The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries

Background: Since the publication of the reports by the Commission on Social Determinants of Health (CSDH), many research papers have documented inequities, explaining causal pathways in order to inform policy and programmatic decision-making. At the international level, the sustainable development...

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Main Authors: Erik Blas, John E. Ataguba, Tanvir M. Huda, Giang Kim Bao, Davide Rasella, Megan R. Gerecke
Format: Article
Language:English
Published: Taylor & Francis Group 2016-02-01
Series:Global Health Action
Subjects:
Online Access:http://www.globalhealthaction.net/index.php/gha/article/view/29002/pdf_240
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spelling doaj-962a50b05d644336bae08f1e28c410652020-11-24T20:57:48ZengTaylor & Francis GroupGlobal Health Action1654-98802016-02-019011410.3402/gha.v9.2900229002The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countriesErik Blas0John E. Ataguba1Tanvir M. Huda2Giang Kim Bao3Davide Rasella4Megan R. Gerecke5 International Public Health Consultant, Copenhagen, Denmark Health Economics Unit, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa School of Public Health, University of Sydney, Sydney, Australia Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam Institute of Collective Health, Federal University of Bahia, Salvador, Brazil Social Determinants of Health, World Health Organization, Geneva, SwitzerlandBackground: Since the publication of the reports by the Commission on Social Determinants of Health (CSDH), many research papers have documented inequities, explaining causal pathways in order to inform policy and programmatic decision-making. At the international level, the sustainable development goals (SDGs) reflect an attempt to bring together these themes and the complexities involved in defining a comprehensive development framework. However, to date, much less has been done to address the monitoring challenges, that is, how data generation, analysis and use are to become routine tasks. Objective: To test proposed indicators of social determinants of health (SDH), gender, equity, and human rights with respect to their relevance in tracking progress in universal health coverage and population health (level and distribution). Design: In an attempt to explore these monitoring challenges, indicators covering a wide range of social determinants were tested in four country case studies (Bangladesh, Brazil, South Africa, and Vietnam) for their technical feasibility, reliability, and validity, and their communicability and usefulness to policy-makers. Twelve thematic domains with 20 core indicators covering different aspects of equity, human rights, gender, and SDH were tested through a review of data sources, descriptive analyses, key informant interviews, and focus group discussions. To test the communicability and usefulness of the domains, domain narratives that explained the causal pathways were presented to policy-makers, managers, the media, and civil society leaders. Results: For most countries, monitoring is possible, as some data were available for most of the core indicators. However, a qualitative assessment showed that technical feasibility, reliability, and validity varied across indicators and countries. Producing understandable and useful information proved challenging, and particularly so in translating indicator definitions and data into meaningful lay and managerial narratives, and effectively communicating links to health and ways in which the information could improve decision-making. Conclusions: This exercise revealed that for monitoring to produce reliable data collection, analysis, and discourse, it will need to be adapted to each national context and institutionalised into national systems. This will require that capacities and resources for this and subsequent communication of results are increased across countries for both national and international monitoring, including the successful implementation of the SDGs.http://www.globalhealthaction.net/index.php/gha/article/view/29002/pdf_240sustainable development goalsuniversal health coverageequityhuman rightsgenderintersectoral action
collection DOAJ
language English
format Article
sources DOAJ
author Erik Blas
John E. Ataguba
Tanvir M. Huda
Giang Kim Bao
Davide Rasella
Megan R. Gerecke
spellingShingle Erik Blas
John E. Ataguba
Tanvir M. Huda
Giang Kim Bao
Davide Rasella
Megan R. Gerecke
The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries
Global Health Action
sustainable development goals
universal health coverage
equity
human rights
gender
intersectoral action
author_facet Erik Blas
John E. Ataguba
Tanvir M. Huda
Giang Kim Bao
Davide Rasella
Megan R. Gerecke
author_sort Erik Blas
title The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries
title_short The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries
title_full The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries
title_fullStr The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries
title_full_unstemmed The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries
title_sort feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries
publisher Taylor & Francis Group
series Global Health Action
issn 1654-9880
publishDate 2016-02-01
description Background: Since the publication of the reports by the Commission on Social Determinants of Health (CSDH), many research papers have documented inequities, explaining causal pathways in order to inform policy and programmatic decision-making. At the international level, the sustainable development goals (SDGs) reflect an attempt to bring together these themes and the complexities involved in defining a comprehensive development framework. However, to date, much less has been done to address the monitoring challenges, that is, how data generation, analysis and use are to become routine tasks. Objective: To test proposed indicators of social determinants of health (SDH), gender, equity, and human rights with respect to their relevance in tracking progress in universal health coverage and population health (level and distribution). Design: In an attempt to explore these monitoring challenges, indicators covering a wide range of social determinants were tested in four country case studies (Bangladesh, Brazil, South Africa, and Vietnam) for their technical feasibility, reliability, and validity, and their communicability and usefulness to policy-makers. Twelve thematic domains with 20 core indicators covering different aspects of equity, human rights, gender, and SDH were tested through a review of data sources, descriptive analyses, key informant interviews, and focus group discussions. To test the communicability and usefulness of the domains, domain narratives that explained the causal pathways were presented to policy-makers, managers, the media, and civil society leaders. Results: For most countries, monitoring is possible, as some data were available for most of the core indicators. However, a qualitative assessment showed that technical feasibility, reliability, and validity varied across indicators and countries. Producing understandable and useful information proved challenging, and particularly so in translating indicator definitions and data into meaningful lay and managerial narratives, and effectively communicating links to health and ways in which the information could improve decision-making. Conclusions: This exercise revealed that for monitoring to produce reliable data collection, analysis, and discourse, it will need to be adapted to each national context and institutionalised into national systems. This will require that capacities and resources for this and subsequent communication of results are increased across countries for both national and international monitoring, including the successful implementation of the SDGs.
topic sustainable development goals
universal health coverage
equity
human rights
gender
intersectoral action
url http://www.globalhealthaction.net/index.php/gha/article/view/29002/pdf_240
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