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Organisation

Equity and Health

Research Unit

Lifecycle:1 Jan 1990 →  Today
Organisation profile:

“Equity in health can be defined as the absence of systematic disparities in health (or in the major social determinants of health) between social groups who have different levels of underlying social advantage/disadvantage—that is, different positions in a social hierarchy” (Braverman and Gruskin in J Epidemiol Community Health 2003;57).

Health and health care inequities place people who may already be socially disadvantaged or disenfranchised at further disadvantage with respect to their health, well-being, and livelihoods.  In our unit, we aim to contribute to better understanding of the root causes of health inequities and development of strategies to improve access, acceptability, quality, and accountability of health systems and services to communities, particularly for individuals in marginalised and precarious positions in both the global South and North.  The unit’s objectives are to:

  1. Conduct rigourous, topical, and inter-disciplinary research on the relationship between key social and structural indicators of equity/inequity and health-seeking and health outcomes, as well as health systems responsiveness;
  2. Offer high-quality teaching modules that capitalise on our unit themes, build on our expertise, and draw on the rich experience of working and conducting research in the global South and North and;
  3. Contribute, through active engagement with health systems and policy actors, communities, academia, and advocates, to promoting and practicing equity, fairness, and transparency in our research collaborations and development partnerships.

Unit members Karina Kielmann, Nandini Sarkar, Engy Sawah, Marie Meudec and Theo Cosaert represent a range of disciplines including anthropology, psychology, public health, and health systems research.  Current projects fall into two distinct themes;

I.  Examining the impact of inequities based on sex, age, race, ethnicity, migration status and other social determinants of health on access to and experience of health care, as well as health information systems and research priorities.   social identities   access to, and experience, of health care e.g.

  • Ethnic minorities’  access to and uptake of COVID vaccines (COVER-ME); 
  • Role of social networks in migrants’ management of chronic illnesses in Belgium (MiChronicity); 
  •  Representation of racially minoritized groups in health research RECoRd;
  • Access to mental health and psycho-social services for victims of sexual violence.

II.   Lived experiences and adaptive practices among health care workers, policy-makers, and communities responding to health crises in multiple settings. 

  • Improving continuity of care across PHC community level heath workers in Tanzania, using a digital health support application (AFYA-TEK)
  • Health workers’ and communities practices in balancing safety and good care within the context of evolving guidelines for infection prevention and control in Uganda (BASYC)
  • Social science research conducted in relation to epidemic outbreaks examining factors involved in the transmission and spread of outbreak-prone diseases, the design and evaluation of early detection methods and models, and the assessment of different intervention strategies for preventing and controlling epidemics.

Unit members currently coordinate the advanced teaching module Health Policy and Research Methodology, and contributes to teaching on the following topics across the MPH core and advanced modules: 

  • Outbreak Investigation and Research
  • Racism and Health
  • Community participation in health systems
  • Quality of care in maternal health
  • Mental health in LMIC
  • Qualitative and mixed methods research

🗨 “It’s very difficult to define this vulnerability. For example, for some women we know that they probably have some money and [health] insurance and so on … but we don’t know what happens in their family. Maybe there is some violence in the family and this is the factor that impacts later on the adherence.” - Doctor on MDR-TB ward (Latvia)

 

🗨 “It’s too little money that the social assistance gives for food, there is this system of coupons and every 10 days, patients get 4 coupons and each coupon is worth 1 Euro 60. This is meant for food but it is not sufficient … It’s about 19 Euro 20 per month [but the patients] need more protein, like cheese. It’s not enough!” - DOT nurse, TB clinic (Latvia)