Maternal and child survival program equity toolkit: A practical guide to addressing equity in reproductive, maternal, newborn, and child health programs

There is a common assumption that programs aiming to increase coverage of health services and reduce morbidity and mortality among the poor are, by virtue, equitable. However, without careful attention to equity in the design, implementation, monitoring, evaluation, and adjustment of the strategy, these programs may result in narrow impacts that only improve the situation of those who are comparatively advantaged, while failing to meet the needs of the poorest and most marginalized communities. The only way to ensure equity improves is to choose approaches likely to reach the underserved, incorporate pro-equity design, monitor equity outcomes using feasible and valid measurements, and adjust programs based on these findings. To do so, it is important to communicate how equity is defined within the context of individual programs, what specific actions are aimed at improving equity, how these improvements will be demonstrated, and how these actions, if successful, might be sustained, institutionalized and scaled up in programs and policies. 
This guide was developed to give those who design and implement community-oriented health programs a systematic approach to programming that incorporates identifying and addressing health inequities and measuring equity improvements. This guide is aimed at professionals working in reproductive, maternal, newborn, and child health (RMNCH) programs, especially those that are part of country programs of the Maternal and Child Survival Program (MCSP), funded by the U.S. Agency for International Development (USAID). 
While this is not a prescriptive document promoting one approach to equity programming, this guide presents a series of concepts and approaches to take into consideration and decisions to be made that lead to the development of a coherent equity strategy as part of program design. These questions can serve as a basis for dialog among teams involved in designing programs and can help to ensure a shared understanding of the equity approach used. (author introduction) #P4HEwebinarOctober2024