EQUITY Approach: Promoting social justice in health by meeting the FP/RH needs of the poor

PURPOSE: A central pillar of social justice is meeting the needs of poor, vulnerable groups. However, research shows that, often, the better off benefit most from public health spending. Inequalities are seen especially in family planning (FP) and reproductive health (RH), as the poor tend to have higher total fertility, lower contraceptive use, and higher unmet FP need. Improving the poor's access to FP/RH is essential for enhancing their health (e.g., reducing maternal and infant mortality) and creating a path out of poverty (e.g., with lower fertility, households have more resources to invest in each child). METHODS: We designed the EQUITY Approach to help policymakers and advocates integrate the voices of the poor and pro-poor strategies throughout the policy-to-action continuum. The approach involves Engaging the poor; Quantifying inequalities; Understanding access barriers; Integrating equity goals into policies and strategies; Targeting resources to the poor; and Yielding public-private partnerships for equity. RESULTS: Based on the EQUITY Approach, we have assisted partners in various countries, including Guatemala, Kenya, India, and Peru, to design and implement policy responses to improve FP/RH access for the poor. POLICY IMPLICATIONS: While international and national commitments call for alleviating poverty and involving the poor, few policies include clear equity goals, strategic interventions, and equity indicators to ensure accountability. A pro-poor policy response must be informed by evidence and supported by resources and multisectoral engagement. The poor must also be engaged throughout, as they are best able to identify their challenges and offer potential recommendations to address these issues.