Frameworks of analysis for looking at health and the very poor

A number of documents have strongly influenced current understandings of social protection. Social risk management: a new conceptual framework for social protection and beyond defines social protection as public interventions to assist individuals, households and communities to manage risk better and provide support to the poor.

In this approach a social risk management framework (SRM) is used to analyse the intensity and frequency of risk, and the degree to which the impact on different individuals is correlated. The framework distinguishes between strategies for risk reduction (e.g. immunisation of one’s child), risk mitigation (e.g. subscription to an insurance) and risk coping (e.g. getting into debt for financing one’s health care).

Transferring the concept of risk to the health sector will enable policy makers to devise intervention strategies based on a more nuanced understanding of health-poverty interrelationships. Intervention strategies from both within and outside the health sector are needed for dealing with health risk.

An Overseas Development Institute (ODI) policy paper on social protection argues that the SRM framework fails to pay enough attention to the long-term impact of shocks. It argues that more needs to be done to assist the very poor to emerge from chronic poverty, and to assist the less active poor to live a dignified life.

Recent conceptual work by the Chronic Poverty Research Centre provides another useful analytical framework for looking at health-poverty linkages. Health and poverty linkages: perspectives of the chronically poor identifies six dimensions through which aspects of ill-health interact with other components of poverty to cause chronic long-term poverty. This work provides a useful framework for uncovering some of the underlying processes behind ill-health and chronic poverty, and for identifying entry points for intervention.