Health: Working with our affiliates

Overview

The health sector in many countries has changed radically since the period of post-colonial and post-revolutionary construction of state-led services. Some residents of very poor or remote localities still have little access to skilled health workers, drugs and information about science-based health care, but this is becoming increasingly rare.  Meanwhile complex markets have emerged for a wide variety of health-related goods and services and people have access to many sources of health-related information. Their predominant problems now concern the quality of care and its cost.

The STEPS Centre is collaborating with the POVILL and Future Health Systems Consortia to generate knowledge about this new reality and support the design, implementation and evaluation of interventions to address these problems. This work complements the work by the epidemics project of the STEPS Centre.

Health in a dynamic world

The STEPS Working Paper “Health in a Dynamic World” (see below) describes the emergence of big inter-regional differences in interactions between ecology, socio-economic development and health. At one extreme, are localities that are undergoing rapid economic growth, industrialization, urbanization and associated changes in demography and the burden of disease. At another extreme, are areas that have a history of economic stagnation, decay of state institutions, and have experienced a sequence of shocks associated with crop failures, natural disasters, conflict and civil disorder. Life expectancy has declined in some of the latter localities.
Go to STEPS Health page

Our affiliates: POVILL and Future Health Systems

The POVILL and Future Health Systems consortia work in countries at different positions in this spectrum including Afghanistan, Bangladesh, Brazil, Cambodia, China, India, Lao PDR, Nigeria and Uganda.

Dynamics between househoold livelihoods and ill-health

One strand of work focuses on the dynamics of interactions between household livelihoods and ill-health. The POVILL Consortium is studying how the transition to a market economy and household-based agricultural production (in the case of China) has faced households with a rising level of financial risk.

Migration of family members to cities has increased household incomes but it has made them more vulnerable when an illness disrupts the inter-generational division of labour.

The consortium is studying how different types of household cope with different kinds of illness and how government interventions affect their coping strategies. The consortium has begun to expand its work on dynamics to include the environment, in the light of the ecological challenges associated with rapid development.
Go to STEPS Dynamics page

Market innovation

A second strand of work focuses on generating knowledge on how markets for health-related goods and services work and on the impact of a variety of innovations that could catalyse major changes in how poor people meet their health needs.

These innovations include strategies for improving the performance of informal providers, the creation of “franchises” to build and maintain reputations for competent and ethical behaviour, the role of civil society organisations and/or disease-specific organisations in building partnerships with service providers and the opportunities and challenges associated with the rapid spread of information and communications technologies. This strand of work emphasises the role of local innovations in response to specific contexts.

Governance and regulation

A third strand of work focuses on the changing role of government and new kinds of regulatory partnership. The aim is to move beyond a false dichotomy between models of change that focus on local innovations and those that focus on scaling-up known interventions and importing new institutional arrangements.

We understand change management as an iterative process in which new kinds of organization and new rules of engagement are jointly created by local innovators and national legislators and the state. This involves new approaches to monitoring and evaluation to foster a learning approach to change management and the construction of governance arrangements.
Go to STEPS Governance page

Vientiane Conference October 2008:
Health and social protection meeting the needs of the poor

9-10 October 2008, Vientiane, Lao PDR
Hosted by the National Institute of Public Health, Vientiane, the China Health Development Forum and the POVILL Consortium

STEPS Working Paper 5: Health in a dynamic world

The world has faced a number of health major health challenges over the past few decades - HIV, pollution, chronic illness, SARS. We need national and global health systems that take into account complex interactions between ecology, technology and social organisation.

Affliated projects

Find out more about our affiliated projects

Community-Led Total Sanitation (CLTS) Bangladesh, India, Cambodia, Indonesia, China, Nepal and trials in Africa.
A participatory approach to encourage communities to carry out their own appraisal and analysis of community sanitation.

Future Health SystemsFuture Health Systems China, India, Bangladesh, Nigeria, Uganda, the UK and the US. Strategies for improving access to appropriate health services by the poor in contexts of rapid institutional, economic and demographic change.

Development and HIV at the Institute of Development Studies
A new programme on Development and HIV at IDS, focusing on questions of the dynamic inter-action of resilience and vulnerability between individual biological and gendered human beings and in inter-relation to the virus itself. Contact: Jerker Edstrom

Realising RightsRealising Rights Bangladesh, Kenya, Ghana, the UK and the US. Addressing the factors underlying the low priority given to sexual and reproductive heath and rights in policy and practice.

POVILL China, Cambodia, Laos, Belgium, Sweden and the UK. Policies to help households cope with major illness

Veterinary Science, Transboundary Animal Diseases and Markets
Southern Africa – Botswana, Nambia, South Africa and Zimbabwe. Exploring the economic, social and political trade-offs arising from foot and mouth disease control strategies.

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