An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. Persons with disabilities have the right to the highest attainable standard of health as those without disabilities. However, the WHO Global report on health
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equity for persons with disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself. Countries have an obligation under international human rights law to address the health inequities faced by persons with disabilities. Furthermore, the Sustainable Development Goals and global health priorities will not progress without ensuring health for all.
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Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in th
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e development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Methods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
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An estimated 1.3 billion people globally experience significant disability. This figure has grown over the last decade and will continue to rise due to demographic and epidemiological changes. In 2022, the World Health Organization launched the Global report on health
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equity for persons with disabilities. This report demonstrated that many persons with disabilities are still being left behind. Experiencing persistent health inequities, persons with disabilities die earlier, they have poorer health and functioning, and they are more affected by health emergencies than the general population. These differences are largely associated with unjust factors both inside and beyond the health sector and are avoidable. The Global Report called upon Member States to take actions to make health sector more inclusive for persons with disabilities through the primary health care approach. This will be essential for countries to make health coverage truly universal and to progress towards other health-related targets in the sustainable development goals.
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This 400 page guide, created by PHI’s Center for Climate Change and Health and the American Public Health Association (APHA), with support from the California Department of Public Health helps local health departments prepare for and mitigate climate change effects—from drought and heat to flood
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ing and food security—with concrete, implementable suggestions.
The guide: Provides a basic summary of climate change and climate impacts on health; Prioritizes health equity, explains the disproportionate impacts of climate change on vulnerable communities, and targets solutions first to the communities where they are most needed, including low-income, elderly and people of color communities; Connects what we know about climate impacts and climate solutions with the work of local health departments; and Offers specific examples of how local health departments can address and ameliorate the impacts of climate change in every area of public health practice.
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Under the theme Equity at the Heart of Health, this Plan seeks to catalyze efforts in Member States to reduce inequities in health within and between countries and territories in order to improve health outcomes. The Plan identifies specific actions
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to tackle health inequality, including those recommended by the Commission on Equity and Health Inequalities in the Americas, with guidance from the High-level Commission for Universal Health. Four cross-cutting themes are central to this Plan’s approach to addressing the determinants of health: equity, gender, ethnicity, and human rights
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The Urban Health Equity Assessment and Response Tool (Urban HEART) is a user-friendly guide for policy- and decision-makers at national and local levels to: identify and analyse inequities in health between people living in various parts of cities,
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or belonging to different socioeconomic groups within and across cities; facilitate decisions on viable and effective strategies, interventions and actions that should be used to reduce inter- and intra-city health inequities.
Also available in French and Spanish: https://apps.who.int/iris/handle/10665/79060
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Multizentrische Analyse des Erkrankungsspektrums und der Versorgungsqualität anhand dezentralisierter Routinedaten des Verbunds PriCarenet
Health Equity Studies & Migration Report Series 2021-03
This document aims to assist countries to take the first step towards better considering gender and equity issues in their efforts to tackle antimicrobial resistance (AMR), to inform the implementation of strategies in national action plans and cont
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ribute to improved reach and effectiveness of AMR efforts in the longer term. It is part of a series of papers being developed y WHO, FAO and OIE to build a better global evidence base for implementing AMR national action plans. This version is illustrated by examples from the health sector predominantly but
will be updated with advice from the food and animal sectors in due course.
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Since 2002 the distribution of external funding to reproductive, maternal, newborn, and child health (RMNCH) has become more equitable and better targeted at the poorest countries and those experiencing the highest mortality. The aid envelope is not large enough or well enough concentrated to close
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gaps in domestic government fund ing between the poorest and middle income countries. Donors and governments of low and middle income countries should increase their investments for RMNCH . Donors should further concentrate their funds on the poorest countries and those with the highest maternal, newborn, and child mortality. Investment is also needed to close serious data and methodological gaps for assessing equity of financing between and within countries
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Charting a Path to Achieve Health Equity. The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of setting
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s and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions.
Free download available, register for free
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 109
This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and
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cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting.
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To support the achievement of health equity in the Region, the regional inter-agency movement Every Woman Every Child Latin America and the Caribbean (EWEC-LAC) advocates for and supports the use of equity
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and evidence-based policies, strategies and interventions to accelerate equitable progress in the health of women, children and adolescents. Although progress has been made, great inequities persist. Women from the LAC region’s poorest countries are almost four times more likely to die due to complications during childbirth than those living in the wealthiest countries. Through the years, several tools, instruments and methods (TIMs) have been developed by global, regional and country partners that can be used to conduct systematic equity-based analyses and/or re-designs of health systems, programs, strategies and interventions. The main purpose of this document is to present an overview of existing TIMs that can be used by policymakers, program managers, development partners, nongovernmental organizations, academia and civil society partners to strengthen systematic identification, analysis and responding to social inequities in the health of women, children and adolescents in LAC. The TIMs included were identified through a systematic search process
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The Disability inclusion guide for action supports ministries of health and their partners in both advancing health equity for persons with disabilities by identifying entry points, and planning appropriate actions that strengthen the health system
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through disability inclusion. It focuses on addressing the contributing factors which relate to the health system – namely, the attitudinal,
institutional, and physical barriers faced by persons with disabilities across all health system building blocks. Such factors include the exclusion of persons with disabilities in governance and decision-making processes in the health sector; gaps in knowledge, negative attitudes, and discriminatory practices among the health and care workforce; inaccessible physical infrastructure, health
information and communication; and a lack of information or data collection and analysis on disability in monitoring and evaluation in the health system.
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Sep 22, 2021.
In our updated analysis we find that, as of September 9, there continue to be wide disparities in access and at current rates, most low-income countries (LICs) and most countries in Africa will not reach global vaccination targets. We also find that, compared to July, the rate at whic
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h vaccination would have to increase for LICs to meet global targets is even greater now, due to more ambitious goals and continued low rates of dose administration in these countries.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP
since its introduction in Uganda’s health system,
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and findings were further validated during a oneday
national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people.
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The Health Equity Assessment Toolkit (HEAT) is a software application for use on desktop or laptop computers and mobile devices (minimum screen size of 7.9 inches recommended). It was developed to facilitate the assessment of within-country health i
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nequalities. The Built-in Database Edition, Version 1.0 is available as an online application and as a standalone version for download
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for deve
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loping EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced.
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