Promoting Health Equity and Human Rights

Since its inception, a leading global funder has promoted equitable and rights-based approaches to health as core principles. Internal and external evaluations of funded and proposed programming suggested that grantees faced challenges operationalizing and even defining these principles. Therefore, a decision was made to systematically include equity considerations into performance-based funding decisions. Specifically, all grantees are required to establish baseline measures against which progress will be monitored. Baseline information must be established through an analytical assessment of inequities, gaps and barriers in current responses, and must include appropriate corrective actions, as well as monitoring mechanisms.

To help grantees negotiate the new process, an applied guidance was developed to 1) provide working definitions of equity, 2) outline the process of conducting equity assessments, 3) detail the steps and actions necessary to provide evidence of health equity progress at all stages of a grant lifecycle, and 4) provide information on technical assistance, capacity building and resources to successfully satisfy funder expectations. Promoting equity in health policies and programs in a specific country context can involve difficult choices and can require challenging long held beliefs or changing priorities. Clear guidance on the development of action plans based on equity assessments using objective criteria to identify gaps, inequities and barriers in reaching populations in need – particularly the most marginalized or vulnerable—was fundamental.

The equity assessment highlights the importance of multiple stakeholder participation, including those at highest risk, to ensure a transparent and inclusive process. The guidance also provides data identification and analytic methods for a range of settings and data availability, as well as guidelines for data interpretation to identify gaps and opportunities. The final section of the equity assessment provides information on how to translate the results of the analysis into effective, evidence- and rights-based programming, since a common challenge is that even a good analysis is not effectively translated into work plans, budgets and performance frameworks.