How do World Health Organization technical officers working on noncommunicable diseases approach health equity?

Abstract

Introduction: Health equity has become a common objective in both global and public health. Although there has been recent scholarship to critically examine how this concept has been applied by the World Health Organization (WHO), there has not been any detailed investigation into the WHO's work on noncommunicable diseases (NCDs). This study aims to fill this gap by investigating the approaches taken by WHO technical officers working on NCDs to address health equity.

Methods: The perspectives of technical officers working on NCDs at the WHO were collated through semi-structured key informant interviews. Interviews were transcribed verbatim to facilitate data analysis by two independent reviewers in NVivo 14.

Results: Key informants felt: a disconnect between NCDs programmatic efforts and health equity; that equity in health primarily involves ensuring equitable access to healthcare, with an emphasis on addressing financial hardship; and that equity in health entails targeting those who are most 'vulnerable'. In investigating how health equity is being applied in NCD efforts, it was apparent that a consideration of health equity is missing in program implementation and policy design, and that donors' goals supersede long-term prevention efforts. Lastly, in pinpointing concrete changes or results seen around how health equity is operationalized in NCDs efforts, several success stories from various regions emerge.

Conclusion: The findings of this study demonstrate that WHO technical officers working on NCDs often possessed a limited understanding of health equity that resulted in little meaningful action to embed health equity considerations into programmatic and policy work. Evidently, WHO technical officers need to better navigate or contest industry interference and learn more about health equity as a concept and the links to NCDs.