Links among agriculture, nutrition, and health (ANH) are established, but the role of inequity is less understood. In this scoping review, we aimed to understand the range of ways that ANH research addresses inequity issues in low- and middle-income countries. We used PRISMA guidelines to structure our study. From an initial >26 000 studies, 243 published reports met inclusion criteria and were mapped. The number of reports addressing inequity in ANH research has increased over time from < 10 articles in 2008 to > 40 in 2018. Within equity, a majority of articles (n = 327) focused on describing how nutrition and health outcomes differ for different groups. Many (n = 134) looked at the material circumstances that shape people’s life chances. Fewer (n = 51) looked at the most basic structural determinants of (in)equity. The same aspects of equity remain the least studied in ANH research, including the intersections of equity issues shaping life chances, and inequity’s structural determinants. We suggest ways forward for this community, drawing on conceptual frameworks and theory of inequity from different disciplines.
This paper presents the results of a scoping review that examines the extent to which legal empowerment has been used as a strategy in efforts to improve access to quality health services in low- and middle-income countries. The review identifies lessons learned regarding legal empowerment program strategy, as well as impact on health empowerment and health outcomes, research gaps, areas of consensus and tension in the field. The review included three main sources of data: 1) peer-reviewed literature, 2) grey literature, and 3) interviews with key legal empowerment stakeholders. Peer-reviewed and grey literature were identified via keyword searches, and interviewees were identified by searching an organizational database and snowball sampling. The key findings were: first, there is very limited documentation on the use of legal empowerment strategies for improving health services. Second, the legal empowerment approach tends to be focussed on issues that communities themselves prioritize, often narrowly defined local challenges. However, legal empowerment as a strategy that pursues collective and individual remedies has the potential to contribute to structural change. Third, for this potential to be realised, legal empowerment entails building capacity of service providers and other duty bearers on health and related rights. Finally, the review also highlights the importance of trust—trust in state institutions, trust in the paralegals who support the process and trust in the channels of engagement with public authorities for grievance redress. Several gaps also became evident through the review, including lack of work on private health providers, lack of discussion of the ‘empowerment’ effects of legal empowerment programs, and limited exploration of risk and sustainability. The paper concludes with a caution that practitioners need to start with the health challenges they are trying to address, and then assess whether legal empowerment is an appropriate approach, rather than seeing it as a silver bullet. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01731-3.
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