Equity Research

Comprising an interdisciplinary team of medical doctors, social epidemiologists, anthropologists and sociologists, the ASSET Equity Work Package (WP) explores how an multi-dimensional and intersectoral conception of health equity may be brought to bear on the health system strengthening (HSS) agenda. Whereas the pursuit of health equity is foundational to the global health enterprise, it remains far from clear how such concerns can or should translate into global health policies, programmes and practices, including those aimed at strengthening health systems (Braveman et al. 2017; McCartney et al. 2019; Orkin et al. 2019). In collaboration with ASSET’s in-country research teams, the Equity Work Package combines conceptual and empirical investigations into ways that a broadened health equity lens may ground HSS efforts.

One particular focus of our work is on exploring the role of health workers as a key pillars of countries’ health systems and important levers in the strive towards health equity. In collaboration with ASSET WP 6 (‘Maternal Mental Health and Violence against Women in South Africa’), we explore the impacts of task shifting interventions on health workers themselves, as well as on the link between health workers’ own well-being and satisfaction and the delivery of high-quality and equitable care.

We also work with WP7 (‘Surgical Care in Sierra Leone’) to investigate some of the ‘systemic’ inequities that prevent equitable surgical care provision. Here our focus is on how the ambiguous nature of existing fee exemption categories and the prevalence of informal payments structure both patients’ ability to receive and providers’ ability to deliver appropriate, equitable care.

References

Braveman, P., Arkin, E., Orleans, T., Proctor, D., and Plough, D. (2017) What Is Health Equity? And What Difference Does a Definition Make? Princeton, N.J: Robert Wood Johnson Foundation.

McCartney, G., Popham, F., McMaster, R., and Cumbers, A. (2019) “Defining Health and Health Inequalities.” Public Health 172 (May): 22–30.

Orkin, A.M., McArthur, A., McDonald, A., Mew, E.J., Martiniuk, A., Buchman, D.Z., Kouyoumdjian, F., Rachlis, B., Strike, C., and Upshur, R. (2018) “Defining and Measuring Health Equity Effects in Research on Task Shifting Interventions in High-Income Countries: A Systematic Review Protocol.” BMJ Open 8 (7).