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Measuring Equity of Reproductive Health Services

Annual Call for Projects 2005


Health - Public Health


Countries committed themselves to the attainment of "universal access to reproductive health for all by 2015" in 1994 at the International Conference on Population and Development (ICPD). However, considerable literature shows unequal use of reproductive health services by population sub-groups. At the Millennium Summit in 2000, the international community set goals and targets to promote improvements in development and health. Three out of eight Millennium Development Goals (MDGs) are related to different aspects of reproductive health. In its January 2005 report, the Millennium Project -- the independent advisory body to the UN working on strategies in achieving the MDGs -- highlighted the importance of sexual and reproductive health services in achieving all eight MDGs.

It is increasingly recognised that achieving international goals and targets related to reproductive health and development is difficult without addressing inequalities in women's receiving services. This requires rigorous evaluation of equity of services in order to understand the sources of inequalities.

Equity in health is broadly defined as the elimination of "avoidable, unfair and unjust differences" in health. More precise definitions focusing on health services define equity in terms of utilisation as the equal treatment of individuals with equal need. Current literature on equity in health mainly focuses on financing of health systems and distribution of resources. How these concerns at the macro level are reflected at the micro level -- in individuals' actual benefit from services -- is, however, studied to a lesser extent. This study will contribute to existing literature by providing an approach to systematic assessment of equity of reproductive health services at the user level.

A variety of factors at the user or health systems level influence women's use of services. The effects of these are modified by the wider context within which health systems function and by other societal influences. It is necessary to develop a means by which complexities of the setting...

The grant provided by the GIAN for this project totals SFr 160,000

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Project Team

Dr. Shawn Koppenhoefer , Former Member, Geneva Foundation for Medical Education and Research (GFMER) .