02-01901910.3402/gha.v9.2904229042Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in BrazilDavide Rasella0Daiane Borges Machado1Marcelo Eduardo Pfeirrer Castellanos2Jairnilson Paim3Celia Landmann Szwarcwald4Diana Lima5Laio Magno6Leo Pedrana7Maria Guadalupe Medina8Gerson Oliveira Penna9Mauricio Lima Barreto10 Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil ICICT, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil Fundação Oswaldo Cruz (Fiocruz), Brasilia, Brazil Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, BrazilBackground: The importance of the social determinants of health (SDH) and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC) in Brazil and other developing countries. Objective: To evaluate a set of proposed indicators of SDH and barriers to the access and utilization of healthcare – proposed by the SDH unit of the World Health Organization – with respect to their relevance in tracking progress in moving toward equitable population health and UHC in Brazil. Design: This study had a mixed methodology, combining a quantitative analysis of secondary data from governmental sources with a qualitative study comprising two focus group discussions and six key informant interviews. The set of indicators tested covered a broad range of dimensions classified by three different domains: environment quality; accountability and inclusion; and livelihood and skills. Indicators were stratified according to income quintiles, urbanization, race, and geographical region. Results: Overall, the indicators were adequate for tracking progress in terms of the SDH, equity, gender, and human rights in Brazil. Stratifications showed inequalities. The qualitative analysis revealed that many of the indicators were well known and already used by policymakers and health sector managers, whereas others were considered less useful in the Brazilian context. Conclusions: Monitoring and evaluation practices have been developed in Brazil, and the set of indicators assessed in this study could further improve these practices, especially from a health equity perspective. Socioeconomic inequalities have been reduced in Brazil in the last decade, but there is still much work to be done in relation to addressing the SDH.http://www.globalhealthaction.net/index.php/gha/article/view/29042/pdf_241monitoringsocial determinants of healthinequalityequityuniversal healthcare coverage |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Davide Rasella Daiane Borges Machado Marcelo Eduardo Pfeirrer Castellanos Jairnilson Paim Celia Landmann Szwarcwald Diana Lima Laio Magno Leo Pedrana Maria Guadalupe Medina Gerson Oliveira Penna Mauricio Lima Barreto |
spellingShingle |
Davide Rasella Daiane Borges Machado Marcelo Eduardo Pfeirrer Castellanos Jairnilson Paim Celia Landmann Szwarcwald Diana Lima Laio Magno Leo Pedrana Maria Guadalupe Medina Gerson Oliveira Penna Mauricio Lima Barreto Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil Global Health Action monitoring social determinants of health inequality equity universal healthcare coverage |
author_facet |
Davide Rasella Daiane Borges Machado Marcelo Eduardo Pfeirrer Castellanos Jairnilson Paim Celia Landmann Szwarcwald Diana Lima Laio Magno Leo Pedrana Maria Guadalupe Medina Gerson Oliveira Penna Mauricio Lima Barreto |
author_sort |
Davide Rasella |
title |
Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil |
title_short |
Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil |
title_full |
Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil |
title_fullStr |
Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil |
title_full_unstemmed |
Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil |
title_sort |
assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in brazil |
publisher |
Taylor & Francis Group |
series |
Global Health Action |
issn |
1654-9880 |
publishDate |
2016-02-01 |
description |
Background: The importance of the social determinants of health (SDH) and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC) in Brazil and other developing countries. Objective: To evaluate a set of proposed indicators of SDH and barriers to the access and utilization of healthcare – proposed by the SDH unit of the World Health Organization – with respect to their relevance in tracking progress in moving toward equitable population health and UHC in Brazil. Design: This study had a mixed methodology, combining a quantitative analysis of secondary data from governmental sources with a qualitative study comprising two focus group discussions and six key informant interviews. The set of indicators tested covered a broad range of dimensions classified by three different domains: environment quality; accountability and inclusion; and livelihood and skills. Indicators were stratified according to income quintiles, urbanization, race, and geographical region. Results: Overall, the indicators were adequate for tracking progress in terms of the SDH, equity, gender, and human rights in Brazil. Stratifications showed inequalities. The qualitative analysis revealed that many of the indicators were well known and already used by policymakers and health sector managers, whereas others were considered less useful in the Brazilian context. Conclusions: Monitoring and evaluation practices have been developed in Brazil, and the set of indicators assessed in this study could further improve these practices, especially from a health equity perspective. Socioeconomic inequalities have been reduced in Brazil in the last decade, but there is still much work to be done in relation to addressing the SDH. |
topic |
monitoring social determinants of health inequality equity universal healthcare coverage |
url |
http://www.globalhealthaction.net/index.php/gha/article/view/29042/pdf_241 |
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