There is a growing body of evidence that health contributes to individual wellbeing, household stability, and national development. In 1978, the Declaration of Alma-Ata was the first international declaration to state the importance of guaranteeing health as a citizen right, strengthening health systems, and focusing on primary health care. While important efforts have been made since then, the achievement of ‘health for all’ is still a challenge.
In 2017, globally, 36.9 million people were living with HIV/AIDS. Tuberculosis killed 1.7 million people in 2016 (most of them poor), remaining the single biggest killer of adults in the world. Approximately 91 per cent of Malaria-related deaths in 2016 happened in sub-Saharan Africa. Maternal and child mortality were far higher in low-income countries. These well-known statistics remind us about the importance of keeping the Alma-Ata principles alive and working to improve the health status of those living in poverty.
The Economic and Social Research Council (ESRC) and Department for International Development (DFID) Strategic Partnership funds world-class scientific research which contributes to a robust conceptual and empirical basis for development. This booklet of research projects funded through the ESRC-DFID Joint Fund for Poverty Alleviation Research presents the efforts of research groups working in low- and middle-income countries to better understand how and under which conditions a range of health promotion, health protection, and curative interventions are contributing to health improvement. This comprehensive understanding of health brings together efforts to address the wider causes of poor health, which includes the persistent inequalities that inhibit poorer and more vulnerable communities from living healthy lives, such as lack of access to vital services, or inadequate living standards.
While efforts are being made to develop theoretical approaches towards constructing a theory of health causation and distribution that spans both poor and rich countries, research programmes are looking at critical conditions that disproportionally affect poor people. In this vein, researchers are working to measure both the impact of the AIDS epidemic, tuberculosis, malaria, unsafe abortion, disability, and dementia on household welfare; and different strategies that are being used to mitigate their negative impact. They are also investigating how to effectively reach poor and otherwise disadvantaged groups, and promote policy initiatives that bring communities, government actors, and NGOs together to break the vicious cycle between women’s low empowerment, poor reproductive and newborn health, child malnutrition, poor utilisation of health services, and poverty.
Furthermore, many programmes are concerned with a health system’s effectivity. The use of mobile phones to train community health workers and guarantee citizens access to reliable and trustworthy health information and advice is being tested. Management tools, such as performance-based financing and the use of incentive regimes to prevent unnecessary over-treatment, pharmaceutical regulation, biomedical experimentation, and health management to build resilience to disaster risks are also being studied and evaluated. Finally, there is a debate concerning how different types of accountability politics, institutions, and professionals who broker health policies and sectorial programmes at the national, regional, and international level contribute to the reduction of health inequalities.
The results already produced by the research teams working in Africa, Asia, Latin and South America reinforce our understanding about the multidimensional efforts that need to be made in order to break the cycle between poverty and poor health. Women’s education; capacity-building for health professionals; technology incorporation; improvement in diagnosis and treatment; development of policy, professional, and community networks; and political activism are all part of the mosaic of interventions needed to address the critical barriers to meeting the health Sustainable Development Goals. The results also shed light on the richness of bringing together a diversity of methodological approaches. Surveys, qualitative research, mixed methods approaches, randomised controlled trials, and impact evaluation are being used and combined in different degrees to produce evidence about what works, where, how, and for whom.
The ESRC-DFID Joint Fund for Poverty Alleviation Research is investing in rigorous social science research and helping to communicate the findings to the policymaking community. This effort will certainly contribute to the goal of reducing poverty and improving the health amongst the poorest countries and peoples of the world.
- The Impact Initiative is hosting a satellite session on 'Making Universal Health Coverage a reality by 2030: evidence of what works' at the Fifth Global Symposium on Health Systems Research (HSR2018). The session takes place on 8 October at 9am.
- Read/download ESRC-DFID Research Evidence on Achieving Health for All by 2030.