Equity is at front and centre in the health sector
In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust.
Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.
The Ministry of Health’s National Screening Unit recently published the Equity and Performance Matrix. Their aim is to ensure that equity is placed at the front and centre of all newly-commissioned work in the health sector.
“While equity is an essential part of a functioning health system, by itself it doesn’t provide the full picture. Health systems must also be performing to the expected levels,” says Toby Regan, Manager National Screening UNIT, Screening Insights and Analytics.
“Frequently the two measures of equity and performance are viewed one at a time. Invariably overall performance against a performance target takes precedence as the headline measure while equity is relegated to a second tier measure.”
The Equity and Performance Matrix intertwines both measures so that one cannot be considered without the other, essentially elevating equity to a tier one measure.
How the equity and performance matrix works
The matrix provides a visual picture of any ‘equity gaps’ that exist as well as ‘how effectively’ health services are being delivered for a population against a defined target.
Any measure that has a target can incorporated into the matrix and the dimension of equity can also be adapted to help demonstrate particular issues, such as ethnicity, deprivation, sex, rurality etc. The key feature is the quadrant that the provider or service falls within.
Health services failing to meet performance targets are underperforming. Likewise, health services that result in equity gaps for different populations must also considered to be underperforming. Both situations may occur simultaneously. In all these situations, health services should take action to address these differences.