Equitable Access to Health Care and Infectious Disease Control - Concepts, Measurement and Interventions
Report of an International Symposium, held 13–15 February 2006 in Rio de Janeiro, Brazil, hosted by the Oswaldo Cruz Foundation (FIOCRUZ) and co-organized with the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), the World Health Organization (WHO) and the United Nations Research Institute for Social Development (UNRISD). Published in the Conference News No 19 of the United Nations Research Institute for Social Development (UNRISD) (www.unrisd.org)
Summary
Access to quality health care and disease control tools such as drugs, vaccines and diagnostics is a crucial determinant of population health and an essential component of strategies designed to reach the Millennium Development Goals. The United Nations and its various technical agencies and programmes therefore play a critical role in advancing the agenda to improve access to health care.
While there is general agreement that more equitable access to life-saving technologies must be improved, there is an ongoing debate over the best means of enhancing such access and, at a more basic level, a lack of consensus on the definition of what access actually means and how it ought to be measured. It can be argued that this lack of consensus on the definition and operationalization of the concept has hampered progress in generating and applying knowledge to identify and strengthen pathways between access and health outcomes, especially in low-income countries.
This symposium, which took place on 13–15 February 2006 in Rio de Janeiro, Brazil, brought together 31 international experts who work on different dimensions of access and who represent different organizations and distinct perspectives on this topic. The Oswaldo Cruz Foundation (FIOCRUZ) organized the symposium, in collaboration with the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), the World Health Organization (WHO) and the United Nations Research Institute for Social Development (UNRISD). The symposium was financially supported by the TDR Programme
The objective of the symposium was to stimulate critical debate on current concepts and measurement tools related to access to health care, its relationship to social determinants of health, and the focus on pro-poor programmes. To this end, sessions were devoted to reviewing approaches, definitions and measurements of access in relation to various dimensions of health care; discussing the relationship between access to health care and social determinants of health; reviewing operational approaches for measuring and improving inequities in access; summarizing existing approaches within the United Nations (UN) system to the construction of indicators and measurement tools around access; highlighting the critical role of research on access to health care for reaching the Millennium Development Goals; and identifying research gaps from a social science research perspective.