In response to the call in the Rio Political Declaration on Social Determinants of
Health (2011) and the Strategy for addressing the key determinants of Health in the
African Region (2010) for Member States to produce evidence-based research on
health inequalities, the Government of Seychelles with financial assistance from the
World Health commissioned the study to identify social and economic factors which
disadvantage certain population groups from realizing their potential life years. In
Seychelles, non-communicable diseases such strokes, heart attacks, diabetes,
cancer, asthma and depression causes highest burden on mortality and morbidity.
Thus, a large part of this report will be devoted to non-communicable diseases.
However, HIV & AIDS is emerging as one of the serious health threats in Seychelles
and hence is included in the report.
Considering the numerous frameworks available for analysis of social determinants,
the one developed by Dahlgren and Wilson (1991) has been found appropriate for
this study because of its relevance to the variables being investigated and its
amenability to quantification of the risk factors. The framework demonstrates the
influences of social and economic determinants of health on population health
through the use of rainbow-like layers model that include the individual lifestyle
factors, social and community networks, living and working conditions and the
general socioeconomic, cultural and environmental factors.
The report has used secondary data available in the Seychelles and these include the
2010 census, three waves of the Heart Study (1989, 1999 and 2004), the annual
Global School Health Surveys and Global Youth Tobacco Surveys, Vital Registration
System and other health statistics. However, the absence of the DHS-types of
surveys, limits the measurement of socio-economic variables and availability of a
wide array of other health outcome variables. In the analyses, while the traditional
methods have been used, other new methods have been introduced to add value to
the development of techniques for measuring health inequalities. The report has
been structured to present health inequalities in the first part and discuss the social
determinants in the second part