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This article discusses the challenges and opportunities in bridging the concepts of the Geneva Charter for Well-being with policy and political realities. It provides case studies from Finland, Thailand, and the United Arab Emirates, as well as the Wellbeing Economy Alliance, to demonstrate how these countries and organizations are working towards building and supporting well-being societies. The article emphasizes the importance of governance and leadership, national and global collaboration, local action, resources and capabilities, and healthcare in promoting well-being. It concludes by highlighting the need for a common language and understanding of well-being, the publication of intervention information, the support of boundary spanners, and reflexivity in moving forward. [Extracted from the article]

A life-course approach to health encompasses strategies across individuals' lives that optimize their functional ability (taking into account the interdependence of individual, social, environmental, temporal and intergenerational factors), thereby enabling well-being and the realization of rights. The approach is a perfect fit with efforts to achieve universal health coverage and meet the sustainable development goals (SDGs). Properly applied, a life-course approach can increase the effectiveness of the former and help realize the vision of the latter, especially in ensuring health and well-being for all at all ages. Its implementation requires a shared understanding by individuals and societies of how health is shaped by multiple factors throughout life and across generations. Most studies have focused on noncommunicable disease and ageing populations in high-income countries and on epidemiological, theoretical and clinical issues. The aim of this article is to show how the life-course approach to health can be extended to all age groups, health topics and countries by building on a synthesis of existing scientific evidence, experience in different countries and advances in health strategies and programmes. A conceptual framework for the approach is presented along with implications for implementation in the areas of: (i) policy and investment; (ii) health services and systems; (iii) local, multisectoral and multistakeholder action; and (iv) measurement, monitoring and research. The SDGs provide a unique context for applying a holistic, multisectoral approach to achieving transformative outcomes for people, prosperity and the environment. A life-course approach can reinforce these efforts, particularly given its emphasis on rights and equity. Une approche sanitaire fondee sur le parcours de vie englobe des strategies tout au long de la vie des indivldus qui optimisent leur capacite fonctionnelle (en prenant en compte l'interdependance de facteurs individueis, sociaux, environnementaux, temporels et intergenerationnels), assurant ainsi le bien-etre et l'exerdce des droits. Cette approche s'inscrit parfaitement dans les efforts deployes pour parvenira une couverture sanitaire universelle et atteindre les objectifs de developpement durable (ODD). Lorsqu'elle est correctement appliquee, une approche fondee sur le parcours de vie peut accroitre l'efficacite de la premiere et aider a concretiser l'ambition des seconds, en assurant notamment la sante et le bien-etre pour tous a tous les ages. Sa mise en ceuvre exige une comprehension commune par les individus et les societes de la maniere dont la sante est fagonnee par de multiples facteurs tout au long de la vie et d'une generation a l'autre. La plupart des etudes realisees ont porte sur des maladies non transmissibles et le vieillissement des populations dans les pays a revenu eleve, ainsi que sur des aspects epidemiologiques, theoriques et cliniques. L'objectif de cet article est de montrer que l'approche sanitaire fondee sur le parcours de vie peut etre elargie a toutes les tranches d'age, toutes les questions de sante et tous les pays en s'appuyant sur une synthese des donnees scientifiques existantes, les experiences de differents pays et l'avancement des strategies et programmes en matiere de sante. Un cadre conceptuel de l'approche est presente ainsi que les consequences de sa mise en qeuvre sur: (i) la politique et l'lnvestissement; (ii) les services et systemes de sante; (iii) les actions locales, multisectorielles et multipartites; et (iv) les mesures, la surveillance et la recherche. Les ODD fournissent un contexte unique pour l'application d'une approche globale et multisectorielle en vue d'obtenlr des resultats porteurs de transformation pour les individus, la prosperite et l'environnement. Une approche fondee sur le parcours de vie peut renforcer ees efforts, notamment parce qu'elle met l'accent sur les droits et l'equite. Un enfoque basado en la salud para toda la vida engloba estrategias durante la vida de las personas, que optimizan su capacidad funcional (teniendo en cuenta la interdependencia de los factores individuales, sociales, ambientales, temporales e intergeneracionales), permitiendo asi el bienestar y la realizacion de los derechos. El enfoque encaja perfectamente con los esfuerzos por lograr una cobertura sanitaria universal y cumplir los objetivos de desarrollo sostenible (ODS). SI se aplica correctamente, un enfoque para toda la vida puede aumentar la eficacia del primero y ayudar a alcanzar la vision de este ultimo, especialmente para garantizar la salud y el bienestar en todas las edades. Su aplicacion requiere una comprension compartida entre individuos y sociedades sobre como la salud depende de multiples factores presentes a lo largo de la vida y entre generaciones. La mayoria de los estudios se han centrado en las enfermedades no contagiosas, en el envejecimiento de la poblacion en los paises con ingresos altos y en cuestiones epidemiologicas, teoricas y clinicas. El objetivo de este articulo es mostrar como el enfoque basado en la salud para toda la vida se puede extender a todos los grupos de edades, temas de salud y paises, mediante la creacion de una sintesis de las pruebas cientificas existentes, la experiencia en diferentes paises y los avances en estrategias y programas de salud. Se presenta un marco conceptual del enfoque junto con las implicaciones para la aplicacion en los siguientes campos: (i) politica e inversion; (ii) servicios y sistemas de salud; (iii) accion local, multisectorial y de varias partes Interesadas; y (iv) medicion, supervision e investigacion. Los ODS proporcionan un contexto unico para aplicar un enfoque holistico y multisectorial a fin de alcanzar unos resultados transformadores para las personas, la prosperidad y el medio ambiente. Un enfoque para toda la vida puede intensificar estos esfuerzos, sobre todo por su enfasis en los derechos y la equidad., Introduction The right to the highest attainable standard of health for all people, is enshrined in the World Health Organization's (WHO) constitution and in the United Nations' (UN's) human rights [...]

Intersectoral actions, defined as the alignment of strategies and resources between actors from two or more policy sectors to achieve complementary objectives, (1) are central to the health-related sustainable development [...]

Health in All Policies approaches support the integration of health considerations into the policies of traditionally siloed governance systems. These siloed systems are often ignorant of the fact that health is created outside of the health system and starts long before you see a health professional. Thus, the purpose of Health in All Policies approaches is to raise the importance of the broad‐based impacts on health from these public policies and to implement healthy public policy that delivers human rights for all. This approach requires significant adjustments to current economic and social policy settings. A well‐being economy similarly aspires to create policy incentives that increase the importance of social and non‐monetized outcomes, such as increased social cohesion environmental sustainability and health. These outcomes can evolve deliberately alongside economic benefits and are impacted by economic and market activities. The principles and functions underpinning Health in All Policies approaches, such as joined‐up policy making can be helpful to transition towards a well‐being economy. Governments will need to move beyond the currently held principle of "economic growth and profit above all else" if countries are to tackle growing societal inequity and catastrophic climate changes. Rapid digitization and globalization have further entrenched the focus on monetary economic outcomes rather than other aspects of human welfare. This has created an increasingly difficult context within which to prioritize social policies and efforts aimed to achieve primarily social and not profit‐oriented goals. In the face of this larger context, alone, Health in All Policies approaches will not bring about the needed transformation to achieve healthy populations and economic transition. However, Health in All Policies approaches do offer lessons and a rationale that is aligned with, and can support the transition to, a well‐being economy. Transforming current economic approaches to a well‐being economy is imperative to achieve equitable population health, social security and climate sustainability. [ABSTRACT FROM AUTHOR]

Available from: https://www.oecd.org/wise/measuring-well-being-and-progress.htm 15 Valentine N, Ajuebor O, Fisher J, Bodenmann B, Baum F, Rasanathan K. Planetary health benefits from strengthening health workforce education on the social determinants of health. And this diverse responsibility carries with it the threat that it becomes nobody's responsibility.[11] HEALTH PROMOTION EXPERTISE The health promotion field has evidence-based knowledge and experience that is useful in supporting change. Environmental impact assessments are a useful tool and health promotion expertise in health impact assessments is convertible. [Extracted from the article]

Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in 'Pathfinder' countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of early country dialogues and promising entry points for implementation that involve model, network and capacity building. The insights communicated through this note from the field will be of interest for others aiming to advance health equity through taking action on the social determinants of health, in particular as regards structural determinants. [ABSTRACT FROM AUTHOR]

This latter element refers to the implementation of "how to" questions that are so often absent from emerging evidence.[10] The research-policy-implementation gaps need to be addressed - if we are to see the ambitious well-being economy agenda come to fruition. This special issue, the "Well-being Economy and Health in All Policies: Fostering Action", highlights the need for societal change in the way we think about health and well-being. The papers in this special issue provide a valuable insight to the early emergence of the well-being economy field and the existing and future intersections with HiAP and other joined-up approaches to governance. [Extracted from the article]

Social inequalities are perpetuating unhealthy living and working conditions and behaviours. These causes are commonly called 'the social determinants of health'. Social inequalities are also impacting climate change and vice-versa, which, is causing profound negative impacts on planetary health. Achieving greater sustainability for human and planetary health demands that the health sector assumes a greater leadership role in addressing social inequalities. This requires equipping health and social care workers to better understand how the social determinants of health impact patients and communities. Integration of the social determinants of health into education and training will prepare the workforce to adjust clinical practice, define appropriate public health programmes and leverage cross-sector policies and mechanisms being put in place to address climate change. Educators should guide health and social workforce learners using competency-based approaches to explore critical pathways of social determinants of health, and what measurements and interventions may apply according to the structural and intermediary determinants of health and health equity. Key institutional and instructional reforms by decision-makers are also needed to ensure that the progressive integration and strengthening of education and training on the social determinants of health is delivered equitably, including by ensuring the leadership and participation of marginalized and minority groups. Training on the social determinants of health should apply broadly to three categories of health and social workforce learners, namely, those acting on global or national policies; those working in districts and communities; and those providing clinical services to individual families and patients. [ABSTRACT FROM AUTHOR]

The Challenge Throughout the world, people who are vulnerable and socially disadvantaged have less access to health resources, get sicker, and die earlier than people in more privileged social positions. [...]

Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/ rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/ rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC., Background In recent years the monitoring of health inequalities--defined as the observed health differences between subgroups of a population--has gathered momentum at the global level [1-4]. Monitoring health inequalities can [...]

Health system responsiveness is an indicator that can be used for evaluating how well healthcare systems respond to people's needs in non-clinical areas such as communication, autonomy and confidentiality. This study analyses health system responsiveness from the perspective of community-dwelling adults aged 50 and over in China, Ghana, India, the Russian Federation and South Africa using cross-sectional data from the World Health Organization Study on global AGEing and adult health. The aim is to assess and compare how individual, health condition and healthcare factors impact differently on outpatient and inpatient responsiveness. Poor responsiveness is measured according to participants' responses to questions on a five-point Likert scale. Five univariate and multiple logistic regression models test associations between individual, health condition and healthcare factors and poor responsiveness. The final model adjusts for country. Key results are that travel time is a major contributor to poor responsiveness across all countries. Similarly there are wealth inequalities in responsiveness. However no clear difference in responsiveness was observed in presentations for chronic versus other types of conditions. This study provides an interesting baseline on older patients' perceived treatment within outpatient and inpatient facilities in five diverse low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background: The concept 'vulnerability' is prevalent in the public domain, health care, social institutions and multidisciplinary research. Conceptual heterogeneity is present, hampering the creation of a common evidence-base of research achievements and successful policies. Recently an international expert group combined a specific literature review with a 2-stage Delphi procedure, arriving at a seemingly universal concept of vulnerability for the elderly with applications for research instruments. We replicated and extended this study, to generalize this result to health in general, and perinatal health in particular. Methods: Two independent expert panels (general health, perinatal health) repeated the Delphi-procedure, using an extended and updated literature review to derive statements on the concept and defining pathways of vulnerability. Additional views were collected on research tools. Consensus-by-design was explicitly avoided. Data collection and processing was independent. Results: Both panels showed surprising convergence on the pathways of vulnerability to health/ill-health, and their interaction. The agreed conceptual model describes a dynamic relation between health and ill-health and vulnerability. The 2 key pathways that link to vulnerability, are complementary, but not symmetrical as biological processes of maintaining health or obtaining better health are not reciprocal to recovery, so also not in terms of vulnerability impacts. An individual's degree of vulnerability is the net balance of risk effects and protective and healing factors (socially, biologically and in terms of health literacy and health care access). These factors can for measurement purposes (according to the panels: interview for exploration, checklists for population research) be grouped into ‘material resources’, ‘taking responsibility for one’s own health’, ‘risky activities and behaviors’, and ‘social support’. Supportive and transforming action can thus be undertaken. Conclusion: A universal concept of vulnerability in the context of health was successfully derived after careful replication and extension of an international Delphi study on vulnerability among the elderly. [ABSTRACT FROM AUTHOR]

Background: The concept of responsiveness was introduced by the World Health Organization (WHO) to address non-clinical aspects of service quality in an internationally comparable way. Responsiveness is defined as aspects of the way individuals are treated and the environment in which they are treated during health system interactions. The aim of this study is to assess responsiveness outcomes, their importance and factors influencing responsiveness outcomes during the antenatal and delivery phases of perinatal care.Method: The Responsiveness in Perinatal and Obstetric Health Care Questionnaire was developed in 2009/10 based on the eight-domain WHO concept and the World Health Survey questionnaire. After ethical approval, a total of 171 women, who were 2 weeks postpartum, were recruited from three primary care midwifery practices in Rotterdam, the Netherlands, using face-to-face interviews. We dichotomized the original five ordinal response categories for responsiveness attainment as 'poor' and good responsiveness and analyzed the ranking of the domain performance and importance according to frequency scores. We used a series of independent variables related to health services and users' personal background characteristics in multiple logistic regression analyses to explain responsiveness.Results: Poor responsiveness outcomes ranged from 5.9% to 31.7% for the antenatal phase and from 9.7% to 27.1% for the delivery phase. Overall for both phases, 'respect for persons' (Autonomy, Dignity, Communication and Confidentiality) domains performed better and were judged to be more important than 'client orientation' domains (Choice and Continuity, Prompt Attention, Quality of Basic Amenities, Social Consideration). On the whole, responsiveness was explained more by health-care and health related issues than personal characteristics.Conclusion: To improve responsiveness outcomes caregivers should focus on domains in the category 'client orientation'. [ABSTRACT FROM AUTHOR]

Background: Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking. Objective: To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to monitoring, analysis, and assessment approaches informed by an intersectoral vision of health. Design: The study is designed as a series of ecological, cross-country regression analyses, covering between 23 and 57 countries with dependent health variables concentrated on the years 2002-2003. Countries cover a range of development contexts. Health outcome and health service coverage dependent variables were derived from World Health Organization (WHO) information sources. Predictor variables representing determinants are derived from the WHO and World Bank databases; variables used for health systems' responsiveness are derived from the WHO World Health Survey. Responsiveness is a measure of acceptability of health services to the population, complementing financial health protection. Results: Health determinants' indicators -- access to improved drinking sources, accountability, and average years of schooling -- were statistically significant in particular health outcome regressions. Statistically significant coefficients were more common for mortality rate regressions than for coverage rate regressions. Responsiveness was systematically associated with poorer health and health service coverage. With respect to levels of inequality in health, the indicator of responsiveness problems experienced by the unhealthy poor groups in the population was statistically significant for regressions on measles vaccination inequalities between rich and poor. For the broader determinants, the Gini mattered most for inequalities in child mortality; education mattered more for inequalities in births attended by skilled personnel. Conclusions: This paper adds to the literature on comparative health systems research. National and international health monitoring frameworks need to incorporate indicators on trends in and impacts of other policy sectors on health. This will empower the health sector to carry out public health practices that promote health and health equity. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented that focuses on the scope of indicators required in national monitoring systems if they are to address the determinants of health equity and how related analyses would be seen by policymakers.

Introduction: Achieving a fair and equitable distribution of health in the population while progressing toward universal health coverage (UHC) is a key focus of health policy in Vietnam. This paper describes health barriers experienced by women (and children by inference) in Vietnam, and measures how UHC, with reference to maternal health services and child mortality rates, is affected by selected social determinants of health (SDH), termed 'barriers'. Methods: Our study uses a cross-sectional design with data from the 2011 Vietnam Multiple Indicator Cluster Survey. The study sample includes 11,663 women, aged 15-49 years. Weighted frequency statistics are cross-tabulated with socioeconomic characteristics of the population to describe the extent and distribution of health barriers experienced by disadvantaged women and children in Vietnam. A subset of women who had a live birth in the preceding two years (n_1,383) was studied to assess the impact of barriers to UHC and health. Six multiple logistic regressions were run using three dependent variables in the previous two years: 1) antenatal care, 2) skilled birth attendants, and 3) child death in the previous 15 years. Independent predictor variables were: 1) low education (incomplete secondary education), 2) lack of access to one of four basic amenities. In a second set of regressions, a constructed composite barrier index replaced these variables. Odds ratios (ORs) and 95% confidence intervals (95% CI) were used to report regression results. Results: In Vietnam, about 54% of women aged 15-49 years in 2011, had low education or lacked access to one of four basic amenities. About 38% of poor rural women from ethnic minorities experienced both barriers, compared with less than 1% of rich urban women from the ethnic majority. Incomplete secondary education or lack of one of four basic amenities was a factor significantly associated with lower access to skilled birth attendants (OR_0.28, 95% CI: 0.14-0.55; OR-0.19, 95% CI: 0.05-0.80) and a higher risk of having had a child death in the previous two years (OR-1.71, 95% CI: 1.28_2.30; OR-1.59, 95% CI: 1.20-2.10). Conclusions: Our study shows the need for accelerating education and infrastructure investments for ethnic minority communities living in rural areas so as to be able to contribute to equity-oriented progress toward UHC. [ABSTRACT FROM AUTHOR]

Data presented at the United Nations Summit in September in New York has revealed that many countries are unlikely to achieve all the health targets of the Millennium Development Goals [...]

Background: The concept of responsiveness, introduced by the World Health Organization (WHO), addresses non-clinical aspects of health service quality that are relevant regardless of provider, country, health system or health condition. Responsiveness refers to “aspects related to the way individuals are treated and the environment in which they are treated” during health system interactions. This paper assesses the psychometric properties of a newly developed responsiveness questionnaire dedicated to evaluating maternal experiences of perinatal care services, called the Responsiveness in Perinatal and Obstetric Health Care Questionnaire (ReproQ), using the eight-domain WHO concept. Methods: The ReproQ was developed between October 2009 and February 2010 by adapting the WHO Responsiveness Questionnaire items to the perinatal care context. The psychometric properties of feasibility, construct validity, and discriminative validity were empirically assessed in a sample of Dutch women two weeks post partum. Results: A total of 171 women consented to participation. Feasibility: the interviews lasted between 20 and 40 minutes and the overall missing rate was 8%. Construct validity: mean Cronbach’s alphas for the antenatal, birth and postpartum phase were: 0.73 (range 0.57-0.82), 0.84 (range 0.66-0.92), and 0.87 (range 0.62-0.95) respectively. The item-own scale correlations within all phases were considerably higher than most of the item-other scale correlations. Within the antenatal care, birth care and post partum phases, the eight factors explained 69%, 69%, and 76% of variance respectively. Discriminative validity: overall responsiveness mean sum scores were higher for women whose children were not admitted. This confirmed the hypothesis that dissatisfaction with health outcomes is transferred to their judgement on responsiveness of the perinatal services. Conclusions: The ReproQ interview-based questionnaire demonstrated satisfactory psychometric properties to describe the quality of perinatal care in the Netherlands, with the potential to discriminate between different levels of quality of care. In view of the relatively small sample, further testing and research is recommended. [ABSTRACT FROM AUTHOR]

This article describes an innovative knowledge translation project involving researchers and key stakeholders commissioned by the World Health Organization (WHO) for the Commission on Social Determinants of Health (CSDH). The project aimed to develop 'cameo' reports of evidence-based policies and interventions addressing social determinants of health, intended for use by leaders and advocates, as well as policy and programme decision makers, to advance global action. The iterative process of developing the framework and content of the cameos, in the context of a limited evidence base, is described, and a number of issues related to the integration of multiple sources of evidence for knowledge translation action are identified. [ABSTRACT FROM AUTHOR]

Describes a comparative advantage of the South African Development Community in international trade for member states and for the collective group. Introduction of an indicator to help identify sectors with export potential; Use of the law of comparative advantage; Role of the Revealed Comparative Advantage indicator in assessing comparative and competitive advantage.

Focuses on incorrect claims on the World Health Organization's (WHO) approach to measuring health system performance as reported by Robert J. Blendon and colleagues. Role of people's expectations on health care; Strategy of WHO in measuring responsiveness; Enhancement of the comparability of survey results.

Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC. [ABSTRACT FROM AUTHOR]