Box 1.

Integrating equity, gender and human rights into WHO’s resources for leaving no one behind: key concepts.

With respect to health, a leaving no one behind approach refers to vast and heterogeneous population groups, which face a wide range of barriers to health services that differ across countries, communities and individuals. As such, health system strengthening to leave no one behind needs to account for this heterogeneity and the complexity of barriers [19]. Equity is the absence of avoidable, unfair or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification. Rooted in social justice, ‘health equity’ or ’equity in health’ implies that everyone should be able to attain their full health potential and that no one should be disadvantaged from achieving this potential [41]. Health inequity is a normative concept, and thus cannot be accurately measured or monitored; however, health inequalities (i.e. observable differences between subgroups within a population) can be measured and monitored, and they serve as an indirect means of evaluating health inequity [22]. Although related, health equity and health inequalities are different from the human rights principle of equality, which refers to the right of every individual to receive the same treatment without discrimination. Gender refers to the socially constructed norms that impose and determine power, roles and relationships between groups of women, men, boys and girls in all their diversity, and which operate at various levels, from households to communities and institutions. Gender also refers to expressions and identities of women, men, boys, girls and gender-diverse people. It is important to be sensitive to different identities that do not necessarily fit into binary male or female (biological) sex categories. Gender is inextricable from other social and structural determinants shaping health and equity and can vary across time and place [41]. The right to health: The right to health in international human rights law is a claim to a set of social arrangements – norms, institutions, laws and an enabling environment – that can best secure the enjoyment of this right. It is an inclusive right extending not only to timely and appropriate health care, but also to the underlying determinants of health. The right to health is subject to progressive realization and acknowledges resource constraints. However, it also imposes on states various obligations, which are of immediate effect, such as the guarantee that rights will be exercised without discrimination of any kind and the obligation to take deliberate, concrete and targeted steps towards its full realization.