For whom are health systems designed? Political determinants of health and equity in the context of a health system reform in Finland (POLDEQUITY)

POLDEQUITY explores how power and politics shape health care equity at multiple levels of the health system.

The Finnish health system reform provides a unique opportunity to use a large-scale reform as a context for examining the equity of health care.

The health care equity means that health systems should provide equal access to good quality care according to equal need. However, disparities in access to and quality of health services have remained consistent and systematic.

Objectives

The purpose of the study project is to propose actionable solutions to promote health care equity.

Implementation

POLDEQUITY is implemented by the Finnish Institute for Health and Welfare (THL).

The project examines the health care equity through the political determinants of health (PDOH) framework. The framework asserts that different groups are not valued equally in political systems, which leads to structural barriers to health care equity for people who lack power and privilege. 

The project utilizes multimethodological approaches in a multidisciplinary research group, including a document analysis, interviews, ethnography and register data. 

The project is organized into three phases as follows:

1. We study policy formulation at the national level by identifying competing policy ideas that have influenced and finally constitute the content of the health system reform, and the policy choices resulting from the regional interpretations of the reform in three regions.
2. We study the lived experiences of those working at the front lines of primary health care and those targeted by the health care reform. We also study how the reform that redistributes power and resources impacts geographic equity within and between regions among vulnerable population groups (e.g., frequent primary health care attenders).

3. We review the results obtained in the project with key stakeholders and develop new solutions to promote equity in health care.

Partners

• Tampere University
• Wellbeing services county of North Karelia 
• Wellbeing services county of Ostrobothnia
• Wellbeing services county of Vantaa and Kerava

Funding

Research Council of Finland

Contact information

Liina-Kaisa Tynkkynen 
Chief Researcher 
tel. +358 29 524 8517
[email protected]