Address Health Inequities Research Articles

Addressing the Inverse Care Law in Scottish general practice: systematic scoping review.

Background Recent evidence demonstrates persistence of the inverse care law (ICL) in general practice in England. Although the ICL was well-described in Scotland 20 years ago, progress in interventions since then is unclear. Aim To review national and local interventions which aimed to specifically address the ICL in Scottish general practice since 2000. Design & Setting Systematic scoping review, Scotland. Method We searched EMBASE, Web of Science, MEDLINE, CINAHL, Cochrane and BASE from 2000 to February 2024. We also performed a systematic grey literature search of government, NHS and third sector websites. All papers were double screened for inclusion. We included quantitative and qualitative studies and assessed quality using the Joanna Briggs Institute tools. Results Out of 13089 results, 67 papers reporting on 20 interventions were included. Interventions to improve general practice in deprived areas were categorised as: 1) enhancing patients' financial or social support, 2) targeting specific health conditions, 3) targeting specific groups and 4) enhancing generalist healthcare. Six interventions accounted for 49% of all included papers. Only two interventions have been rolled out nationally - Community Link Workers and Welfare Advice and Health Partnerships - with both facing uncertain long-term funding. Conclusion There remains a major implementation gap between Scottish Government's policy ambitions to address health inequalities and sustainable delivery on the ground. To address the inverse care law, greater overall investment in general practice is needed, together with additional resources for more deprived areas according to local population need (a "proportionate universalism" approach).

Launching the Indianapolis Health Equity, Access, outReach & Treatment (iHEART) Collaborative: A Case Study.

Objective: To describe the creation, deployment, and initial impact of a place-based, multi-level, multi-component initiative designed to prevent cardiovascular health disparities in high-risk neighborhoods in Indianapolis, Indiana. Methods: The Indianapolis Health Equity Access outReach & Treatment (iHEART) Collaborative uses a community-driven, place-based approach and leverages partnerships with local organizations, businesses, and residents to implement health screenings, educational outreach, and support for social determinants of health (SDOH). Results: From September 2022 - September 2024, iHEART conducted 4048 blood pressure screenings; 3135 in community settings. >38% of participants were identified as having Stage 1 hypertension or being at risk. 29% of 1219 individuals with elevated CVD risk were previously undiagnosed. 94.6% of 223 individuals referred for medical care completed follow-up care. Barbershop 2.0 screened 378 patrons, with 126 returning for additional screenings. >50% of these returning participants demonstrated improvements between their initial and follow-up screenings. The Convenient Home Evaluation for Cardiovascular Health and Individual Tracking (CHECK-IT) program enrolled 1105 patients; 63.9% achieved blood pressure control, or their last recorded blood pressure reading below 140/90mmHg, by the end of the 4-month program. Conclusions: iHEART's approach highlights the potential benefits of combining health and SDOH interventions, offering a promising model for addressing health inequities.

Supporting women with diabetes experiencing menopause: A workshop to co-design research recommendations for improving the understanding of and support for women with diabetes experiencing menopause.

Based on direct feedback on the challenges faced by women with diabetes navigating menopause, the Diabetes Research Steering Groups (DRSGs), organised by Diabetes UK, conducted a workshop aimed at outlining key research priorities in this area. The statement will provide actionable recommendations for researchers and funders, ensuring future studies address the unique needs and lived experiences of women living with diabetes during this life phase. The DRSGs also highlighted the need to bring researchers and healthcare professionals in the field of diabetes together with those working in women's health to collaborate in this field. The goal is to bridge the gap in understanding and support, driving research that informs more effective care strategies and improves quality of life during this critical and often challenging life stage. In November 2023, Diabetes UK convened a workshop on diabetes and menopause, bringing together 49 participants, including people with lived experience, researchers, healthcare professionals, and representatives from charities and funding bodies. The workshop began with presentations from experts and case studies, followed by small-group discussions facilitated by Diabetes UK staff. Participants were asked to identify key evidence gaps and refine research questions related to diabetes and menopause. Groups focused on thematic topics, discussing barriers and potential solutions. Insights from these discussions were collated and thematically analysed, resulting in key recommendations to address health inequalities in diabetes research. The following key areas were identified for increased future research focus: Improving the understanding of the mechanisms underlying the impact of menopause on blood glucose control in women with diabetes Understanding the safety and efficacy of treatments, technology, and exercise in the management of diabetes and menopause Understanding how to best support women from underserved communities in their management of diabetes and menopause Understanding the impact of menopause on the mental health of women with diabetes and tailoring psychosocial interventions that support women during this period. Supporting healthcare professional education in how to effectively support women with diabetes experiencing menopause. Exploring how innovative models of care can support women with diabetes experiencing menopause more effectively. This position statement presents recommendations to address the unmet needs of women with diabetes experiencing menopause. The diabetes research community is to act upon these recommendations to ensure the views and needs of this group are well-represented.

Income-Based Disparities in Perceived Benefits and Challenges of Virtual Global Health Activities During the COVID-19 Pandemic: Mixed Methods Analysis.

Global health activities (GHAs) can potentially reduce health disparities by facilitating resource sharing, promoting medical education and professional development worldwide, and enhancing collaboration among high-income countries (HICs) and low- and middle-income countries (LMICs). However, the COVID-19 pandemic disrupted in-person GHAs due to strict infection control and travel restrictions. To ensure the continuity of GHAs and further address health inequity, virtual GHAs (VGHAs) are gaining traction. Our research aimed to understand how people perceive the benefits and challenges of VGHAs, analyze and compare whether HIC and LMIC respondents have different perceptions of virtual and in-person GHAs, and summarize suggestions for improvement to inform the future development of VGHAs. We conducted a cross-sectional web-based survey during the COVID-19 pandemic in early 2022. Eligible participants were adult students, trainees, or professionals who participated in, created, taught, or facilitated GHAs. We thematically analyzed participants' free-text responses regarding their perceptions of the benefits and challenges of virtual and in-person GHAs. The patterns differed depending on whether respondents were from HICs or LMICs; thus, we compared frequencies of each theme between the 2 groups. A total of 154 respondents from 34 countries were included in the analysis. Key benefits of VGHAs were improved access to global health resources or content, reduced cost, easier scheduling and planning, expanded remote participation, and wider participation and reach. The themes that emerged as challenges of VGHAs included a lack of infrastructure to engage virtually, being less motivated and engaged, a lack of in-person and hands-on experience, and challenges with virtual communication and collaboration. LMIC respondents, compared to HIC counterparts, were more likely to identify reduced cost (26/67, 39% LMIC compared to 20/87, 23% HIC; χ21=4.5; P=.03) and expanding knowledge, experience, or skills (15/67, 22% LMIC compared to 8/87, 9% HIC; χ21=5.2; P=.02) as benefits of VGHAs, lack of infrastructure to engage virtually as a challenge of VGHAs (38/67, 57% LMIC compared to 31/87, 36% HIC; χ21=6.8; P=.009), and to suggest improving the content to be more interesting and relevant (6/67, 9% LMIC compared to 1/87, 1% HIC; χ21=5.3, P=.02). In contrast, HIC respondents were more likely to identify fostering continuity of relationship or activities (28/87, 32% HIC compared to 6/67, 9% LMIC; χ21=11.9; P<.001) as a benefit of VGHAs and being less engaged and motivated to participate virtually (43/87, 49% HIC compared to 19/67, 28% LMIC; χ21=7.0; P=.008) as a challenge of VGHAs. Our findings add to the existing literature by understanding how GHA participants from HICs and LMICs perceive the benefits and challenges of VGHAs differently. These data help elucidate what makes VGHAs acceptable to global health partners and suggest improvements to ensure partner needs are served equitably within the partnership.

Social determinants of distress in South Asian men with long-term conditions: a qualitative study in primary care.

People with long-term physical conditions are more likely to experience distress, depression, or anxiety. Physical-mental comorbidity is associated with lower quality of life, poorer clinical outcomes, and increased mortality than physical conditions alone. People of South Asian origin are the largest minority group in the UK, and more likely to have long-term conditions (LTCs) such as diabetes and heart disease. To explore how men of South Asian origin with LTCs understand and experience emotional distress as well as the experiences of GPs supporting them. A UK qualitative study interviewing South Asian men with diabetes or coronary heart disease, and GPs working at practices with higher proportions than average in the UK of people of South Asian origin. Online semi-structured interviews with South Asian men and GPs were undertaken. Data were analysed via reflexive thematic analysis. Topic guides were modified iteratively as data collection and analysis progressed. An ethnically appropriate patient advisory group of South Asian men was involved in all stages of the research. Seventeen South Asian men with LTCs and 18 GPs were interviewed. Participants described contextualising distress, including LTCs influencing distress and the intersections of social determinants of distress including ethnicity, poverty, and perceptions of prejudice. Participants understood distress as different from depression with the need to negotiate multiple identities as well as integrative paradigms of health. This study highlights the influence of social determinants of distress in South Asian men with LTCs. It provides an insight into how primary care has the potential to address health inequalities by considering the intersection of these factors.

Healthy lifestyle habits, educational attainment, and the risk of 45 age-related health and mortality outcomes in the UK: A prospective cohort study.

Healthy lifestyle habits, educational attainment, and the risk of 45 age-related health and mortality outcomes in the UK: A prospective cohort study.

The relationship between frailty, ethnicity and health inequality – a scoping review

This scoping review highlights the need for research to address the intersectional relationship between racialisation, health inequality and frailty in older age. We map research addressing the relationship between frailty and ethnicity across literature exploring health inequality in order to collate findings, identify trends and highlight research gaps. Our most significant finding is the absence of attention to the role of racism despite the majority of studies identifying a positive correlation between frailty and minority ethnicity. In countries with ageing populations, ill health and frailty was generally found to strike earlier and more severely in racially minoritised groups. However, there is a paucity of research addressing ageing and ethnicity. To focus the review, we asked: how are frailty and ethnicity/race related in the current literature addressing health inequality? We map the existing literature, commenting on terminology, findings and methodology. While social, economic and cultural factors are speculated to be explanations for inequality, there has been little analysis of the association between frailty, ethnicity and socioeconomic inequality, no explicit attention to the role of racism and little qualitative research to explore the lived experience of frailty and ethnicity. Despite the contested nature of both frailty and ethnicity, the majority of studies lacked definitions of the terms used, particularly with respect to ‘identifying terms’ used for ethnicity. We call for further research (particularly qualitative research) to address frailty and ethnicity in the context of racialisation and health inequality and for critical engagement with ‘identifying terms’ used.

A Three-Book Analysis of Global Health and Policy in Emerging Economies

This article presents a comprehensive book critique of three influential works on global health systems, policy, and equity in low- and middle-income countries (LMICs). It offers a comparative analysis of "Global Health: An Introduction to Current and Future Trends" by McCracken and Phillips, "Introduction to Global Health" by Jacobsen, and "Health Systems in Low- and Middle-Income Countries: An Economic and Policy Perspective" by Smith and Hanson. Through thematic analysis, the critique explores key areas such as health disparities, the role of health systems, global health challenges, and the intersection of social and biological factors in shaping health outcomes. The review identifies common themes across the books, including the emphasis on strengthening health systems, addressing health inequalities, and the need for policy interventions to overcome economic and resource challenges in LMICs. It also highlights the distinct approaches of each book. McCracken and Phillips focus on emerging health trends, Jacobsen provides global health solutions, and Smith and Hanson delve into economic and policy frameworks for health system improvement. The critique emphasizes the importance of adopting multidimensional strategies to address the evolving health challenges in LMICs, particularly in light of the growing burden of noncommunicable diseases. This analysis serves as a valuable resource for scholars, policymakers, and practitioners aiming to enhance global health systems and promote health equity in resource-constrained settings.

AI and public health: Charting a path to smarter decision-making

Artificial intelligence is fundamentally transforming public health decision-making through sophisticated computational techniques that analyze complex health data at unprecedented scale and speed. This technical article examines how AI technologies are being integrated into public health systems to enhance disease surveillance, optimize resource allocation, and address health inequities. The paper explores multimodal data integration for outbreak detection, census-level analytics for chronic disease risk assessment, and applications in health system planning including social determinants analysis and emergency resource optimization. Methodological considerations regarding model architecture selection and validation frameworks are discussed, highlighting the balance between complex deep learning approaches and more interpretable models. The article addresses critical ethical challenges including data privacy architectures and bias mitigation strategies necessary for responsible implementation. Future research directions are identified, including causal AI methodologies, multimodal learning systems, adaptive models that update with evolving health patterns, and explainable AI techniques. Throughout, the article emphasizes that successful AI integration depends not only on technical sophistication but also on thoughtful implementation that balances computational capabilities with human expertise and judgment within appropriate governance frameworks.

Incidence, patient-directed discharge, readmission, and mortality among people hospitalized with injecting-related infection: A population-based linkage study

Abstract Background Despite international reports of increasing hospitalization for injecting-related infection, there has been limited large-scale evaluation of in-hospital and post-discharge outcomes. This study aimed to characterise population-level injecting-related infection hospitalization and correlates associated with patient-directed discharge, readmission, and all-cause mortality among persons who inject drugs with hepatitis C in New South Wales, Australia between 2001–2022. Methods Hepatitis C notifications in NSW (1993-2022) were linked to hospital (2001-2021), opioid agonist treatment (1985-2022), incarceration (1994-2021), and death registration (1993-2022) data. Hospitalizations among people who inject drugs with injecting-related infections were identified using validated ICD-10 code algorithms. Incidence of patient-directed discharge, readmission, and mortality were calculated, and correlates associated with each outcome assessed using extension of Cox proportional hazards model for recurrent events. Results In total, 18,074 injecting-related infection hospitalizations were included among 9,045 individuals, predominantly males (64%) with average age 41 years. Incidence was 47.2 per 100 person-years and increased over time. The proportion of hospitalizations ending in patient-directed discharge was 18%, associated with stimulant use and incarceration, and less likely in those with severe disease and on opiate agonist therapy. The proportion of hospitalizations that were followed by a 30-day and 1-year readmission was 25% and 61%, respectively and had a strong association with patient-directed discharge. Mortality was 2% and 15% at 30-days and 1-year post discharge. Conclusions Patient-directed discharge was common among people admitted with injecting-related infections and was associated with readmission, but not mortality. Person-centered models of care are necessary to address health inequity experienced by people who inject drugs.

Challenges in implementing evidence-based standardized home visits for newborns, infants, and their caregivers: Lessons from the Republic of Korea

Objective In Japan, home-visit programs for newborns and infants have been implemented based on the Maternal and Child Health Act and Child Welfare Act. However, these programs vary widely across municipalities. This study aimed to examine the current state and challenges of scientifically designed and standardized home-visit programs in the Republic of Korea and obtain practical implications for Japan.Methods Information was collected through collaboration with individuals affiliated with the Seoul National University College of Medicine and from publicly available sources.Results In the Republic of Korea, the Maternal and Early Childhood Home Visiting Program targets children aged ≤ 2 years and their mothers. Based on "the Family Partnership Model," the program emphasized partnerships between nurses, social workers, and caregivers. Initiated in Seoul in 2013 as the Seoul First Step Project, it expanded nationwide in 2019 as part of the Early Life Health Management Program. The program integrates the social-ecological model, proportionate universal approach, and life course approach, offering basic visits to all applicants and ongoing visits to families requiring additional support. The coverage rate of home-visit programs relative to the number of births has reached approximately 30%.To address the shortage of nurses, group programs in which mothers learn parenting skills together and the distribution of parenting manuals and leaflets were implemented. A standardized 320-h in-service training program was developed to ensure standardized home visits. Regular supervision and reflection opportunities were provided to the staff to ensure the quality of the home visits. Inspired by the U.S. HomVEE framework, multidimensional evaluation indicators assessed home environment, child safety, growth and development, maternal well-being, and community support.Conclusion In the Republic of Korea, partnerships between universities, administrative organizations, and healthcare professionals (nurses, social workers, and physicians) have fostered evidence-based program designs, standardized in-service training, and evaluation outcomes. Although Japan has achieved high implementation rates of meticulous home visits, in-service training and evaluation should be improved. To address health inequalities from early life stages, translate evidence into practical applications, and improve the quality of home-visit programs by leveraging the strengths of all stakeholders involved.

Pathways to nurse development and retention: development of an academic/community-engaged partnership.

A looming nursing shortage is anticipated by 2025 due to 30% of faculty retirement and the global shortage of 13million nurses by 2030. Addressing this crisis requires innovative strategies that prioritize diversity and address health inequities. This study aimed to develop and assess the pilot implementation of a community-engaged program targeting underrepresented high school students in a southeastern state. Evaluation of a nurse development and retention for underrepresented (URM) high school students. Workshop attendance rates were recorded. Program acceptability was measured using the Client Satisfaction Questionnaire-3 (CSQ-3). Changes in participants' intention to apply to nursing programs were assessed using the General Self-Efficacy Scale (GSE). Registered nurses provided mentoring and offered educational workshops and presentations on nursing career pathways. Twenty-one African American students from an underserved high school participated. Attendance rates were high, with 81% attending all workshops. Mean CSQ-3 scores demonstrated high program satisfaction (mean = 11). There was a significant increase in GSE scores from 30.81 to 32.57 (p = 0.017), indicating improved self-efficacy to pursue nursing careers. The study demonstrates that a community-engaged nurse development program was effective as potential approach to address the nursing shortage among URMs and promoting workforce diversity. Mentorship-driven initiatives have the potential to inspire and empower URMs to pursue nursing careers. Further research is necessary to evaluate the program's long-term impact on workforce development and its scalability to other communities, contributing to the evidence base for community-centered approaches to address the global nursing workforce crisis and advance health equity.

Variations in Acceptance of American Society of Addiction Medicine (ASAM) Continuum Levels of Care for Substance Use Disorder Treatment in an Urban Safety Net Primary Care Health Setting: A Qualitative and Quantitative Analysis and Implications for Health Equity

Objectives: To assess patients’ demographic factors associated with declination of recommended American Society of Addiction Medicine (ASAM) Continuum levels of care and analyze patients’ self-reported reasons for declination. Methods: This cross-sectional observational study examined data collected during clinical care delivery in a safety net health system’s primary care setting for patients receiving medication treatment and recovery support services for opioid and/or alcohol use disorder (OUD, AUD). We evaluated intake assessments to identify recommended levels of care, acceptance or declination of the recommendation, and self-reported reasons for declination. We stratified the acceptance data by demographic factors and analyzed reasons for declination to identify themes. Results: Of 1399 completed intakes, 42% declined all ASAM levels of care as a complement to medication and within-clinic recovery support services. Patients who identified as non-White, male, and/or 60 years or older were significantly more likely to decline all levels of care. Among the 125 patients who provided a documented reason for declining, 26% endorsed work, financial, or family obligations; 26% indicated a preference for alternative forms of psychosocial support; and 14% indicated possible interest in the future. Conclusions: It is important for substance use disorder treatment providers and policymakers to understand the barriers patients face regarding engagement in treatment and reasons for the declination of services. Recognizing variations in care acceptance by demographic factors can help us understand common barriers and guide future directions to address health inequities.

“If you show them respect, you’re going to [get] respect back": a theory for engaging First Nations for knowledge translation within a national nutrition and health survey

BackgroundKnowledge translation (KT) research aims to bridge the gap between research results and application which is vital to addressing health inequities. Despite the increasing emphasis on engaging Indigenous communities in research, there is limited research examining how to effectively engage communities to achieve Indigenous KT. The Food, Environment, Health, and Nutrition of First Nations Children and Youth (FEHNCY) is a nationally representative survey collaborating with First Nations’ (FNs) communities across Canada to inform policies and programs. The FEHNCY Community Engagement and Mobilization (CEM) supports partnerships with participating FNs communities and the application of study findings into action. This formative research aimed to examine how, for whom, and in which circumstances community engagement approaches support KT within FNs communities.MethodsData were generated with one rural and one semi-urban community participating in the FEHNCY pilot from the Atlantic and Eastern regions of Canada, respectively. A total of 26 in-depth interviews were conducted, 1 modified Talking Circle with community partners and 2 focus group discussions with the FEHNCY team. We used a realist approach combining inductive and deductive coding stages to develop a middle-range theory examining the connections between community engagement and KT.ResultsOur findings highlight the contexts, interventions, mechanisms, and outcomes that create pathways to KT. The participants described the societal, study and community contexts that affected engagement processes. The essential community engagement strategies included supporting Indigenous leadership in the research, supporting community decision-making, promoting project visibility, applying youth-specific engagement strategies, and incorporating FNs knowledges. The participants also described that centering positive relationships between research and community partners and valuing FNs knowledge systems were essential mechanisms for supporting KT. Lastly, participants highlighted KT outcomes namely, community self-determination in research, improved research findings and application of results for FNs benefit.ConclusionThis research can inform the strategic use of community engagement in research for KT among FNs. This study is the first to generate a middle-range theory using primary data collection for supporting KT through community engagement approaches in Indigenous health research.

Global burden of ectopic pregnancy from 1990 to 2019: A tendency, forecasted trend and inequality analyses based on the Global Burden of Disease Study 2019.

Global burden of ectopic pregnancy from 1990 to 2019: A tendency, forecasted trend and inequality analyses based on the Global Burden of Disease Study 2019.

The time is now: Addressing health inequities in the workforce.

As a major provider of health insurance for working-age Americans, employers can play a significant role in improving the health equity of their employees and family members. In this commentary, we describe how different stakeholders, including employers, their employees, clinicians, and health systems and health plans, each contribute to the observed inequities. Other systems-level factors, including racism, implicit bias, medical mistrust, health literacy limitations, and health care access and affordability concerns have been also shown to contribute to inequitable outcomes. Opportunities exist for employers to improve health equity among their benefits-enrolled employees and family members using data-driven approaches to ensure that benefits are more equitable in scope, access, and affordability. As an illustrative example of employer strategic considerations, we describe opportunities to identify and address inequities in prescription medication use. Additionally, employers can, and perhaps should, advocate for transparency in community-based health system and health plan reporting regarding health inequities and progress toward more equitable health care utilization and outcomes. Employers can also advocate for the delivery of more patient-centered, systems-based solutions, such as enhanced primary care and/or worksite clinics, and give consideration to establishing health equity performance-based incentives in their health care contracting. Further research in the employer setting can help to expand the adoption of a best-practices approach to achieving more equitable health outcomes.

Trends and cross-country inequalities in global burns burden among children and adolescents: A population-based study from 1990 to 2021.

Trends and cross-country inequalities in global burns burden among children and adolescents: A population-based study from 1990 to 2021.

Addressing Health Inequities: Understanding the Relationship Between Social Determinants of Health and Necrotizing Enterocolitis.

Addressing Health Inequities: Understanding the Relationship Between Social Determinants of Health and Necrotizing Enterocolitis.

269 Systems Marketing Analysis for Research Translation (SMART) innovation program

Objectives/Goals: The goal of the RC2 Systems Marketing Analysis for Research Translation (SMART) special innovation program is to develop and test a structured approach for working with research teams and communities to accelerate the translation of clinical and community innovations to address health inequities by integrating social marketing with community-based system dynamics. Methods/Study Population: The SMART program is a consultancy service for CTS teams focused on selecting and tailoring implementation strategies for advancing equity. We use social marketing for understanding the alignment of practice innovation feature sets with community priorities for advancing health equity; and community-based system dynamics to understand and refine the dynamics of scaling up and sustaining the implementation of innovations with sufficient reach to address regional health inequities. The program is implemented as community-engaged group model-building workshops with research teams, with follow-up marketing analyses and computer simulation of implementation strategies of innovations and development of implementation roadmaps. We use developmental program evaluation to revise the SMART program. Results/Anticipated Results: Anticipated results from piloting the SMART innovation program with four research teams include (1) design matrices pre and post-workshop for each innovation; (2) system dynamics simulation models and analyses of implementation and scale-up of innovations; (3) analysis of the SMART program for highest impact, with priors for estimating subsequent SMART program performance; and (4) a revised SMART program based on results from the developmental program evaluation. Discussion/Significance of Impact: This work highlights the feasibility and benefits of combining methods that have been cited in implementation science for understanding the complexity of implementation to accelerate the translation of innovations into clinical and community settings for advancing health equity.

How do high-level African directors of policy and planning operationalize health equity? Findings from a regional survey.

This study investigates the operationalization of health equity and associated challenges faced by directors of policy and planning and those in related positions in the African Region. The results of this study demonstrate that health equity is generally a priority for policymakers in practice and is operationalized in four ways: (i) targeting priority groups, (ii) focusing on the entire population; (iii) through procedural justice; and (iv) operationalizing population health data. The targeted approach, which predominated, tended to focus on individuals with lower socioeconomic status, maternal and child health services, and select infectious diseases (e.g., HIV/AIDS). The population-wide approach entailed the inclusion of health equity in institutional laws, constitutions, and national policies with efforts to ensure access to health services for all. Procedural justice largely focused on the inclusion of stakeholders in decision-making processes. Lastly, operationalizing population health data was noted to guide policy and planning to address health inequities, often through aiding in the selection of priority groups or areas for intervention and monitoring and evaluation actions focused on improving health equity. Four main domains of challenges for incorporating health equity emerged relating to: (i) understanding health equity, (ii) governance, (iii) resources, and (iv) lack of data. Our recommendations are two-fold: (i) we recommend that researchers focus on improving understandings of health equity among policymakers through knowledge translation and exchange, and (ii) we recommend that policymakers and those working within donor organizations focus on reforming any top-down processes through which priorities are set and decisions are made.