4
Figure 1: Regional and global gains in average life expectancy per decade, 1970–2015
Note: Source: World Health Statistics 2016 (WHO 2017e). Sub-regions: AFR=Africa, AMR=Americas,
SEAR=South East Asia, EUR=Europe, EMR=Eastern Mediterranean, WPR=Western Pacific.
Good health and economic prosperity are mutually supportive, and equitable health status forms one
of the foundations of social justice. It is one of the essential parts of all development initiatives (Sen
1999a, 1999b, 2015). Equitable health means that the improvement in health status need to happen
equitably across community/groups, country and/or regions. The Commission on Social Determinants
of Health (CSDH) has described health equity as the absence of unfair and avoidable or remediable
differences in health among social groups (Solar 2007). A more operational way of measuring health
inequity is to ascertain whether health status vary across population and whether these disparities
can be understood through social determinants such as gender, socio-economic status, level of
education, geographic location etc. (Bloom 2000, Braveman and Gruskin 2003, Davies et al. 2014,
Evans et al. 2001). While this serves as a basis of understanding for the variation in state of health
status across communities, countries and/or regions, the focus of this study is to understand the access
to health services by the population groups with poor socio-economic status. The following section
explains why understanding access to health services is important, globally and why is it challenging
for the poor.
Ensuring access to health services for the poor
Ensuring access to health services forms the core of global health agenda. In 2015, 193 countries
endorsed 17 goals for continued global development to end poverty, promote well-being and protect
the planet, commonly known as Sustainable Development Goals (SDGs). The SDG 3 focuses specifically
on “ensuring healthy lives and promoting well-being for all at all ages.” Alike Millennium Development