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9789290231660.Pdf (‎3.523Mb) Health Inequities in the African Region of the World Health Organization Magnitudes, Trends and Sources HEALTH INEQUITIES IN THE AFRICAN REGION OF THE WORLD HEALTH ORGANIZATION WORLD HEALTH ORGANIZATION Regional Office for Africa Brazzaville • 2010 HEALTH PROMOTION CLUSTER AFRO Library Cataloguing-in-Publication Data Health inequities in the African Region of the World Health Organization 1. Socioeconomic factors 2. Health status indicators 3. Health services accessibility - trends 4. Cross-cultural comparison 5. Analysis of variance 6. African Region (WHO) I. World Health Organization. Regional Office for Africa ISBN 978 929 023 1660 (NLM Classification: WA 30) © WHO Regional Office for Africa, 2010 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. Copies of this publication may be obtained from the Publication and Language Services Unit, WHO Regional Office for Africa, P.O. Box 6, Brazzaville, Republic of Congo (Tel: +47 241 39100; Fax: +47 241 39507; E-mail: [email protected]). Requests for permission to reproduce or translate this publication – whether for sale or for non-commercial distribution – should be sent to the same address. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital let- ters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization or its Regional Office for Africa be liable for damages arising from its use. Printed in India HEALTH INEQUITIES IN THE AFRICAN REGION OF THE WORLD HEALTH ORGANIZATION iii List of authors and affiliations (in alphabetical order) Dr Eyob Zere Asbu Dr Benjamin M. Nganda Health Financing and Social Protection Officer Programme Manager WHO/AFRO Intercountry Support Team/Eastern and Southern Africa Ethics, Equity, Trade and Human Rights Programme, Harare, Zimbabwe Division of Health Systems and Services Development WHO/AFRO, Brazzaville Cecilia Vidal Fuertes, MA Consultant Dr Guillermo Paraje Department of Ethics, Equity, Trade and Human Rights Professor of Economics Information, Evidence and Research Cluster School of Management WHO, Geneva Universidad Adolfo Ibañez, Chile Dr Ahmad Reza Hosseinpoor Amit Prasad, MPA Epidemiologist, Health Economist Department of Health Statistics and Informatics, Department of Ethics, Equity, Trade and Human Rights Information, Evidence and Research Cluster Information, Evidence and Research Cluster WHO, Geneva WHO, Geneva Dr Jennifer H. Lee Dr Ritu Sadana Technical Officer, Equity Analysis and Research Unit Coordinator Department of Ethics, Equity, Trade and Human Rights Equity Analysis and Research Unit Information, Evidence and Research Cluster Department of Ethics, Equity, Trade and Human Rights WHO, Geneva Information, Evidence and Research Cluster WHO, Geneva iv HEALTH INEQUITIES IN THE AFRICAN REGION OF THE WORLD HEALTH ORGANIZATION CONTENTS ABBREVIATIONS .......................................................................................................................................................................................................xiii ACKNOWLEDGEMENTS ............................................................................................................................................................................................xiv FOREWORD ............................................................................................................................................................................................................xv EXECUTIVE SUMMARY .............................................................................................................................................................................................xvii 1. INTRODUCTION .............................................................................................................................................................................................1 2. HEALTH INEQUALITIES AND INEQUITIES: CONCEPTS, DEFINITIONS AND MEASUREMENT ......................................................................4 APPROACHES AND ISSUES 2.1 Health Inequalities and Inequities: Concepts and Definitions .................................................................................................................4 2.2 The Measurement of Health Inequalities as a Proxy for Health Inequities ...............................................................................................6 2.3 Understanding What Contributes to Health Inequalities and the Associated Health Inequities ................................................................8 2.4 Health Inequities, Health Policy and Development ................................................................................................................................8 3. METHODOLOGY ...........................................................................................................................................................................................10 3.1 The Conceptual Framework .................................................................................................................................................................10 3.2 Data – Types and Sources ....................................................................................................................................................................11 3.3 Countries Covered ...............................................................................................................................................................................13 3.4 Indicators Analysed ..............................................................................................................................................................................13 3.5 The Analytical Approach ......................................................................................................................................................................15 3.6 Presentation of Country Reports ...........................................................................................................................................................18 4. COUNTRY REPORTS ON INEQUITIES AND TRENDS BASED ON THE ANALYSIS OF PUBLICLY ..................................................................19 AVAILABLE COUNTRY DHS DATA 4.1 Benin ...................................................................................................................................................................................................19 4.2 Burkina Faso ........................................................................................................................................................................................22 4.3 Cameroon ...........................................................................................................................................................................................29 4.4 Central African Republic ......................................................................................................................................................................36 4.5 Chad ...................................................................................................................................................................................................40 4.6 Comoros ..............................................................................................................................................................................................43 4.7 Congo (Republic of) .............................................................................................................................................................................46 4.8 Côte d’Ivoire ........................................................................................................................................................................................49 4.9 Ethiopia ...............................................................................................................................................................................................53 4.10 Gabon .................................................................................................................................................................................................57 4.11 Ghana .................................................................................................................................................................................................61
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