Health in all policies and equity : realising the challenge : a discussion paper for the Equity Action Project

The necessity to focus on equity and Health in All Policies has been reiterated as part of Council conclusions in 2006, 2010 and 2011, which in 2011 emphasised that: “A ‘Health in all policies’ approach with an equity focus should be used in specific policy areas and coordinated activities that have the greatest health impact contributing to reducing the persisting health gaps. This might include health, education, research, environment, agriculture, economy, employment and social policies.” As well as called European Commission and Member States to: “Promote the effective implementation of ‘Health in all policies’ approach with an equity focus, to encourage and coordinate all relevant sectors in playing their part in reducing healthgaps within the EU.” However, the practice of how this should be done has remained more elusive. There is no guidance, practice or training of how to implement Health in All Policies and even less for potential avenues in to address equity in this context. This paper seeks to provide some guidance on potential options in the light of existing practices in HIAP as well as knowledge on equity in the context of public policies. We have substantial literature on equity and reducing health inequalities as part of public policies and interventions, however tackling equity as part of HIAP often remains unclear and a further challenge. The purpose of this paper is to focus on current potential and prospects of tackling equity as part of Health in All Policies (HIAP) approach. The paper i) first elaborates what is HIAP and how equity is understood in the context of HIAP, then focuses on ii) the state of current knowledge in relation to HIAP and equity, iii) strategic thinking on HIAP and equity, iv) existing tools and mechanisms for enhancing equity as part of HIAP, v) the role of HIAP as part of political decision-making, vi) needs and scope for capacity building in the area, vii) case studies of relevance to understanding the potential and scope for HIAP, and finally viii) discusses potential and scope for equity focus in HIAP at local, national and European level policy making and ix) concludes and suggests potential agendas for action. at European Union level

“It's very much part of this movement to undermine democracy” : A qualitative study of European Union level opposition strategies against reproductive health and rights

Despite increasing contestations of agreed global commitments on sexual and reproductive health and rights (SRHR), our understanding of strategies of opposition in global health policymaking remains limited. This article explores the opposition to SRHR at the European level focusing on the decision-making institutions of the European Union (EU). The central research questions ask i) how SRHR opposition actors seek to influence EU institutions and ii) what challenges their actions pose for health policymaking at the EU level. Our empirical focus is based on the qualitative method of framework analysis, with data collected from multiple sources, including documentary data on European Parliamentary debates, Council conclusions of the European Union, reports of nongovernmental organisations, and key informant interviews. Our study is in line with observations on globally coordinated efforts to restrict access to SRH services. This is a challenge for specific forums and countries, but as well for European Union's wider internal and external policies. We present a toolbox of strategies and actors operational at the European Union level. Our findings on opposition to SRHR indicate that it can be seen as a political tool that is part of a broader anti-democratic movement. Understanding strategies of anti-SRHR opposition is important for health policymakers as it shapes debates and the achievement of universal health coverage (UHC).Peer reviewe