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      Strengthening and expanding health inequality monitoring for the advancement of health equity: a review of WHO resources and contributions

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          Abstract

          As part of its commitment to advance health equity, the World Health Organization (WHO) has a developed area of work to promote and strengthen health inequality monitoring. This includes an emphasis on the collection, analysis and use of disaggregated health data, which are central to evidence-informed decision making. The aim of this paper is to review WHO's work on health inequality monitoring, namely the 2022–27 Inequality monitoring and analysis strategy and corresponding activities, resources and tools. The strategy has three goals pertaining to: strengthening capacity for health inequality monitoring; generating and disseminating the latest evidence on health inequality and supporting data disaggregation; and developing and refining health inequality monitoring methods, resources and best practices. In alignment with these goals, WHO has published reference materials focused on conceptual approaches to health inequality monitoring, which are applied in the global State of Inequality report series. The Health Inequality Monitoring eLearning channel on OpenWHO and capacity building workshops and webinars facilitate the uptake and application of inequality monitoring practices across diverse settings and stakeholders. A key tool available to support the analysis and reporting aspects of health inequality monitoring is the Health Equity Assessment Toolkit (HEAT) application, which allows users to explore data interactively. The Health Inequality Data Repository, a collection of the largest publicly available database of disaggregated data from around the globe, further enables inequality monitoring and analyses. This collection of resources is an important contribution to promote health inequality monitoring across diverse settings. The uptake of evidence from health inequality monitoring remains crucial to the advancement of equity as part of global health and development initiatives.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12939-022-01811-4.

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          Health Equity Assessment Toolkit (HEAT): software for exploring and comparing health inequalities in countries

          Background It is widely recognised that the pursuit of sustainable development cannot be accomplished without addressing inequality, or observed differences between subgroups of a population. Monitoring health inequalities allows for the identification of health topics where major group differences exist, dimensions of inequality that must be prioritised to effect improvements in multiple health domains, and also population subgroups that are multiply disadvantaged. While availability of data to monitor health inequalities is gradually improving, there is a commensurate need to increase, within countries, the technical capacity for analysis of these data and interpretation of results for decision-making. Prior efforts to build capacity have yielded demand for a toolkit with the computational ability to display disaggregated data and summary measures of inequality in an interactive and customisable fashion that would facilitate interpretation and reporting of health inequality in a given country. Methods To answer this demand, the Health Equity Assessment Toolkit (HEAT), was developed between 2014 and 2016. The software, which contains the World Health Organization’s Health Equity Monitor database, allows the assessment of inequalities within a country using over 30 reproductive, maternal, newborn and child health indicators and five dimensions of inequality (economic status, education, place of residence, subnational region and child’s sex, where applicable). Results/Conclusion HEAT was beta-tested in 2015 as part of ongoing capacity building workshops on health inequality monitoring. This is the first and only application of its kind; further developments are proposed to introduce an upload data feature, translate it into different languages and increase interactivity of the software. This article will present the main features and functionalities of HEAT and discuss its relevance and use for health inequality monitoring.
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            Handbook on health inequality monitoring: with a special focus on low-and-middle-income countries

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              Health Equity Assessment Toolkit Plus (HEAT Plus): software for exploring and comparing health inequalities using uploaded datasets

              ABSTRACT As a key step in advancing the sustainable development goals, the World Health Organisation (WHO) has placed emphasis on building capacity for measuring and monitoring health inequalities. A number of resources have been developed, including the Health Equity Assessment Toolkit (HEAT), a software application that facilitates the assessment of within-country health inequalities. Following user demand, an Upload Database Edition of HEAT, HEAT Plus, was developed. Launched in July 2017, HEAT Plus allows users to upload their own databases and assess inequalities at the global, national or subnational level for a range of (health) indicators and dimensions of inequality. The software is open-source, operates on Windows and Macintosh platforms and is readily available for download from the WHO website. The flexibility of HEAT Plus makes it a suitable tool for both global and national inequality assessments. Further developments will include interactive graphs, maps and translation into different languages.

                Author and article information

                Contributors
                hosseinpoora@who.int
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                17 March 2023
                17 March 2023
                2023
                : 22
                : 49
                Affiliations
                GRID grid.3575.4, ISNI 0000000121633745, Department of Data and Analytics, , World Health Organization, ; 20 Avenue Appia, CH-1211 Geneva 27, Switzerland
                Article
                1811
                10.1186/s12939-022-01811-4
                10022555
                36932363
                114858da-13f2-49ec-b5a5-d7cc900a516f
                © World Health Organisation 2023

                Open AccessThis article is licensed under the terms of the Creative Commons Attribution 3.0 IGO License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the World Health Organisation, provide a link to the Creative Commons licence and indicate if changes were made. The use of the World Health Organisation’s name, and the use of the World Health Organisation’s logo, shall be subject to a separate written licence agreement between the World Health Organisation and the user and is not authorized as part of this CC-IGO licence. Note that the link provided below includes additional terms and conditions of the licence. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/3.0/igo/.

                History
                : 18 November 2022
                : 18 December 2022
                Categories
                Review
                Custom metadata
                © The Author(s) 2023

                Health & Social care
                capacity building,disaggregated data,health equity,health inequality,monitoring,world health organization

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