ArticleInternational journal for equity in health2021
Inequitable access to healthcare in Africa: reconceptualising the "accountability for reasonableness framework" to reflect indigenous principles.
Article in International journal for equity in health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Harnessing data science to control non-communicable diseases in Africa: a systematic review and gap analysis.Communications medicine · 2026Article
- Why Feminist Participatory Methods Matter for Global Health Research in Sub-Saharan Africa.Global challenges (Hoboken, NJ) · 2026Article
- Barriers to healthcare access among female youths in Mozambique: a mixed-effects and spatial analysis using DHS 2022/23 data.BMC public health · 2025Article
- Article
- Human cloning as reproductive means in future: a qualitative thematic study of underpinning values.Frontiers in public health · 2024Article
- Addressing neglected tropical diseases in Africa: a health equity perspective.Global health research and policy · 2023Article
- Professional Values of Undergraduate Students at a Nursing School in South Africa.Nursing research and practice · 2023Article
- Voluntariness or legal obligation? An ethical analysis of two instruments for fairer global access to COVID-19 vaccines.Frontiers in public health · 2023Article
- Public legitimacy of healthcare resource allocation committees: lessons learned from assessing an Israeli case study.BMC health services research · 2022Article
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe "Accountability for Reasonableness" (A4R) framework has been widely adopted in working towards equity in health for sub-Saharan Africa (SAA). Its suitability for equitable health policy in Africa hinges, at least in part, on its considerable successes in the United States and it being among the most comprehensive ethical approaches in addressing inequitable access to healthcare. Yet, the conceptual match is yet to be examined between A4R and communal responsibility as a common fundamental ethic in SAA. METHODOLOGY: A4R and its applications toward health equity in sub-Saharan Africa were conceptually examined by considering the WHO's "3-by-5" and the REACT projects for their accounting for the communal responsibility ethic in pursuit of health equity.
resultsSome of the challenges that these projects encountered may be ascribed to an incongruity between the underpinning ethical principle of A4R and the communitarian ethical principle dominant in sub-Saharan Africa. These are respectively the fair equality of opportunity principle derived from John Rawls' theory, and the African communal responsibility principle.
conclusionA health equity framework informed by the African communal responsibility principle should enhance suitability for SAA contexts, generating impetus from within Africa alongside the affordances of A4R.
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