providing suitable services and facilities to achieve physical, mental, social, and spiritual health are the fundamental rights and needs of humans. Equity in health is the lack of avoidable systematic differences in one or more aspects of health in a population and its economic, social, demographic, and geographical sub-groups; thus is of special importance. The World Health Organization has defined inequity in health as: “difference of health status or the distribution of its social determinants in various social sub-groups of a population”. In other words, avoidable and unjust differences are considered inequities in health. Health status and a country’s ability to provide quality care depends on a lot of factors; some of these –like genetic or biological factors– are mostly fixed, but there are others –such as social and economical status of the individual– that aren’t. For the most part, health status is outside of the Health ministry’s -as the provider- control. These outside factors are called the social determinants (or the social roots) of health. These determinants are connected to the social and economical status of an individual’s environment (that mostly aren’t fixed); for example the housing, education system, and GDP of the residential country.

The health systems must coordinate their services with the needs of society -especially some specific groups- and consider the social roots of health in order to be sufficient and effective. This could be the potential reason why health systems’ plans fail to reach their set goals (especially the ones related to equity). Inequity in social conditions leads to inequity in outcomes; so focusing on social roots of health such as unemployment, addiction, depravity, homelessness, divorce, running away from home, etc. can greatly influence our ability to provide health care and reduce inequity among sub-groups.

According to the 2008 report of the World Health Organization, a significant step towards forming equity is to move towards Universal Health Coverage (UHC) and emphasizing “extent”, “depth”, and “height” of the coverage. In other words, “who’ll be covered”, “what services will be provided” and “how much of the cost is covered”. Advancing towards equity in healthcare services is a challenge faced by policymakers, defined as: “minimizing the avoidable inequities in health and its determinants among groups who have different levels of benefits, social privileges, and wealth.”

 Equal utilization and access to healthcare and the efficient distribution of services are also considered important. In the Islamic Republic of Iran, the subject of equity in health has always been considered, and the existing inequities in health status are one of the foremost concerns of policymakers. In the upstream policies –like the constitution, the 20-year vision plan, the 4th and 5th economic and social development plans, and the health reform– the topic of health equity has been especially emphasized. In the 193rd article of the 3rd development plan, it has been indicated that for balanced provision and distribution of hospitalization services according to the needs of different regions –with considering two factors of accessibility and preventing surplus investments– inpatient services will be classified (divided by province), with compensating patients transfer fees and the government will preserve the rights of individuals from lesser levels. Any construction, creation, development, equipping, and furnishing of the country’s hospitals and assigning human resources for service delivery would be according to the classifications of services.
Further, in article 90 of the 4th development plan, for improving equity in access to services and to reduce low-income individuals’ share of healthcare costs, it has been determined that: distributing resources must be such that financial participation indicator increases to 90%, individual’s share of health costs shouldn’t be more than a maximum of 30% and the families in risk of facing catastrophic health costs should be reduced to 1%. To establish equity and social stability, the government was also obliged to reduce economical and social inequities, income gaps, poverty, and deprivation; establish the equal distribution of income; empower the poor by an efficient and focused allocation of resources and subsidies, comprehensive social equity and poverty alleviation plans.

To address the mentioned issues and challenges risen from the need for equity, and the importance of reaching the set goals of the upstream policies, the need for addressing the inequities in health is realized more than ever before; even though measuring inequities has always been a challenge throughout the times for all countries.
The Health Equity Research Center, affiliated with the Tehran University o Medical Science, to do the healthcare system’s needed research (with the focus on equity and efficiency improvement of the system) officially started its activities in September 2017. This center has had various activities in line with its long-term goals since the time of its establishment. These activities –other than attracting and cooperating with researchers interested in doing equity-related research– include implementing various research projects in health-related social harms, health system efficiency, induced demand and corruption in the health system, holding specialized annual meetings, cooperation with other centers and organizations, sessions with experts and professors and assembling international workshops in cooperation with the National Institute for Health Research. Additionally, the center has been recognized as Tehran University’s research center for social determinants of health.

The following report has been gathered with a focus on center activities until March of 2022.