title: Improving average health and persisting health inequities--towards a justice and fairness platform for health policy making in Asia.
abstract: BACKGROUND
  Following a period of rapid economic and social change across Asia in the 1980s and 1990s, there have been persisting reports of public sector health systems decline and worsening health inequities within countries. Many studies and analyses in the region have indicated that these inequities are socially determined, leading to questions regarding the adequacy of current health policy approaches towards addressing the challenge of persisting health inequities.
  
  
  METHODS
  Utilizing published data from Demographic Health Surveys (DHS) and case studies and reviews on health inequity in the Asian region, this article aims to describe the existing patterns of inequity of health access both within and between countries, focusing on immunization, maternal health access, nutritional outcomes and child mortality, with a view to recommending health policy options for addressing these health inequities. We compare the gap in access and outcomes between the highest and the lowest wealth quintiles, as well as cross-reference these findings with case studies and surveys on health inequities in the region.
  
  
  RESULTS
  In Asia, while in terms of aggregate health more of the poor are being reached, the reduction in the gap between social groups in some cases is stagnating, particularly for maternal health access and childhood stunting. Inequity gaps for immunization are persisting, and remain very wide in large population countries. For child mortality, more of the poor are surviving, although the rate of mortality decline is more rapid in higher than lower socio-economic groupings.
  
  
  CONCLUSIONS
  Both a strategic shift towards public health critique of social and political policy and operational shifts in health management and practice will be required to attain improvements in distributive health in Asia.
authors.affiliation: Cambodia Office, Nossal Institute for Global Health, University of Melbourne, 8c, 183, Tec Tlar, Phnom Penh, 12102, Cambodia, Nossal Institute for Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria 3010, Australia, Institute of Parasitology and School of Environment, McGill University, Montreal, Quebec, Canada and Adjunct Faculty at the Department of Public Health and Community Medicine, Tufts Medical Center, Boston, MA H3A 2T5, USA and Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria 3050, Australia johnjgrundy@hotmail.com.
authors.forename: John
authors.initials: J
authors.lastname: Grundy
authors.affiliation: Cambodia Office, Nossal Institute for Global Health, University of Melbourne, 8c, 183, Tec Tlar, Phnom Penh, 12102, Cambodia, Nossal Institute for Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria 3010, Australia, Institute of Parasitology and School of Environment, McGill University, Montreal, Quebec, Canada and Adjunct Faculty at the Department of Public Health and Community Medicine, Tufts Medical Center, Boston, MA H3A 2T5, USA and Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Annear
authors.affiliation: Cambodia Office, Nossal Institute for Global Health, University of Melbourne, 8c, 183, Tec Tlar, Phnom Penh, 12102, Cambodia, Nossal Institute for Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria 3010, Australia, Institute of Parasitology and School of Environment, McGill University, Montreal, Quebec, Canada and Adjunct Faculty at the Department of Public Health and Community Medicine, Tufts Medical Center, Boston, MA H3A 2T5, USA and Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Chomat
authors.affiliation: Cambodia Office, Nossal Institute for Global Health, University of Melbourne, 8c, 183, Tec Tlar, Phnom Penh, 12102, Cambodia, Nossal Institute for Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria 3010, Australia, Institute of Parasitology and School of Environment, McGill University, Montreal, Quebec, Canada and Adjunct Faculty at the Department of Public Health and Community Medicine, Tufts Medical Center, Boston, MA H3A 2T5, USA and Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: Shakil
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Cambodia Office, Nossal Institute for Global Health, University of Melbourne, 8c, 183, Tec Tlar, Phnom Penh, 12102, Cambodia, Nossal Institute for Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria 3010, Australia, Institute of Parasitology and School of Environment, McGill University, Montreal, Quebec, Canada and Adjunct Faculty at the Department of Public Health and Community Medicine, Tufts Medical Center, Boston, MA H3A 2T5, USA and Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria 3050, Australia.
authors.forename: Beverley-Ann
authors.initials: BA
authors.lastname: Biggs
mesh_terms: D001208:Asia; D002648:Child; D046688:Child Mortality; D006130:Growth Disorders / Q000453:epidemiology; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration; D006304:Health Status; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities / Q000458:organization & administration; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D011050:Policy Making; D011787:Quality of Health Care / Q000458:organization & administration; D012935:Social Justice
keywords: Equity; health planning; public policy; social determinants