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International Journal for Equity in Health

, 15:9

First Online: 19 January 2016Received: 03 July 2015Accepted: 05 January 2016DOI: 10.1186-s12939-016-0297-9

Cite this article as: Guerra, G., Borde, E. & Salgado de Snyder, V.N. Int J Equity Health 2016 15: 9. doi:10.1186-s12939-016-0297-9


BackgroundAlmost seven years after the publication of the final report of the World Health Organization’s Commission on Social Determinants of Health CSDH, its third recommendation has not been attended to properly. Measuring health inequities HI within countries and globally, in order to develop and evaluate evidence-based policies and actions aimed at the social determinants of health SDH, is still a pending task in most low and middle income countries LMIC in the Latin American region. In this paper we discuss methodological and conceptual issues to measure HI in LMIC and suggest a three-stage methodology for the creation of observatories on health inequities OHI and social determinants of health, based on the experience of the Brazilian Observatory on Health Inequities BOHI that has been successfully operating since 2010 at the Fundação Oswaldo Cruz FIOCRUZ.

MethodsA three-stage methodology for the creation of an OHI was developed based on a literature review on the following topics: SDH, HI measurement, and the process of setting-up of health observatories; followed by semi-structured interviews with key informants from the BOHI. We describe the three stages and discuss the replicability of this methodology in other Latin American countries. We also carried out a search of suitable national information systems to feed an OHI in Mexico, along with an outline of the institutional infrastructure to sustain it.

ResultsWhen implementing the methodology for an OHI in LMIC such as Mexico, we found that having strong infrastructure of information systems for measuring HI is required, but not sufficient to build an OHI. Adequate funding and intersectoral network collaborations lead by a group of experts is a requirement for the consolidation and sustainability of an OHI in LMIC.

ConclusionAccording to the described methodology, and the available information systems on health, the creation of an OHI in LMIC, particularly in Mexico, is plausible in the near future. However, institutional support in academic, financial, and policymaking terms is essential to materialize such needed instance, thus locally contributing to attain health equity.

KeywordsSocial determinants of health Health status disparities Methods Data collection AbbreviationsCSDHCommission on Social Determinants of Health

HIHealth inequities

SDHSocial determinants of health

LMICLow and middle income countries

BOHIBrazilian Observatory on Health Inequities

CEPI-DSSCenter for Studies, Policies and Information on Social Determinants of Health at Escola Nacional de Saúde Pública- Fundação Oswaldo Cruz

OHIObservatory on Health Inequities

GDPpcGross domestic product per capita

WHOWorld Health Organization

NGONon- Governmental Organization

BNCSDHBrazilian National Commission on Social Determinants of Health

RIPSAInteragency Network for Health Information

PROSESAMexico’s Health Sector Program 2013-2018

SINAISNational Health Information System

DGPSDirectorate General for Health Promotion of the Secretary of Health in Mexico

INEGINational Institute of Statistics and Geography

CONAPONational Population Council

CONEVALNational Council for the Evaluation of Social Development Policy

REDMEX-DSSMexican Network on Social Determinants of Health

FUNSALUDMexican Foundation for Health

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Autor: German Guerra - Elis Borde - V. Nelly Salgado de Snyder


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