Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia
Background Debate continues in public health on the roles of universal or targeted policies in providing equity of access to health- related goods or services, and thereby contributing to health equity. Research examining policy implementation can provide fresh insights on these issues.Methods We...
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| Format: | Article |
| Language: | English |
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Kerman University of Medical Sciences
2022-10-01
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| Series: | International Journal of Health Policy and Management |
| Subjects: | |
| Online Access: | https://www.ijhpm.com/article_4164_7fb89e8ede56e0ea8e41b1ce64521865.pdf |
| _version_ | 1811158763064786944 |
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| author | Matthew Fisher Patrick Harris Toby Freeman Tamara Mackean Emma George Sharon Friel Fran Baum |
| author_facet | Matthew Fisher Patrick Harris Toby Freeman Tamara Mackean Emma George Sharon Friel Fran Baum |
| author_sort | Matthew Fisher |
| collection | DOAJ |
| description | Background Debate continues in public health on the roles of universal or targeted policies in providing equity of access to health- related goods or services, and thereby contributing to health equity. Research examining policy implementation can provide fresh insights on these issues.Methods We synthesised findings across case studies of policy implementation in four policy areas of primary healthcare (PHC), telecommunications, Indigenous health and land use policy, which incorporated a variety of universal and targeted policy structures. We analysed findings according to three criteria of equity in access – availability, affordability and acceptability – and definitions of universal, proportionate-universal, targeted and residual policies, and devolved governance structures.Results Our analysis showed that existing universal, proportionate-universal and targeted policies in an Australian context displayed strengths and weaknesses in addressing availability, affordability and acceptability dimensions of equity in access.Conclusion While residualist policies are unfavourable to equity of access, other forms of targeting as well as universal and proportionate-universal structure have the potential to be combined in context-specific ways favourable to equity of access to health-related goods and services. To optimise benefits, policies should address equity of access in the three dimensions of availability, affordability and acceptability. Devolved governance structures have the potential to augment equity benefits of either universal or targeted policies. |
| first_indexed | 2024-04-10T05:29:45Z |
| format | Article |
| id | doaj.art-fc6ffa6bd13342e9bb757cf99a2dfa4b |
| institution | Directory Open Access Journal |
| issn | 2322-5939 |
| language | English |
| last_indexed | 2024-04-10T05:29:45Z |
| publishDate | 2022-10-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-fc6ffa6bd13342e9bb757cf99a2dfa4b2023-03-07T09:11:46ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392022-10-0111102308231810.34172/ijhpm.2021.1574164Implementing Universal and Targeted Policies for Health Equity: Lessons From AustraliaMatthew Fisher0Patrick Harris1Toby Freeman2Tamara Mackean3Emma George4Sharon Friel5Fran Baum6Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA, AustraliaCentre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, AustraliaSouthgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA, AustraliaCollege of Medicine and Public Health, Flinders University, Adelaide, SA, AustraliaSchool of Allied Health Science and Practice, University of Adelaide, Adelaide, SA, AustraliaRegNet School of Regulation and Global Governance, Australian National University, Canberra, ACT, AustraliaSouthgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA, AustraliaBackground Debate continues in public health on the roles of universal or targeted policies in providing equity of access to health- related goods or services, and thereby contributing to health equity. Research examining policy implementation can provide fresh insights on these issues.Methods We synthesised findings across case studies of policy implementation in four policy areas of primary healthcare (PHC), telecommunications, Indigenous health and land use policy, which incorporated a variety of universal and targeted policy structures. We analysed findings according to three criteria of equity in access – availability, affordability and acceptability – and definitions of universal, proportionate-universal, targeted and residual policies, and devolved governance structures.Results Our analysis showed that existing universal, proportionate-universal and targeted policies in an Australian context displayed strengths and weaknesses in addressing availability, affordability and acceptability dimensions of equity in access.Conclusion While residualist policies are unfavourable to equity of access, other forms of targeting as well as universal and proportionate-universal structure have the potential to be combined in context-specific ways favourable to equity of access to health-related goods and services. To optimise benefits, policies should address equity of access in the three dimensions of availability, affordability and acceptability. Devolved governance structures have the potential to augment equity benefits of either universal or targeted policies.https://www.ijhpm.com/article_4164_7fb89e8ede56e0ea8e41b1ce64521865.pdfuniversal policytargeted policyequity of accesssocial determinantsindigenous healthaustralia |
| spellingShingle | Matthew Fisher Patrick Harris Toby Freeman Tamara Mackean Emma George Sharon Friel Fran Baum Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia International Journal of Health Policy and Management universal policy targeted policy equity of access social determinants indigenous health australia |
| title | Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia |
| title_full | Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia |
| title_fullStr | Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia |
| title_full_unstemmed | Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia |
| title_short | Implementing Universal and Targeted Policies for Health Equity: Lessons From Australia |
| title_sort | implementing universal and targeted policies for health equity lessons from australia |
| topic | universal policy targeted policy equity of access social determinants indigenous health australia |
| url | https://www.ijhpm.com/article_4164_7fb89e8ede56e0ea8e41b1ce64521865.pdf |
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