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Child health inequities in developing countries: differences across urban and rural areas
Authors:Jean-Christophe Fotso
Affiliation:1. Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, Ontario, K1N 6N5, Canada
2. Ottawa Health ResearchInstitute, Ottawa, Canada
3. Community Interventions and Epidemiological Technologies (CIET Canada), Ottawa, Canada
4. International Development Research Centre, Ottawa, Canada
5. Canadian Society for International Health, Ottawa, Canada
6. VU University Medical Centre, Amsterdam, The Netherlands
7. Department of Epidemiology and CommunityMedicine, University of Ottawa, Ottawa, Canada
Abstract:

Background

The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities.

Methods

This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002.

Results

Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators.

Conclusion

Evidence-based planning tools have much to offer the goal of equitable health development.
Keywords:
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