Making health systems more equitable

Health systems are consistently inequitable, providing more and higher quality services to the well-off, who need them less, than to the poor, who are unable to obtain them. In the absence of a concerted effort to ensure that health systems reach disadvantaged groups more effectively, such inequitie...

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Bibliographic Details
Published in:The Lancet (British edition) 2004-10, Vol.364 (9441), p.1273-1280
Main Authors: Gwatkin, Davidson R, Bhuiya, Abbas, Victora, Cesar G
Format: Article
Language:English
Subjects:
Biological and medical sciences
Delivery of Health Care - organization & administration
Developing Countries
Disadvantaged groups
Empowerment
Equality
General aspects
Goals
Health care delivery
Health care policy
Health Expenditures
Health Policy
Health services
Health Services - utilization
Health Services Accessibility
Households
Humans
Immunization
Insecticides
International Agencies
Maternal-Child Health Centers
Medical sciences
Poverty
R&D
Research & development
Social Justice
Socioeconomic Factors
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Summary:Health systems are consistently inequitable, providing more and higher quality services to the well-off, who need them less, than to the poor, who are unable to obtain them. In the absence of a concerted effort to ensure that health systems reach disadvantaged groups more effectively, such inequities are likely to continue. Yet this situation need not be accepted as inevitable, for there are many promising measures that might be pursued: establishment of goals for improved coverage in the poor, rather than in entire populations, and use of those goals to direct planning toward the needs of the disadvantaged; use of one or more of the several techniques that seem to have been effective in at least some of the settings where they have been tried; and empowerment of poor clients to have a more central role in health system design and operation.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(04)17145-6