This series of 18 articles describes processes for ensuring that relevant research is identified, appraised and used to inform decisions about health policies and programs. The tools were written for people responsible for health policy decision-making (e.g., health system managers and policy-makers) and for those who support them.

CHSRF worked in partnership with the SUPPORT Project to bring you the French version of this series. SUPPORT is an international collaboration network that provides training and support to encourage researchers and policy-makers in collaborative policy-relevant research.

A book version of SUPPORT Tools for evidence-informed health Policymaking (STP) is also available.

Support Tools

Taking equity into consideration when assessing the findings of a systematic review

by Andrew D Oxman, John N Lavis, Simon Lewin, Atle Fretheim | Dec 16, 2009

Full text | PDF


In this article we address considerations of equity. Inequities can be defined as "differences in health which are not only unnecessary and avoidable but, in addition, are considered unfair and unjust". These have been well documented in relation to social and economic factors. Policies or programmes that are effective can improve the overall health of a population. However, the impact of such policies and programmes on inequities may vary: they may have no impact on inequities, they may reduce inequities, or they may exacerbate them, regardless of their overall effects on population health.

We suggest four questions that can be considered when using research evidence to inform considerations of the potential impact a policy or programme option is likely to have on disadvantaged groups, and on equity in a specific setting. These are:

  1. Which groups or settings are likely to be disadvantaged in relation to the option being considered?
  2. Are there plausible reasons for anticipating differences in the relative effectiveness of the option for disadvantaged groups or settings?
  3. Are there likely to be different baseline conditions across groups or settings such that that the absolute effectiveness of the option would be different, and the problem more or less important, for disadvantaged groups or settings?
  4. Are there important considerations that should be made when implementing the option in order to ensure that inequities are reduced, if possible, and that they are not increased?