Underlying Equity Discourses of the World Health Organization

Abstract

Background: Globally, increasing attention has been paid to the concept of equity in the context of health, largely stemming from the work of the World Health Organization (WHO) beginning in the late 1970s with the Declaration of Alma-Ata (WHO, 1978) and more recently following the Commission on the Social Determinants of Health (CSDH, 2008) and their final report in 2008. Despite increasing attention to this issue, there is global ambiguity on the true definition of “health inequity”, “health inequalities”, or “health disparities” (Braveman, 2006, p. 167; Braveman & Gruskin, 2003). Methods/Design: This original scoping review clarifies how the WHO conceptualizes equity. It also identifies the theoretical underpinnings guiding the WHO’s approach to equity and its broader implications. This protocol followed the PRISMA guidelines for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018), with details discussed in the full protocol. Discussion: To date, much of the research on health equity globally has been restricted to chronological discussions over time or specific research fields (Borde & Hernández, 2018, p. 3). Therefore, researching the WHO’s approach to equity in terms of alignment with theory and broader normative standpoint(s) becomes increasingly important in addressing a gap in the literature. In addition, because the definition of equity in the context of health has practical implications for its operationalization (Guerra, Borde, & Salgado De Snyder, 2016), this work seeks to clarify in the concept of equity used by the WHO in hopes of moving towards a shared understanding to bridge action [e.g. in measurement and accountability (Braveman & Gruskin, 2003)].