scholarly journals Addressing inequities in child health and development: towards social justice

2019 ◽  
Vol 3 (1) ◽  
pp. e000503 ◽  
Author(s):  
Nick Spencer ◽  
Shanti Raman ◽  
Bernadette O'Hare ◽  
Giorgio Tamburlini

Inequities have a profound impact on the health and development of children globally. While inequities are greatest in the world’s poorest countries, even in rich nations poorer children have poorer health and developmental outcomes. From birth through childhood to adolescence, morbidity, mortality, growth and development are socially determined, resulting in the most disadvantaged having the highest risk of poor health outcomes. Inequities in childhood impact across the life course. We consider four categories of actions to promote equity: strengthening individuals, strengthening communities, improving living and working conditions, and promoting healthy macropolicies. Inequities can be reduced but action to reduce inequities requires political will. The International Society for Social Paediatrics and Child Health (ISSOP) calls on governments, policy makers, paediatricians and professionals working with children and their organisations to act to reduce child health inequity as a priority. ISSOP recommends the following: governments act to reduce child poverty; ensure rights of all children to healthcare, education and welfare are protected; basic health determinants such as adequate nutrition, clean water and sanitation are available to all children. Paediatric and child health organisations ensure that their members are informed of the impact of inequities on children’s well-being and across the life course; include child health inequities in curricula for professionals in training; publish policy statements relevant to their country on child health inequities; advocate for evidence-based pro-equity interventions using a child rights perspective; advocate for affordable, accessible and quality healthcare for all children; promote research to monitor inequity as well as results of interventions in their child populations. Paediatricians and child health professionals be aware of the impact of social determinants of health on children under their care; ensure their clinical services are accessible and acceptable to all children and families within the constraints of their country’s health services; engage in advocacy at community and national level.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S128-S129
Author(s):  
Melanie S Hill ◽  
James E Hill ◽  
Stephanie Richardson ◽  
Jessica Brown ◽  
Jeremy B Yorgason ◽  
...  

Abstract Identity scholars have suggested that having a unified sense of past, present, and future is related to positive well-being outcomes (Whitbourne, Sneed & Skultety, 2009). One’s occupation can have a profound influence on an individual’s identity throughout the life course (Nazar & van der Heijden, 2012). Research has looked at career mobility among younger age groups (Baiyun, Ramkissoon, Greenwood, & Hoyte, 2018); however, less is known about the impact of career stability later in life. Consistency in career choice over the life course may have positive outcomes down the line as career becomes part of an individual's identity. The current study uses the Life and Family Legacies dataset, a longitudinal state-representative sample of 3,348, to examine individual’s careers at three points in the life course: high school (projected career choice), early adulthood, and later life. Results revealed that a match of desired career in high school and actual career in early adulthood was not predictive of life satisfaction or depressive symptoms in later life. However, a match of career in early adulthood and later life was significantly related to better life satisfaction and less depressive symptoms, which was explained through higher levels of job satisfaction. This study highlights the importance of acquiring and maintaining a career that is fulfilling to the individual over the course of early adulthood to later life.


Author(s):  
Lydia Kapiriri

Background: There is a growing body of literature on evidence-informed priority setting. However, the literature on the use of evidence when setting healthcare priorities in low-income countries (LICs), tends to treat the healthcare system (HCS) as a single unit, despite the existence of multiple programs within the HCS, some of which are donor supported. Objectives: (i) To examine how Ugandan health policy-makers define and attribute value to the different types of evidence; (ii) Based on 6 health programs (HIV, maternal, newborn and child health [MNCH], vaccines, emergencies, health systems, and non- communicable diseases [NCDs]) to discuss the policy-makers’ reported access to and use of evidence in priority setting across the 6 health programs in Uganda; and (iii) To identify the challenges related to the access to and use of evidence. Methods: This was a qualitative study based on in-depth key informant interviews with 60 national level (working in 6 different health programs) and 27 sub-national (district) level policy-makers. Data were analysed used a modified thematic approach. Results: While all respondents recognized and endeavored to use evidence when setting healthcare priorities across the 6 programs and in the districts; more national level respondents tended to value quantitative evidence, while more district level respondents tended to value qualitative evidence from the community. Challenges to the use of evidence included access, quality, and competing values. Respondents from highly politicized and donor supported programs such as vaccines, HIV and maternal neonatal and child health were more likely to report that they had access to, and consistently used evidence in priority setting. Conclusion: This study highlighted differences in the perceptions, access to, and use of evidence in priority setting in the different programs within a single HCS. The strong infrastructure in place to support for the access to and use of evidence in the politicized and donor supported programs should be leveraged to support the availability and use of evidence in the relatively under-resourced programs. Further research could explore the impact of unequal availability of evidence on priority setting between health programs within the HCS.


2018 ◽  
Vol 32 (5-6) ◽  
pp. 285-295 ◽  
Author(s):  
Sara Zella ◽  
Sarah Harper

Objectives: The article addresses whether specific combinations of employment and domestic duties over the life course are associated with variations in women’s health at the time of retirement. It also explores the differences of this relationship in four European welfare states. Method: Women from three waves of SHARE (Survey of Health, Aging and Retirement in Europe) are grouped using sequence analysis. Using logistic regression models, group differences in later life depression and self-reported health are tested. Predicted probabilities are applied to analyze welfares’ differences. Results: The findings confirm that a combination of employment and domestic duties across the life course has a positive association with later life health. Being outside the labor market is detrimental for women’s health. Well-being across the life course is framed by the welfare context in which women live. Discussion: We suggest that further research is needed to explore the mechanisms linking work and care trajectories to poor health and enable appropriate interventions.


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