Developing robust systems for monitoring, evaluation and data analysis is critical to advancing health equity and understanding the impact of programmes and policies at local, national and global levels. Reliable, equity-focused data allows decision-makers, community leaders and public health managers to identify health inequities and the mechanisms that generate them; monitor progress, and refine interventions to ensure their effectiveness and sustainability. However, traditional monitoring and evaluation frameworks often lack the granularity, inclusivity and participatory elements needed to address the complexities of the social determinants of health equity.

Building on the world report recommendation 4.6, “Monitor social determinants of health equity”, this strategic entry point focuses on transforming the environment to support equity-driven decision-making, by improving the availability, quality and utility of data and evidence systems. The work undertaken with countries draws on the WHO technical guidance for national monitoring systems for the social determinants of health equity, Operational Framework for Monitoring the Social Determinants of Health. The framework lists core social determinants of health domains, indicators and steps to leverage monitoring for joint action, intersectoral accountability and equity in Health in All Policies. The experience of  SIMASHE emphasizes participatory and bottom-up approaches to ensure that communities are not only subjects of data collection, but also active contributors to its design, analysis and use. It seeks to empower stakeholders across all levels – local, regional and national – by building the tools, skills and systems needed to track health inequities and their generating mechanisms, and evaluate the impact of interventions.

By enhancing local capacity and integrating community-informed methodologies, this entry point ensures that equity monitoring systems are not only rigorous, but also reflective of local realities and priorities. It is organized into five core areas:

This strategic entry point is interlinked with other strategies to address the social determinants of health and advance health equity, as outlined in the SIMASHE knowledge-sharing diagram.