Uncovering health inequalities
Having a skilled health professional during childbirth can save the life of a woman and her child. But, in many parts of the world and within many countries, the presence of a health worker during childbirth is often a luxury. If a woman is poor, she is even more likely to deliver without support, putting herself and child at risk.
In Indonesia, this is a familiar story for poor women. Twenty years ago, only 1 in 5 women in the poorest 20% of the population gave birth with support from a skilled attendant.
Through recognising the inequalities and targeting programmes towards the poorest populations, Indonesia has been able to improve the number of births attended by skilled personnel among the poorest population to 3 out of 5 births in the period 2007 to 2012. However, nearly all births among the richest 20% of the population were supported.
New WHO tool shows within-country inequalities across the globe
To help countries like Indonesia monitor health inequalities, WHO developed a new toolkit called the Health Equity Assessment Toolkit (HEAT). HEAT is a software package that utilises data from the WHO Health Equity Monitor and enables health professionals and researchers to explore the health inequalities in their countries. Additionally, users can compare the state of inequality in their country with other countries.
Besides data on the proportion of births attended by skilled personnel, HEAT users can assess variations in coverage of immunisation, antenatal care, contraception, and breastfeeding, to name a few of the indicators covered.
In some countries, the gaps are more profound.
Equity in the global agenda
Equity is at the heart of the 2030 Agenda for Sustainable Development. In pledging to achieve the SDGs, countries have committed to leave no one behind. SDG 3 focuses on ensuring healthy lives for all at all ages, positioning equity as a central issue in health, while SDG 10 calls for a reduction in inequality within and between countries to promote the inclusion and empowerment of all.
However, realising equity requires identifying where there are inequalities in the first place, and then monitoring the progress made at reducing them.
"Strong health information systems that collect, analyse and report disaggregated data covering all health areas are essential for achieving health equity," says Ahmad Reza Hosseinpoor, WHO Technical Officer in the Department of Information, Evidence and Research. "HEAT provides evidence on the state of health inequality and can help countries set priorities and establish equity-oriented policies, programmes and interventions."
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