Submission ID 130686
| Issue/Objective | Issue: Health inequities refer to differences in health that are not only avoidable and preventable, but also rooted in injustice. However, health inequities cannot be addressed by the health sector alone, given that many of the root causes of ill health lie outside the health sector. This study aims to deepen our understanding of how intersectoral and multisectoral approaches are being applied in practice to advance health equity, with a focus on the African Region (as defined by the World Health Organization). |
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| Methodology/Approach | Methods: An 18-item survey was developed and administered to directors of policy and planning within national Ministries and Departments of Health, as well as those in related positions, to gather their perspectives on multisectoral policy and how health equity is implemented in practice. |
| Results | Results: There were 42 respondents, with one respondent who did not fully complete the survey, resulting in a response rate of 16.5%. Respondents were from 18 of the 47 countries within the African Region. We found that health equity was the underlying rationale for undertaking multisectoral action. Although a wide diversity of intersectoral and multisectoral action is being undertaken, it was evident that such action was integrated in developing policies, financing of health systems, gathering evidence, and program development and implementation. Implementation challenges stemmed from structural and political barriers, such as shifting actors, inconsistent financing, and uneven levels of engagement. Discussion: Health equity was integrated across the full policy cycle of multisectoral collaboration, from inclusive dialogue and planning to implementation and monitoring. Nonetheless, how health equity is integrated into intersectoral and multisectoral governance was uneven. Although some described concrete practices, others questioned whether health equity is consistently prioritized in implementation, and some characterized efforts as fragmented or siloed. Overall, health equity was most often operationalized through identifying and targeting vulnerable groups, rather than tackling structural drivers of health inequity. |
| Discussion/Conclusion | Conclusion: Among senior policymakers in the African Region, intersectoral and multisectoral action is widely viewed as essential for tackling health inequities, and health equity remains a legitimate political and normative rationale for collaboration. However, multisectoral efforts appear more developed when aimed at coordination, planning, and expanding service access, but appear inadequate when they require sustained, whole-of-government action on structural determinants of health inequity. |
| Presenters and Affiliations | Michelle Amri University of British Columbia Elizabeth Huang Independent researcher Anna Socha Independent researcher Aaron Koay Institute for Global Health, University College London |
