6.5. Equity-oriented monitoring of integrated services and resource allocation

Ensuring accountability and sustainability in integrated service models requires strong monitoring and evaluation frameworks. This area focuses on developing mechanisms to track service effectiveness, equity outcomes and resource distribution, promoting evidence-based decision-making to optimize impact and address health inequities.

Examples from SIMASHE

SDH-informed resource analysis and prioritization in Costa Rica: A methodology for resource analysis and prioritization informed by SDH was implemented across cantons in Costa Rica, allowing for a detailed contextual analysis aligned with local needs. Three out of four cantons prioritized multidimensional poverty but employed distinct strategies. Coto Brus, for instance, focused on enhancing life skills for families in conditions of vulnerability, integrating this initiative with the annual plan of the Mixed Social Assistance Institute to ensure coordinated and context-specific action.

Key intervention activities

SIMASHE is continuously seeking examples related to this area of work, including activities for:

  • ensuring data-driven accountability and transparency in cross-sectoral decision-making.
  • Resource analysis, prioritization and allocation that are informed by SDH and health equity.
  • continuous improvement of service delivery models based on monitoring and evaluation findings, innovative pilot programmes and community feedback.
  • establishing formal, cross-sector data-sharing agreements, and outlining Application Programming Interface (API) standards and metadata protocols to ensure interoperability with existing systems.
  • assessing the SDH and health equity impact of local policies across sectors.
  • defining measurable outcomes (e.g. 10% improvement in selected equity indicators, post-policy implementation), and complementing quantitative data with systematic qualitative evaluations from affected communities.