From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br><div class="gmail_quote">crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font color="maroon" face="Arial" size="3"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold">Considerations for Incorporating Health Equity into Project
Designs:<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><b><font color="maroon" face="Arial" size="3"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold">A Guide for Community-Oriented Maternal, Neonatal, and Child Health
Projects<br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">MCHIP Maternal
and Child Health Integrated Program <br>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Available online PDG [38p.] at: <a href="http://bit.ly/11J85dI" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/11J85dI</span></font></a>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">“…..This guide was developed to give
those who design and implement community-oriented health programs a systematic
way of ensuring that equity is incorporated into program designs and that its
improvement can be better demonstrated and explained. It focuses on equitable
health outcomes….”<br>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">“….While not a prescriptive document
that promotes 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 a 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.<br>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">This guide was developed through a
process of consultation with equity experts in the field and review of
literature on this subject. Although this document should be helpful in its present
form, it is anticipated that it will be improved based on further input and
feedback from experts, including those implementing programs and from further
literature review…..”<br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Content<br>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">I. Introduction <br>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">II. Equity: Definitions, Models, and
Assumptions to Guide our Thinking <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Guiding Assumptions <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Key Assumption 1: Addressing equity
means more than simply working in a disadvantaged geographical region; it means
reaching the most disadvantaged within that region. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Key Assumption 2: Developing
strategies to address inequity requires understanding and deciding how to
handle the underlying conditions. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Key Assumption 3: Obtaining high
coverage levels depends on decisions made along a continuum from narrowly
targeting a disadvantaged group to a universal approach aimed at all groups. <br>
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<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">III. What You Can do to Build Equity
Issues into Your Design and M&E System: <br>
A Six step
Process to Design an Equity focused Project <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Step 1: Understand the Equity Issues
in the Project Area<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Identify inequities in health
outcomes <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Understand the underlying
socioeconomic issues and barriers that lead to inequity <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Step 2: Identify the Disadvantaged
Group on which to Focus <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">How do you determine which group to
prioritize? <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">A. Review secondary data that have
been disaggregated by different groups, specifically ethnic, geographic, age,
gender, religion, or wealth. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">B. Conduct quantitative or
qualitative studies that look at differences between groups. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">C. Work with communities and
religious/social leaders to identify the most disadvantaged groups and work
within the national government definition of disadvantaged groups. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in;text-indent:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">D. Consider the
cost of reaching a particular disadvantaged group compared to reaching another
group that also needs attention. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Step 3: Decide What is in Your
Manageable Interest to Change <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Step 4: Define Equity Goals,
Objectives, and a Project‐specific Operational Definition of Equity <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Project‐specific operational
definition of equity <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Step 5: Determine Equity Strategies
and Activities <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.0in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Step 6: Develop an Equity‐focused
M&E System <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Methodologies for measuring equity <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Modified KPC survey <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Assetbased wealth quintile analysis <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Qualitative techniques <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Monitoring users of services <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Quick Poverty Score <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:1.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Slope Index of Inequality (SII) <br>
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<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">IV. Conclusion <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">References<u></u><u></u></span></font></p>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Annex 1: Adapting the KPC Tool for
Baseline and Monitoring to Capture Inequities in the Project Area:<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Implications for the Questionnaire,
Sample Size, and Sampling Methodology <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Annex 2: Example: Philippine Child
Survival Program (International Aid)<br>
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<p class="MsoNormal" style="margin-left:.5in"><font face="Arial" size="1"><span style="font-size:9.0pt;font-family:Arial" lang="ES-TRAD"><u></u> <u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial" size="1"><span style="font-size:9.0pt;font-family:Arial" lang="ES-TRAD"> </span></font></p></div></div></div><br>