Within the health and
poverty framework, HDE has two important areas of work:
-
Pro-poor
health polices – the need to
ensure that health policies respond to the needs of the poor.
-
Health
and poverty reduction –
understanding the broader determinants of ill health and
promoting health as a force for poverty reduction.
Pro-poor
health policies
Poor people
overwhelmingly shoulder the burden of ill health. On every
health indicator studied by WHO, in any society, the poor fare
worse than the better off. Specifically, those living in
absolute poverty are five times more likely to die before
reaching the age of 5 years, and two-and-a-half times more
likely to die between the ages of 15 and 59 years. The poor
suffer disproportionally from HIV/AIDS, malaria, TB, diarrhoea
and other potentially deadly infections.
Yet in many countries
health sector activities and services are geared towards the
better off. The majority of health personnel work in urban
areas, while the great majority of the poor live in rural areas.
The bulk of health funding goes to expensive hospital treatment
(tertiary care), while poor people need accessible and
affordable primary health care. The allocation of health
financing also favours one-to-one medical care when poor people
benefit most from broad public health measures, such as
improving the supply of clean water and sanitation.
HDE’s
goal is to work with national and
international decision-makers to promote policies focus on the
health problems of the poor and serve the poor more effectively.
For more information on HDE’s work, see activities
Health
and Poverty reduction
Many of the causes of
ill health are beyond the control of the health sector. They
include malnutrition, dirty water, lack of sanitation, poor
shelter, sub-standard education, dangerous and unstable working
conditions, alcohol and drug abuse (which are more common among
the poor) and isolation (which makes accessing health services
difficult). Thus tackling ill health cannot be left to the
health sector alone. A broad range of actors, including
ministers from ALL sectors of government, representatives of the
private sector and civil society must be involved.
As ill health is the
result of under-development and poverty, so ‘good’ health is
increasingly recognised as a contributor to growth and
development. Healthy workers are physically and mentally more
productive, thus a goal in their own right and an incentive for
foreign investment. Better health also leads to higher
educational attainment, and in turn to a workforce with higher
capacity for productivity and expertise. And as people live
longer, societies invest more in social protection schemes,
including pensions and savings, thereby generating greater
domestic savings.
Despite this evidence,
the reality it that the health components of poverty reduction
programmes remain largely absent or marginal. On the one hand,
health authorities limit their responsibility to the
publicly-funded health services. On the other hand, the
architects of poverty reduction policies neglect the human and
social capital contributions of health to sustainable
livelihoods.
HDE’s
goal is to put health at the
centre of poverty reduction efforts and to promote understanding
of and support for the importance of health among a broad range
of actors, in the health sector and beyond. For more information on HDE’s work, see
activities.
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