Social and Economic Determinants of Health

    Case studies

    Action Toolk​​​it for Social Determinants of Health in the African Region​​​


    The Social and Economic Determinants of Health (SDH)  Programme provides technical support to Member States and WHO to reduce health equity gap through action on the determinants of health.

    In the WHO African Region, these health inequities and inequalities exist between and within countries, and contribute disproportionately to high incidences of preventable illness, disability and premature deaths across population groups particularly the poor, women, children, elderly and displaced populations. As these determinants of health exist outside the Health domain, multisectoral and interdisciplinary approaches are required.

    Equity in health is an overarching principle of the World Health Organization. In recent decades, gaps in health equity between countries and among social groups within countries have widened, despite medical and technological progress. WHO and other health and development actors have defined tackling of health inequities as a major priority and aim to provide support to countries in more effective action geared to meeting the health needs of vulnerable groups.

    Meeting this goal will require attending to the social and economic factors that determine people’s opportunities for health. An intersectoral approach, though often politically difficult, is indispensable for substantial progress towards health equity. The Millennium Development Goals underscore the deeply interwoven nature of health and economic development processes, the need for coordination among multiple sectors to reach health goals, and the importance of addressing poverty and gender inequality.

    This situation raises challenges for ministries of health, which must work in innovative ways to foster intersectoral collaboration on the social and economic determinants of health even as they align key health sector specific programmes to respond better to the needs of vulnerable populations. Effective means to promote health gains for vulnerable groups include integration into health-sector policies and programmes of equity-enhancing, pro-poor, gender-responsive, ethically sound approaches. Human rights offer a unifying conceptual framework for these strategies and standards by which to evaluate success.


    For more information contact:

    Dr. Davison Munodawafa
    Email: munodawafad [at]

    Equity, Health, Health Policy and Human Development

    Equity in health and access to health care are central themes in health system stewardship. Addressing inequity requires a comprehensive approach and action on wider social determinants on health. Health inequities are increasingly becoming a major performance issue for ministries of health and governments and feature more prominently in the policy and political discourse in Member States in the African Region. Although economic benefits and scientific advances have increased the length and quality of life for many, still close to 50 percent of the African Region are living in poverty.

    Harsh economic and social conditions have nurtured the growth of both communicable and non-communicable diseases. Health inequities have increased overall, particularly between population groups living in the same country. These patterns of differential health opportunity between population groups affect both middle and lower income countries alike. This is not due only to poverty. These differences in health follow a strong social gradient, which reflect an individual or population group’s position in society and different access to and security of resources such as education, employment and housing, as well as different levels of participation in civic society and control over life.

    Addressing inequity requires a comprehensive approach and action on wider social determinants of health, with the goals of reducing the overall gap in health opportunity in a country, and tackling the social gradient in health across the whole population.

    Through the work on health policy and equity, ETR works with other programmes in the Regional Office and in countries to address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches.

    Globalization, trade and health

    Issues of international trade impinge on health, often in significant ways. ETR works with other programmes in the Regional Office and Member States to achieve greater policy coherence between trade and health policy so that international trade and trade rules maximize health benefits and minimizes health risks, especially for poor and vulnerable populations.

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