EquitAble is a four-year collaborative research project comprised of researchers from
Ireland, Norway, Sudan, Namibia, Malawi and South Africa. The project has produced empirical
knowledge on access to health care for vulnerable people in resource poor settings in Africa.
EquitAble brings together several teams comprised of both leading and upcoming
researchers, from two European and four African countries.
This strong consortium, with established project management and research credentials, presents a valuable opportunity to provide data to inform crucial policy decisions, as well as building research capacity in this area. EquitAble undertook policy analysis, intensive ethnographic analysis, and extensive household surveys across Namibia, Malawi, South Africa, and Sudan.
Healthcare can be neither universal nor equitable if it is less accessible to some
sections of society than it is to others. EquitAble’s focus on activity limitations in Africa has
provided data that is crucial to enable universal and equitable access to healthcare in resource
The project aims to provide the disability sector with data to develop evidence-based advocacy; government ministries with opportunities to implement evidence-based policy decisions; and service-providers with data to enact evidence-based practice. However, this project has gone, and will continue to go, beyond making recommendations and producing guidelines; it will address the process of bridging the evidence-policy-practice gaps, by identifying barriers and facilitators for the implementation of our research findings, thus enabling the project to have a real impact.
EquitAble Project Manager Dr. Hasheem Mannan affirms that ‘currently our health systems and policies and practices are not inclusive for vulnerable groups such as woman-headed households, displaced populations and persons with disabilities’. While the importance of addressing the health needs of vulnerable groups in low-income countries is increasingly being recognised, there are many challenges in how this should be addressed and implemented for different categories of vulnerable people.
While different groups of vulnerable people present some similar challenges for their equitable access to healthcare, there are also distinctive challenges presented by different groups. While a wider range of vulnerable groups have been addressed in the EquitAble project, the project has focused particularly on the challenges that persons with disabilities present to achieving universal and equitable access to healthcare in resource poor settings.
EquitAble’s primary objectives:
EquitAble consists of five work packages:
EquitAble has developed a new policy analysis framework - EquiFrame – with the intention
of developing a health policy analysis framework, that examines policy content, which would
be of particular relevance in low-income countries in general, and in Africa in particular.
The framework, based on a comprehensive development and validation process, was formulated through extensive literature searches and consultation with over 100 stakeholders across Sudan, Malawi, Namibia, South Africa, Norway, and Ireland, incorporating universities, research organizations, and non-governmental organizations. The framework addresses the principles of universal, equitable, and accessible health service provision, by assessing the degree to which vulnerable groups and core concepts of human rights feature in health policies.
Further, this analysis has highlighted
some very strong policies, serious shortcomings in others, as well as country-specific
patterns. As described by Paul E. Farmer, Editor of Health and Human Rights, EquiFrame is
a ‘theoretical tool that facilitates the integration of human rights concepts into policy-making.
It offers a smart and pragmatic strategy for promoting global health equity by moving rightsbased
concepts forward in policy makers’ toolkits’.
The EquitAble project Work Package that developed EquiFrame was led by Professor Mutamad Amin, Director of Research at Ahfad University for Women, Omdurman, Sudan, a former Minister of Health. It was the guiding framework for the development of Malawi's first National Health Policy, and will be used to guide all future health policy revision and development in North Sudan. There are currently plans to use EquiFrame in other countries, and it has already been used to evaluate the health-related donor policies of the Governmental Aid agencies in Ireland, UK and Norway. More than 10 papers have now being published using EquiFrame (please see MacLachlan et al., 2012; Mannan et al., 2011).
Furthermore, ethnographic work conducted is currently being published and the consortium has conducted analyses of its unique quantitative data-set of over 32,000 people across 17 sites in Africa.
The research results arising from EquitAble will feed much-needed
empirical data and analyses into on-going debates in the field of public health regarding how best
to plan interventions that promote access to healthcare and prevent failures in health systems, for
people with activity limitations and other vulnerable groups.
Such systems-failures, such as multiple drug resistance and exacerbation of health problems, could be cured or prevented with better information and greater accessibility. Finally, this consortium is committed to disseminating the Project’s findings to a broad range of people with activity limitations and other characteristics that may make them vulnerable to inequitable access to health services. These groups are also traditionally amongst those with whom research results are seldom shared.
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