 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Norman Daniels, PhD, Prof. of Ethics and Population Health, Dept. of Population and International Health - Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115, 617-432-2360, ndaniels@hsph.harvard.edu
The concept of Benchmarks of Fairness originated at the time of the Clinton Task Force on Health Care Reform as a book entitled – Benchmarks of Fairness for Health Care Reform (Oxford University Press, 1996). While that Task Force was inactivated, the benchmarks were seen as highly relevant to the needs of developing countries. A group of collaborators, supported by the Rockefeller Foundation, proceeded through a process of adapting the U.S. version of the benchmarks to a series of developing countries. Fairness is a many sided concept, including: equity in health outcomes, access to all forms of care and financing; efficiency in management and allocation; accountability; and appropriate forms of patient and provider autonomy. There are nine benchmarks, each with a number of criteria that help standardize what is meant by fairness. These criteria, supported by an evidence base, are used to evaluate reforms, scoring them according to the degree to which they improve the extent of fairness. The benchmarks are not intended to provide an index or scale with which to compare countries in terms of fairness but rather to guide policy deliberations within each country. A striking feature of the adaptation process is that there has been wide agreement on this ethical framework among the collaborating sites despite their substantial historical, political, cultural, and religious differences. After involving a number of countries individually in uses of the benchmarks, the beckoning challenge now is now to proceed to regional levels of capacity building for uses of the benchmarks, thus moving more fully toward a tool of widespread usefulness in ensuring fairness of policy deliberation.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.