Pakistan's health policy: Appropriateness and relevance to women's health needs

The interface between national health policy and women's health needs is complex in developing countries like Pakistan. This paper aims to assess if Pakistan's national health policy 2001 is relevant and appropriate to women's health needs.Through review of existing data on women, a profile of women's health needs was developed which was transformed into framework of analysis. This framework indicates that Pakistani women's health needs are determined by gender disparities in health and health-related sectors.Comparison of national health policy with women's health needs framework reveals that although policy focuses on women's health through prioritization of gender equity, it is however addressed as an isolated theme without acknowledging the vital role gender inequalities in health and health-related sectors play in defining women's health needs. Moreover, gender equity is translated as provision of reproductive health services to married mothers, ignoring various critical overarching issues of women's life such as sexual abuse, violence, induced abortion, etc. Health systems strengthening strategies are though suggested but these fails to recognize main obstacles of utilization of healthcare services by women including non-availability of female healthcare providers and gender-based obstacles to healthcare utilization such as illiteracy, lack of empowerment to make decisions related to health, etc.In order to be relevant and appropriate to women's health needs the policy should: (1) use gender equity in health and health-related sectors as an approach to develop a healthy policy (2) expand the focus from reproductive health to life cycle approach to address all issues around women's life (3) strengthen health systems through creation of gender equity among all cadres of health providers (4) tailoring health interventions to counter gender-based obstacles to utilization of healthcare services and (5) dissemination interventions for behavior change.     

Pakistan's health policy: appropriateness and relevance to women's health needs

The interface between national health policy and women's health needs is complex in developing countries like Pakistan. This paper aims to assess if Pakistan's national health policy 2001 is relevant and appropriate to women's health needs. Through review of existing data on women, a profile of women's health needs was developed which was transformed into framework of analysis. This framework indicates that Pakistani women's health needs are determined by gender disparities in health and health-related sectors. Comparison of national health policy with women's health needs framework reveals that although policy focuses on women's health through prioritization of gender equity, it is however addressed as an isolated theme without acknowledging the vital role gender inequalities in health and health-related sectors play in defining women's health needs. Moreover, gender equity is translated as provision of reproductive health services to married mothers, ignoring various critical overarching issues of women's life such as sexual abuse, violence, induced abortion, etc. Health systems strengthening strategies are though suggested but these fails to recognize main obstacles of utilization of healthcare services by women including non-availability of female healthcare providers and gender-based obstacles to healthcare utilization such as illiteracy, lack of empowerment to make decisions related to health, etc. In order to be relevant and appropriate to women's health needs the policy should: (1) use gender equity in health and health-related sectors as an approach to develop a healthy policy (2) expand the focus from reproductive health to life cycle approach to address all issues around women's life (3) strengthen health systems through creation of gender equity among all cadres of health providers (4) tailoring health interventions to counter gender-based obstacles to utilization of healthcare services and (5) dissemination interventions for behavior change.     

Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings

Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing.     

Social capital in its place: using social theory to understand social capital and inequalities in health

Social capital has been controversially linked to public health benefits, particularly as an explanation for the relationship between economic inequalities and health. This paper focuses on social capital in this context, particularly a recent emphasis on social capital in neighbourhoods and growing use of Bourdieu's social theory in empirical investigations. A review of some of this work is used to suggest the need for a more coherent theoretical approach to using Bourdieu and to introduce an ethnographic study of social connections in New Zealand. Forty-six residents of, a rural town, a deprived city suburb, or an affluent suburb, volunteered to be interviewed about their social connections. Their talk was transcribed and analysed in terms of everyday practice. The results of this study suggest that social connections are not necessarily located in neighbourhoods, and that social capital will be better understood in a broader social context which includes competition for resources between deprived and non-deprived groups, and the practices of all citizens across neighbourhoods. When considering social capital, an exclusive focus on deprived neighbourhoods as sites for research and intervention is not helpful.     

公共卫生机构社会资本及其功能分析

作为一个概念性的工具，社会资本是一种起源于西方并与物资资本、人力资本相对应的一种新的资本形式。尽管国内外众多学者对社会资本的认识尚存诸多争议，但这并不妨碍其给行动主体所带来的经济、政治、文化和社会功能。面对旧的公共卫生服务体系已经打破而新的体系尚未健全的制度性“结”点，公共卫生机构如何应对这“转型性空白”并保持可持续发展的强劲势头，社会资本理论无疑给我们的研究开辟了一个崭新的视角。     

Social capital and health: a meta-analysis

The relationship between social capital and health has received extensive attention in fields such as public health, medicine, epidemiology, gerontology and other health-related disciplines. In contrast, the economics literature on this subject is relatively small. To address this research gap, we investigate the cross-disciplinary empirical literature using meta-analysis. We analyze 12,778 estimates from 470 studies. Our analysis finds that social capital is significantly related to a variety of positive health outcomes. However, the effect sizes are consistently very small. This finding is robust across different types of social capital (e.g., cognitive, structural, bonding, bridging, linking), and for many different measures of health outcomes (e.g., mortality, disease/illnesses, depression). The small effects that we estimate cast doubt on recent initiatives to promote health through social capital such as those by the WHO, the OECD, and US Healthy People 2020.     

Social capital and self-rated health in Argentina

The potential link between social capital and health suggests important pathways by which health may be improved. We examine this relationship using a unique data set from Argentina. This national survey allows us to determine whether the relationships between social capital and health that have been found in the US and Europe also apply to countries in South America (Argentina is the second-largest country in South America with a population of approximately 40 million). We estimate a causal effect of individual-level social capital on health using a measure of informal social interactions as our measure of social capital. Using information about access to public transportation as instrumental variables, we find that both men and women with higher levels of social capital report better health.     

Social capital: a guide to its measurement

The primary aims of this paper are to review the concept of social capital and related constructs and to provide a brief guide to their operationalization and measurement. We focus on four existing constructs: collective efficacy, psychological sense of community, neighborhood cohesion and community competence. Each of these constructs taps into slightly different, yet overlapping, aspects of social capital. The existence of several instruments to measure each of these constructs calls for further study into their use as measures of social capital. Despite differences in the approach to measurement, there is general agreement that community characteristics, such as social capital, should be distinguished from individual characteristics and measured at the community level.     

Manganese--a public health concern: its relevance for occupational health and safety policy and regulation in South Africa

Concerns about the effects of low-level manganese exposures on human health arise at a time when South Africa finds itself in competition with newcomers to the market economy, China and the CIS. This case study illustrates how decisions about occupational health and safety and the environment are influenced by incompleteness of scientific knowledge, competing interests, differences over what is fair or just, and the compartmentalization of public policy. In addition, an assessment is made of the ability of the occupational health and safety system in South Africa in its current form to address the challenges posed by manganese-related issues. The importance of tracking developments abroad, strengthening participatory processes, developing national policy, linking economic policy and OHS policy, and establishing appropriate trade agreements is stressed.     

Making sense of social capital, health and policy

This paper summarizes current knowledge about social capital and its application to health policy. There is a consensus that social capital is a characteristic of social groups, rather than individuals, and is born of shared experience which fosters mutual trust and reciprocity. It is a collective resource that may accumulate over time and facilitates the accomplishment of objectives that would otherwise be unlikely. The theoretical articulation of social capital remains under-theorized, and its measurement is subject to considerable debate. Health researchers, searching for a pathway to explain the adverse health outcomes associated with income inequality, as well as to understand the results of multi-level analyses that demonstrate an independent etiological role for community of residence, may find social capital an attractive notion. Despite professions of interest, the utility of social capital for health policy formation remains problematic; however, as a theoretical paradigm for policy it may have particular appeal to exponents of the "Third Way".     

Social capital and health promotion: a review

Interest in social capital and health has emerged at an exciting time. In public health, there is a renewed interest in mechanisms that link social inequalities and health. In epidemiology, there has been a critical interrogation of methods and a call for a more explicit use of theory. In health promotion over the last 20-30 years, social health interventions have been somewhat marginalised in an era dominated by interest in traditional cardiovascular disease risk factors. Now that social hypotheses are being reborn in health, there is a risk that the sophistication that has developed in social health promotion and the literatures that have informed it could be overlooked. In this paper, we present a brief history of social capital and how it has come into recent prominence through the debate linking income inequality and health. We present the background to this, the earlier literatures on social environmental influences on health and the possible processes thought to underlie this relationship. Social capital has relational, material and political aspects. We suggest that, although the relational properties of social capital are important (eg, trust, networks), the political aspects of social capital are perhaps under recognised. The paper also reviews how complex social processes at the community level have come to be operationalised by social theorists and intervention agents in other fields. We suggest that social capital research so far has inadequately captured the underlying constructs, in particular the qualitative difference between the macro/context level and the micro/individual level. While being cautious about the science, we conclude that social capital's power as rhetoric and as a metaphor may be of value. We conclude by suggesting that the coalescence of interests in context-level influences on health now invites a revitalisation of theories and interventions inspired by diverse fields, such as geography and ecological community psychology.     

Social capital and health promotion in Latin America

Latin America faces common development and health problems and equity and overcoming poverty are crucial in the search for comprehensive and high impact solutions. The article analyzes the definition of social capital, its relationship with health, its limitations and potentialities from a perspective of community development and health promotion in Latin America. High-priority challenges are also identified as well as possible ways to better measure and to strengthen social capital. Particularly, it is discussed how and why social capital may be critical in a global health promotion strategy, where empowerment and community participation, interdisciplinary and intersectorial work would help to achieve Public Health aims and a sustainable positive change for the global development. Also, some potential limitations of the social capital concept in the context of health promotion in Latin America are identified.     

Social capital, health, and Francophone minorities

The goal of this article is to outline the analytical perspectives of the concept of social capital regarding health and health management. Social capital, as defined in terms of social networks and resources, has a positive impact on a number of areas, notably the health, well-being, and social and economic development of communities. It is also a useful tool for implementing social policy, especially for marginal populations, the elderly, social assistance payments, etc. An action strategy based on the support and development of networks is the key to achieving the social development, health, and well-being of populations. The social ties promoted by these networks provide people with social, cognitive, and emotional support. This has a direct impact on their self-esteem and sense of personal achievement. They also facilitate access to social resources, including social advancement opportunities. In this paper, we examine the vitality, determinants of health, and health management of Canada's minority Francophone communities.     

Accountability and health systems: toward conceptual clarity and policy relevance

Improved accountability is often called for as an element in improving health system performance. At first glance, the notion of better accountability seems straightforward, but it contains a high degree of complexity. If accountability is to be more than an empty buzzword, conceptual and analytical clarity is required. This article elaborates a definition of accountability in terms of answerability and sanctions, and distinguishes three types of accountability: financial, performance and political/democratic. An analytic framework for mapping accountability is proposed that identifies linkages among health sector actors and assesses capacity to demand and supply information and exercise oversight and sanctions. The article describes three accountability purposes: reducing abuse, assuring compliance with procedures and standards, and improving performance/learning. Using an accountability lens can: (1) help to generate a system-wide perspective on health sector reform, (2) identify connections among individual improvement interventions, and (3) reveal gaps requiring policy attention. These results can enhance system performance, improve service delivery and contribute to sound policymaking.