Social determinants approaches to public health: from concept to practice
A new publication from the World Health Organization explores methods of addressing the social factors that impact public health, and the challenges that arise during implementation of such programmes. The book features 13 case studies from public health programmes in widely varied settings, ranging from menstrual regulation in Bangladesh and suicide prevention in Canada to malaria control in Tanzania and prevention of chronic noncommunicable diseases in Vanuatu.
The book, entitled Social determinants approaches to public health: from concept to practice, looks at efforts to address the social determinants of health and equity in large-scale public health programmes, and the challenges that arise during implementation. Addressing the social determinants of health and equity in large-scale public health programmes, including infectious disease control efforts, is challenging and research on the implementation of such programmes is scarce. Four case studies of the case studies, which were funded and overseen by TDR, present experiences with different programmes targeting infectious diseases in Tanzania, South Africa, Nigeria and Indonesia. The primary objective of undertaking these case studies was to review their implementation processes and to draw lessons that can be learned by others embarking on the difficult path to correct inequities in health by addressing the social determinants.
The case studies focused on the five types of implementation: going to scale, managing policy change, managing intersectoral processes, adjusting design, and ensuring sustainability. Among the key messages emerging from the study: the importance of evidence and establishing baseline data; that in the long haul, the battle for equity takes place in the public space through intelligent use of the evidence and partners; and finally, that scale-up should consider three phases – providing proof of principle, testing the scalability of the programme with particular focus on the drivers of expansion and how to transfer the values torch, and roll-out with systematic monitoring, repeated evaluation and timely adjustments to the programme.
The case studies were commissioned by the TDR coordinated research node of the Knowledge Network on Priority Public Health Conditions (PPHC-KN), a WHO-based inter-departmental working group associated with the WHO Commission on Social Determinants of Health, which published its report in 2008. The case study project was overseen and managed by the WHO Department of Ethics, Equity, Trade and Human Rights (ETH) of the World Health Organization, in collaboration with the Special Programme for Research and Training in Tropical Diseases (TDR), the Special Programme of Research, Development and Research Training in Human Reproduction (HRP), and the Alliance for Health Policy and Systems Research (AHPSR).
The publication was edited by Erik Blas, TDR's former Programme Manager, TDR staff Johannes Sommerfeld and Anand Sivasankara Kurup of WHO's Department for Ethics, Equity, Trade and Human Rights complements an earlier monograph originating from the WHO-based Knowledge Network on Priority Public Health Conditions entitled Equity, social determinants and public health programmes. This publication was featured by TDR in 2010.
For more information, contact Dr Johannes Sommerfeld