[Understanding local concepts of equity to formulate public health policies in Burkina Faso].
Equity is an essential health promotion concept and must be included at the heart of public health policy making. However, equity, which can also be referred to as social justice, is a polysemic and contextual term which definition must stem from the discourse and values of the society where the policies are implemented. Using a case study from Burkina Faso, we try to show that the non-acknowledgement of the local concept of social justice in the policy making process partly explains the resulting policies' relative failure to achieve social justice. Data collection methods vary (individual and group interviews, concept mapping, participant observation, document analyses) and there are qualitative and quantitative analyses. The four groups of actors who generally participate in the policy making process participated in the data collection. With no intention to generalise the results to the entire country, the results show that mass social mobilisation for justice is egalitarian in type. Health or social inequalities are understood by individuals as facts which we cannot act upon, while the inequalities to access care are qualified as unjust, and it is possible to intervene to reduce them if incentive measures to this effect are taken. We also observed a certain social difficulty to conceive sub-groups of population and fierce will to not destabilise social peace, which can be provoked when looking for justice for the impoverished sectors of the population. This research allows better understanding about the emic aspect of equity and seems to confirm the importance of taking into account local values, especially social justice, when determining public policy.
Ridde
Valéry
V
Unité de Santé Internationale, Faculté de médecine, Université de Montreal, 3875, rue Saint-Urbain, Montréal, Qc, Canada. valery.ridde@umontreal.ca
D002050:Burkina Faso; D006291:Health Policy; D006297:Health Services Accessibility / Q000941:ethics*; D006801:Humans; D009111:Local Government; D019982:Organizational Case Studies; D011634:Public Health / Q000941:ethics*; D012935:Social Justice; D012945:Social Values