Abstract
This chapter explores equity as a moral concern within the framework of the public good and an ethical challenge of social justice within the African context. Health equity refers to the absence of unjust and preventable differences in the health status of persons that are socially and institutionally maintained through unequal distribution of resources and the mechanisms or processes by which this occurs. Health inequity does not occur uniformly across populations but may differ between ethnic, socio-economic, cultural and gender groups within a specific country. Health inequity therefore broadly has two dimensions, inequality on the one hand, which describes how health is distributed and the processes by which it is achieved, and inequity as a pointer to social injustice on the other hand. In Africa, health inequity is all pervasive as Africa suffers from fragmentation and underinvestment in health, with a high burden of disease and a lack of resources to manage it. Social science is important in identifying and addressing the challenges caused by inequity.
The fact that health status is rarely the outcome of an autonomous choice, especially in the developing world, places it at the centre of public health ethics locally as well as globally. Health equity issues pertaining to Social Science research is a distributive justice matter, as limited public resources are directed to the majority of the population who are poor, while the bulk of the resources are more readily available to the wealthy because of their favourable economic position. This calls for both policy and ethical considerations.
The implication of the commitment to establish more equity in health has some impact on Social Science research. Some advances have been made in the understanding of the health inequities and its key drivers. However, in a rapidly changing world, the evidence needs to be updated to remain relevant. It is noteworthy to mention the increasing recognition of Social Sciences’ approach to health services and clinical research. This brings along immense pros and offers some challenges as well.
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Suggested Further Readings
Braveman, P. (2010). Social conditions, health equity, and human rights. Health and Human Rights, 12(2), 31–48. Retrieved from https://www.hhrjournal.org/2013/08/social-conditions-health-equity-and-human-rights/
Jull, J., Whitehead, M., Petticrew, M., et al. (2017). When is a randomised controlled trial health equity relevant? Development and validation of a conceptual framework. BMJ Open, 7, e015815. https://doi.org/10.1136/BMJopen-2016-015815.
Kombe, F., Anunobi, N. E., Tshifugula, N. P., Wassenaar, D., Njadingwe, D., Mwalukore, S., Chinyama, J., Randrianasolo, B., Akindeh, P., Dlamini, P. S., Ramiandrisoa, F. N., & Ranaivo, N. (2014). Promoting research integrity in Africa: An African voice of concern on research misconduct and the way forward. Developing World Bioethics, 14(3), 158–166. https://doi.org/10.1111/dewb.12024.
Molyneux, C., Goudge, J., Russell, S., Chuma, J., Gumede, T., & Gilson, L. (2009). Conducting health-related social science research in low income settings: Ethical dilemmas faced in Kenya and South Africa. Journal of International Development, 21, 309–326. https://doi.org/10.1002/jid.1548.
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Hendricks, M.L., Donnir, G.M. (2019). Equity, Equality and Justice in Social Science Research in Africa. In: Nortjé, N., Visagie, R., Wessels, J. (eds) Social Science Research Ethics in Africa. Research Ethics Forum, vol 7. Springer, Cham. https://doi.org/10.1007/978-3-030-15402-8_13
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