POLICY BRIEF

Achieving Health Equity within the Context
of the Right to Health and Wellbeing for All

The principle of health equity is enshrined in the World Health Organization (WHO) Constitution, which affirms that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.” This principle is echoed in international frameworks, including the Universal Declaration of Human Rights (Article 25) and the Sustainable Development Goals (SDGs), particularly SDG 3, which aims to “ensure healthy lives and promote well-being for all at all ages,” and SDG 10, which seeks to reduce inequalities within and among countries. Despite progress, stark disparities persist in health outcomes, access to care, and the social determinants of health. Achieving health equity requires systemic changes to address these disparities so that all individuals have an opportunity to attain their highest standard of health, regardless of social, economic, or demographic status. This Fast-Track Health policy brief explores best practices through five case studies, discusses challenges and opportunities, and provides actionable recommendations for municipal, national, and regional health authorities.

Social Health Equity Programs in Costa Rica: Costa Rica’s universal healthcare system emphasizes equity by providing comprehensive, publicly funded health services to all residents, regardless of socioeconomic status. The country invests heavily in primary healthcare, with a network of EBAIS (Basic Teams for Comprehensive Health Care) providing community-based services. These teams prioritize underserved and rural populations, reducing health disparities in maternal and child health and chronic disease outcomes. Costa Rica’s approach highlights the importance of universal access and primary care in achieving health equity. (WHO, 2023)

Indigenous Health Equity in Canada: Canada’s First Nations Health Authority (FNHA) delivers culturally appropriate healthcare services to Indigenous populations. The FNHA integrates traditional healing practices with Western medicine and focuses on addressing the social determinants of health, such as housing and education. Programs targeting mental health and chronic disease prevention have reduced health inequities among First Nations communities. This model underscores the importance of culturally tailored healthcare delivery in advancing equity. (Journal of Indigenous Wellbeing, 2023)

Health Equity Zones in the United States: The U.S. State of Rhode Island’s Health Equity Zones (HEZs) initiative is a place-based strategy that engages community stakeholders in designing and implementing solutions to local health challenges. Each HEZ focuses on addressing root causes of health inequities, such as food insecurity, housing, and transportation. Early evaluations show reductions in emergency department visits and improvements in community health indicators. This initiative demonstrates the potential of locally driven, multi-sectoral approaches to reduce health disparities. (American Journal of Public Health, 2023)

Gender Equity in Health in Kenya: Kenya’s Linda Mama program provides free maternity care to all pregnant women in public health facilities, including antenatal care, delivery, postnatal care, and treatment of complications, reducing financial barriers for women from low-income households. Additionally, community-based interventions are engaging men in maternal health. The country has seen a 15% reduction in maternal mortality and increased utilization of skilled birth attendants. Kenya’s experience illustrates how targeted policies and community involvement can address gender-based health disparities. (Ministry of Health Kenya, 2023)

Global Health Solidarity in Norway: Norway’s commitment to global health equity is reflected in its significant contributions to international health initiatives, including Gavi, the Vaccine Alliance, and the Global Fund. Domestically, Norway ensures equitable access to healthcare through its universal coverage system, which includes policies to reduce financial barriers for vulnerable populations. Norway’s model highlights the role of high-income countries in advancing global health equity through both domestic and international actions. (Norwegian Ministry of Health, 2023)

Efforts to achieve health equity face persistent challenges, many rooted in systemic inequalities. Disparities in social determinants of health, such as income, education, and housing, create significant barriers to accessing care and achieving positive health outcomes. In low- and middle-income countries, underfunded health systems struggle to provide equitable services, leading to poor outcomes for marginalized populations. Discrimination and stigma – based on gender, race, ethnicity, or disability –further exacerbate health inequities by limiting access to healthcare services and employment opportunities. Fragmented health data systems hinder the ability to monitor and address disparities, while political resistance to redistribution policies often impedes progress. The increasing burden of climate change adds another layer of inequity, disproportionately affecting vulnerable populations and compounding existing health disparities. Additionally, the lack of equitable access to health innovations, including essential medicines, digital health tools, and advanced diagnostics, widens the gap in achieving health equity globally.

Significant opportunities exist to advance health equity by aligning health systems with the principles of the right to health and wellbeing and the goal of achieving Universal Health Coverage (UHC). Strengthening primary healthcare systems can serve as a foundation for equitable service delivery and act as a critical pathway toward UHC. Multisectoral collaborations demonstrate the potential of addressing social determinants of health through coordinated community action, reducing disparities that UHC frameworks aim to address. Digital health innovations, including telemedicine and health information systems, offer scalable solutions to expand access to underserved populations and improve data tracking to measure progress toward equity goals. International solidarity can mobilize resources and promote equity between high- and low-income countries, particularly in advancing UHC principles. Additionally, integrating equity considerations into climate change adaptation strategies and leveraging UHC mechanisms to cover health services for climate-affected populations can mitigate the disproportionate impacts on marginalized groups. Advocacy for inclusive policies and sustained political commitment to equity-focused UHC can transform the vision of equitable health systems into a reality.