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Social Protection

Building social protection floors and comprehensive social security systems

International collaboration for social health protection

Updated by Xenia Scheil-Adlung on 12.06.2015


Human Rights

The ILO approach to social health protection is founded on the human rights to health and social security - and on the significance of such protection with regard to rights at work and employment. Since the ILO’s founding in 1919, it has emphasized the role of social health protection in reducing poverty, generating income and increasing wealth.

“Everyone has the right to a standard of living adequate for the health and well being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.  Motherhood and childhood are entitled to special care and assistance.  All children, whether born in or out of wedlock, shall enjoy the same social protection. (The Universal Declaration of Human Rights, Article 25)


Millennium Development Goals

The links between ill health and poverty have been addressed in the Millennium Development Goals (MDGs) aimed at halving extreme poverty and improving health by the year 2015. Implementing universal social health protection might turn out to be a milestone for achieving the MDGs by that target date. 


Decent Work Agenda

The ILO supports the MDGs through its Decent Work Agenda and in the context of fair globalization.  The four pillars of this approach include:

  • Employment - the principal route out of poverty is through work and income.
  • Rights – the absence of which will not empower people to escape from poverty.
  • Social protection - as a safeguard of income and underpins health.
  • Dialogue - the participation of employers’ and workers’ organizations in shaping and ensuring appropriate and sustainable government policy for poverty reduction.

The importance of strengthening linkages between rights, employment and development was underlined in the 2008 ILO Declaration on Social Justice for a Fair Globalization and the 2004 report of the ILO World Commission on the Social Dimension of Globalization



Global Campaign on Social Security and Coverage for All.

In view of the alarming deficit in social health protection coverage in many countries and ILO's long experience in this field, a new strategy has been developed to contribute towards achieving universal coverage at a global level. This strategy reinforces the agreement on social security reached among representatives of governments, workers' and employers' organizations at the International Labour Conference in 2001 to give highest priority to "policies and initiatives that can bring social security to those who are not covered by existing systems". It is part of the Global Campaign on Social Security and Coverage for All.


Providing for Health: Social Health Protection Initiative

The Providing for Health (P4H) initiative is a partnership of governments and organizations engaged in supporting low and middle income countries on social health protection.

The current core group of P4H network comprises 5 partners, the World Health Organization (WHO), the World Bank, the International Labor Organization (ILO,) the French Ministry of Foreign and European Affairs, and the German Federal Ministry for Economic Cooperation and Development (BMZ). There is an open invitation to other development partners working in areas related to social health protection to join the network at country, regional and/or global level.

The focus of the P4H network is on country support. The bulk of P4H’s efforts and resources are allocated to support low- and middle-income countries in their efforts to reach Social Health Protection (SHP) and Universal Coverage (UC);


Social Determinants of Health

The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries. The WHO Commission on Social Determinants of Health (2005-2008) declared health care a common good, not a market commodity. The Commission advocated ?nancing the health-care system through general taxation and/or mandatory universal insurance.

The Rio Political Declaration on Social Determinants of Health was adopted during the World Conference on Social Determinants of Health on 21 October 2011. The declaration expresses global political commitment for the implementation of a social determinants of health approach to reduce health inequities and to achieve other global priorities. It will help to build momentum within countries for the development of dedicated national action plans and strategies.



Social Protection Floor Initiative

The joint UN Social Protection Floor Initiative promotes access to essential services and social transfers for the poor and vulnerable, thus presenting a comprehensive approach to social protection that highlights both the supply and demand side of extending social protection and ensuring effective access.

The SPF emphasizes the need to guarantee services and transfers across the life cycle, from children, to the economically active with insufficient income, to older persons, paying particular attention to vulnerable groups by considering key characteristics that cut across all age groups (gender, socio-economic status, ethnicity, disability, people living with  HIV/AIDS, migrants, populations exposed and/or highly sensitive to adverse external effects such as natural hazards, extreme climate phenomena, etc.).

Recognizing the strategic importance and necessity of ensuring universal social protection, the United Nations System Chief Executives Board adopted in April 2009 the Global Initiative for a Universal Social Protection Floor (SPF-I) as one of nine initiatives in response to the current social security crisis.



WHO Commission on Macroeconomics and Health

Social health protection is increasingly seen as contributing to building human capital that yields economic profits through gains in productivity and higher macroeconomic growth.

 “Macroeconomics and health” refers to a process that seeks to place health at the centre of a broader development agenda. It engages ministries of finance, planning and health to act in tandem with development agencies, civil society, philanthropic organizations, academia, and the private sector. Together, they take forward a shared agenda for addressing financial and system constraints on equitable and timely delivery of quality health and social services.