June 20

Standards for Equity in Healthcare: An Organizational Self-Assessment Tool


The Task Force on Migrant-friendly and Culturally Competent Healthcare has developed a set of standards aimed at monitoring and measuring equity in health care for immigrants and other vulnerable groups. The Standards for Equity in Healthcare provide opportunity for staff and services to question what they do, why they do it, and whether it can be done better. The Standards is a free self-assessment tool which produces valuable data on your organization’s practices, its strengths as well as its gaps, enabling effective quality improvement. Data is rolled up by country. Your organization’s results are confidential.


Elizabeth Abraham, Vice President, Critical Link International

How do we make sure Health Care is accessible, effectively utilized, that health care staff have the skills and knowledge to deliver care equitably?

We have CLAS standards, but they are only recommendations. Elizabeth’s team developed a tool that organizations can use to measure these factors.

The tool was developed in Europe and uses European terms. Such as “migrant” where in the U.S. we would say “immigrant.”

It was started by the Migrant-Friendly Hospital project involving hospitals in 12 countries in Europe.

Outcomes for the Task Force hospitals:

  1. Whole organizational development
  2. Interpreting/mediation services
  3. Patient education and information
  4. Staff training

The MFH task force was charged to create a framework for measuring and monitoring for continuity.

What constitutes a vulnerable population? Examples:

  1. Migrants/immigrants
  2. Elderly
  3. Homeless
  4. LGBTQ
  5. Disabled
  6. Orphans
  7. Mentally ill
  8. Indigent
  9. Victims of domestic violence
  10. Low-literacy
  11. Low education
  12. Children
  13. Ethnic minorities
  14. People living with AIDS (PLA)
  15. Chronically ill
  16. Sex professionals
  17. People living with addiction
  18. Runaways
  19. Low-income
  20. Veterans
  21. Uninsured
  22. Indigenous people, etc.

The tool was revised after the first pilot test. The second-generation tool is now available for download.

It’s a Free tool: If you submit results to the Task Force, they will show how you compare with other organizations in your country and compared to Canada and some other countries.

Standards for Equity that the tool is designed to measure:

  • Equity in policy
  • Equitable access and utilization
  • Equitalble Quality of Care
  • Equitable Participation
  • Promoting Equity

In 2012, 45 orgs participated in the pilot test. They gave feedback on the tool.

The second pilot was carried out in 16 countries and 54 organizations.

It takes 2-3 meetings to get through the 7 phases of the assessment.

  1. General information
  2. Identify and describe areas of improvement.
  3. Describe an action plan.

This self-assesment tool has not been used in the U.S. You are invited to download the tool and use it. If you think you can get your organization to use and report from the tool, or if you would like more information, contact Elizabeth Abraham at elizabethjabraham@gmail.com or Antonio.chiarenza@ausl.re.it.

See also the handouts for this presentation, which include the Self-Assessment Tool.



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