Measuring Health Equity in Small Areas

Findings from Demographic Surveillance Systems

Measuring Health Equity in Small Areas involves analyzing localized health indicators to identify disparities, support policy decisions, and promote fair access to healthcare services. The selection of INDEPTH sites as the common denominator for the various analyses is in itself an important statement related to equity. In the early years of the
21 Millennium, it is indeed worrisome that in many parts of the world we remain ‘in the dark’ about life’s vital events – namely birth and death. In Sub-Saharan Africa,
registration of these vital events remains incomplete in every country with only partial coverage in a small minority of countries. From this extreme, a strong association can
be drawn between coverage of vital registration systems and the level of population health: those countries with no, or limited, registration have the poorest levels of
health. This dissonance between the absence of health information and the need given the magnitude of health challenges has been referred to as the ‘information
paradox’. INDEPTH sites, through the demographic surveillance systems – accurate and continuous coverage of a total population’s health – are an important step in
redressing what I refer to as the ‘first injustice’ i.e. the lack of a right for one’s life to be counted. Although significant as single sites, together the INDEPTH sites can
pool their vital data to provide critical insights in the patterns of health in some of the world’s poorest areas where health problems are the greatest and unfortunately the
least understood or appreciated. More simply put, INDEPTH as an entity makes the critical statement that all lives count and deserve to be counted.
From this ‘first right’ – i.e. the right to be counted, this volume examines inequalities and inequities in health and access to health care within the various INDEPTH sites