Tackling social determinants of health through community based initiatives

Abstract

Women are often the key to improving a population's health, and this is especially true in the Eastern Mediterranean region. Projects that empower women and provide basic needs are transforming poor communities Many of the inequalities in health, both within and between countries, are due to inequalities in the social conditions in which people live and work.1 These social determinants have a important effect on health status and general wellbeing. Tackling these underlying causes of poor health can contribute to improving health and health equity.2 The World Health Organization has given this approach added impetus by the creation of the Commission on Social Determinants of Health. Over the past two decades the basic development needs programme, a component of the community based initiatives programme in the WHO Eastern Mediterranean region, has developed and implemented community based initiatives to improve health in poor populations through actions on social determinants. The basic needs development programmes, which enhance the status of women and their role in the health of families, are an important part of this work. The low status of women in the Eastern Mediterranean region is one of the key underlying social determinants of health. Sex differences in access to health care and poor health indicators for women and girls in several countries have resulted in differences in mortality and morbidity between male and female infants,3 differences in the quality of care for male and female children,4 high maternal mortality (estimated at 1600 deaths per 100 000 live births in Afghanistan and Somalia),5 limited prenatal and postnatal care and lack of skilled attendants at birth,6 higher prevalence of mental illness among women than …