The recent past has witnessed an increased interest in the concept of wellbeing both in academia and public policy. Governments and international organizations have developed a policy agenda with the broad goal of improving individual and collective wellbeing; positioning it as the desired outcome of, and the benchmark with which to evaluate social and economic progress, and the effectiveness of governments and their policies. The majority of such efforts have been conducted in Euro-American nations with limited efforts in developing countries. In the low-to-middle income countries where such efforts exist, they are based on experiences and indicators from the high-income western countries. As such, limited initiatives that aim to understand how wellbeing is conceptualized in time and place exist in low-to-middle income countries (LMICs) as societal progress in these resource-constrained areas are persistently assessed by econometric measures such as Gross Domestic Product (GDP). To address this gap, the present thesis explored indicators for constructing a healthy population index, an important domain of societal wellbeing in the context of LMICs. As part of the global index of wellbeing project, this thesis set out to understand how Kenyans socially construct their health and wellbeing across place, socio-demographic characteristics, and over their life-course. Using an explorative study design, the thesis employs the social constructionists' perspectives and the eco-social theory to answer three specific research questions. First, the thesis responds to the question, what are the perceptions, meanings and determinants of societal health and wellbeing that matter most to Kenyans and are there differences and similarities by gender and region? Second, how do the youth (15-24 years), the middle-aged (25-49) and the seniors (≥50 years) in Kenya socially construct their health and wellbeing? Third and lastly, what are the indicators of a healthy population domain of wellbeing that matter in the context of Kenya and are there potential secondary data sets that could be used to evaluate progress in health over the past years and into the future? In answering these questions, this thesis adopted qualitative research methodologies - including in-depth interviews (IDIs) and focus group discussions (FGDs). The IDIs with representatives of youth groups (male and female), women, and men groups, representatives of Community-Based Organizations (CBO), and with policy makers (i.e., Member of County Assembly) were conducted to explore their work and lived experiences of health and wellbeing in their respective communities. Focus group discussions (FGDs) with lay participants were conducted to understand their perceptions, meanings, determinants and the social construction of societal health and wellbeing and to determine similarities and differences by gender and across place. The thesis also highlights the indicators of the healthy population domain that matter to Kenyans as revealed in the collected data and suggest potential data sources for evaluating progress. Using the constructs of embodiment and pathways of embodiment of the eco-social theory, the thesis provides a framework with which to map population health indicators for wellbeing assessment in the context of LMICs. The social constructionists' viewpoint on the other hand, is employed in this thesis to explore the social production of knowledge about societal health and wellbeing. The findings reveal that concepts of healthy community and a good life (a proxy of wellbeing) are used interchangeably and are defined using similar concepts. Additionally, having a healthy community and a good life is shown to be dependent on the ability of the community to meet the basic needs for all its members. Specifically, six themes emerge as critical descriptors of a healthy community and a good life in Kenya: a) community health status and quality of healthcare; b) economic and living standard factors; c) social relationships; d) the state of the environment; e) political and governance issues; and f) cultural and societal values, beliefs, norms and practices which influence perceptions and meanings of population health and wellbeing. These contextual factors and the individual and immediate factors interact to create social hierarchies based on gender, age, social class, and regional power imbalances which limit accessibility to resources to certain groups of people. For example, the findings show that gender-based violence (GBV) is a key social determinant of health which disproportionally affects women because of the preexisting cultural structures that act to disempower them. Moreover, the findings reveal that the politics and governance structures - including real engagement in political decision-making, tribalism, corruption and electoral violence are important factors that propagate health inequalities in communities, thus influencing perceptions and meanings of health and wellbeing. Furthermore, the results of this thesis reveal that across their life-course, Kenyans adopt unique social constructs to explain their lived experiences of health and wellbeing. The youth (15-24 years) for example, consider themselves as - "bleeding bodies", "untrustworthy bodies", "culturally disadvantaged bodies" and "bodies at risk". The middle-aged (25-49 years), on the other hand, construct health and wellbeing around issues of domestic violence, whereas the seniors (≥50 years) narrate how they embody distress associated with care for their children and grandchildren in contexts characterized by economic poverty and socio-cultural erosion. According to the participants' narratives, the indicators for the healthy population domain range from health outcome indicators such as the prevalence and incidence rates for infectious diseases (e.g. HIV and the opportunistic diseases), non-communicable diseases (e.g. cancer, hypertension, diabetes and unintentional injuries), mortality rates as well as accessibility, effectiveness and acceptability of healthcare services, lifestyle and behavior, and indicators of public health programs. Theoretically, this study provides the wellbeing literature with a rudimentary framework premised on the social constructionists' perspectives and the eco-social theory for understanding the healthy population indicators that matter in LMICs. In so doing, it highlights socially, geographically and culturally relevant indicators thus allowing for evidence-based policy and policy evaluation across time and space. For example, this research reveals that even though constructs around community health status and quality of healthcare services remain frequent descriptors of the health and wellbeing of populations, social and cultural inclusion, issues such as GBV, socio-cultural erosion and care responsibilities are some aspects of the community that need to be included in evaluation of progress in health and quality of life. This information is important in formulation of relevant health policies and interventions.

We live in a world currently faced by unprecedented social and environmental changes (WEF, 2017). In the face of such rapid change, it is becoming difficult to understand what population wellbeing might mean as well as the indicators that capture its essence. Since the post-war era, Gross Domestic Product (GDP) has been widely used as an indicator of population wellbeing (Potter et al. 2012). However, in recent times, population wellbeing or how people are doing and their progress is increasingly seen as more than merely the value of economic activity undertaken within a given period of time. In response to the growing discontent with the use of economic measures to reflect societal progress and population wellbeing, there has been a global momentum to develop and encourage the use of community-level indicators of wellbeing (Michalos, 2011; Davern et al., 2017). These initiatives aim to increase public understanding of wellbeing and ideas of the 'good life' beyond traditional economic measures. Despite the relevance of these alternative measures for practical and policy purposes, their application remains limited in low to middle-income countries (LMICs), especially sub-Saharan Africa (SSA). The limited usage is due to the narrow focus of current measures and their inability to adequately capture what wellbeing means in the SSA context. Also of critical importance is whether the constituents of these 'Beyond GDP' measures represent what really matters to people in their specific contexts and captures the collective, contextual and compositional attributes that shape wellbeing of places in low to middle-income countries. This thesis explores the meaning of wellbeing, with emphasis on the role of inequality as a key contributor to the wellbeing of places in low to middle-income countries (LMICs), using Ghana as a case study. The research focused on three broad objectives: first, to develop an integrated framework for understanding links between inequality and wellbeing in LMICs; second, to explore lived experiences, perceptions and understanding of wellbeing and its indicators in LMICs and finally, to explore the potential pathways that link inequalities, and wellbeing in the context of LMICs. A mixed-method approach involving a conceptual review, key informants interviews, focus group discussions and a survey were used in the research. The conceptual review suggests that the role of place and inequality in wellbeing research is inadequately conceptualized and inequality as a key attribute of the wellbeing of places in LMICs is not given adequate attention. The review thus suggested that an integrated framework will enable researchers to adequately conceptualize inequality and wellbeing. It further shows that inequality affects wellbeing through multiple pathways. First, inequality may lead to poor wellbeing through status anxiety- the psychosocial response of individuals or societies to the perception of their place in the status ladder. Secondly, the 'social facts' of communities and societies like inequalities may have long-lasting impacts on social cohesion and community vitality. This is especially important in the context of LMICs where communities, and not individuals, mostly serve as the units of identification and development. Thirdly, inequality is detrimental to population wellbeing in LMICs through the differential accumulation of exposures and experiences that have their sources in the material world, which weakens societies' willingness to make investments that promote the common good. Results from the key informants and focus group discussions revealed similarities as well as context-specific descriptions or definitions of wellbeing across Ghana. Description of wellbeing consists of an embodiment of both material and non-material circumstances. The descriptions or definitions that people ascribe to wellbeing were complex and context dependent. Perceptions of the relative importance of indicators differed depending on sex, gender, and location. Further, findings from the survey (n=1036) reveal that inequalities affect wellbeing by constraining access to basic amenities like water, food, and housing and also through its effects on community social capital and cohesion. This research makes important contributions to knowledge, policy, and practice. Theoretically, the research links capability framework with an ecosocial theory to demonstrate the multidimensional nature of wellbeing by revealing the contextual influences that simultaneously facilitate and constrain optimum experience of wellbeing. The framework outlined is a useful tool for exploring how structural forces at different scales interact to shape population patterns of wellbeing in low to middle-income countries. The framework is beneficial as it enables researchers to connect interactions between environmental risks and (re)actions with broader socio-economic factors to understand wellbeing inequalities and how populations literally embody inequalities. Moreover, the framework can be applied to the embodiment of other risks (e.g., water/air pollution) within similar (or different) contexts. Methodologically, the research contributes to the conceptualization and measurement of wellbeing in a cross-cultural context and expands health geographers' substantive focus to include population wellbeing. The research also provides an effective example of an embedded mixed-method design by highlighting the strengths of mixing quantitative methods with other research methods such as focus group discussions and key informants interviews in order to gain a nuanced understanding of wellbeing. In terms of policy, the research highlights to adopt wellbeing as the central focus of policy interventions. It also highlights the need for policies to respect community perspectives and experiences in identifying what matters to forge a common understanding not only of wellbeing but also what is fair and just.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Outlines the key aspects & issues concerning health systems of low- & middle-income countries, recognising the current global context within which these systems operate & the dynamics of this context. It brings together a set of renowned authors to tackle the issues that face population health & health care in the twenty-first century

"The Handbook on health inequality monitoring: with a special focus on low- and middle-income countries is a resource that enables countries to do just that. It presents a comprehensive yet clear overview of health inequality monitoring in a user-friendly manner. The handbook succeeds in giving those involved in health inequality monitoring an appreciation of the complexities of the process, as well as building the practical knowledge and skills for systematic monitoring of health inequalities in low- and middle-income countries. The use of the handbook will enable countries to better monitor and evaluate their progress and performance with a high degree of accountability and transparency, and allow them to use the results to formulate evidenced-based policies, programmes and practices to tackle inequalities in an effective manner."--Publisher's description.

This book highlights lessons from the COVID-19 pandemic and explains how these can be used to build sustainable health systems, especially in Low- and Middle-Income Countries (LMIC). It investigates the impact of outbreak response and management on health sustainability in LMIC from the perspective of SDG3: "Ensuring healthy lives and wellbeing for all at all ages". Despite strides being made in some areas for SDG target 3.3 to fight communicable diseases, the COVID-19 pandemic has caused interruptions that will considerably affect vaccination coverage as well as the progress that was made, for example: in reducing malaria cases. Vulnerable populations who were already struggling to access their healthcare needs before the pandemic may face even greater challenges at present and in the years to come, post-pandemic. This book considers the progress on attaining the SDG3 targets, specifically: to improve early warning systems for management of national and global health risks, and the effect of pandemics - including but not limited to the COVID-19 pandemic - and emerging disease outbreaks. It explores the weaknesses and strengths in LMIC and how to strengthen capacities in these countries. The author also investigates and proposes approaches that can, or should, be implemented to ensure sustainable health systems in developing countries, including early warning systems, risk reduction, and the management of global and national health risks. This book is of great interest to public health professionals, infectious diseases experts, and epidemiologists, as well as students and researchers of public health systems and healthcare infrastructure in developing countries.