How area health management leads to improved equity in health: a scoping review

Background: The scoping review of published studies aims to explore what practices and processes can improve equity (horizontal and vertical) in countries that adopted Area Health Management (AHM) utilizing the "Six Building Blocks Plus" (SBBP) concept. Method: An electronic search was conducted from the inception to January 27, 2021, from 6 databases (Embase, Social Sciences, Web of Science, PubMed, CINAHL, and WHO) and the gray literature. The inclusion criteria were AH, SBBP, and equity. Data extraction was using a standardized data collection form. Results: This scoping review includes 63 full-text studies. SBBP are identical in the horizontal and vertical equity. However, the majority of SBBP were health service delivery, leadership & governance, and health workforce. The result showed the practice and process to improve health equity were related to a health service delivery (HSD). Conclusion: The included study showed horizontal and vertical equity. The equity measurement focused on utilization. AHM utilizing SBBP was mostly showed in HSD, HWF, leadership & governance. This review indicates that HSD could improve equity or cooperate with other SBBP by increasing healthcare accessibility and utilization. The demographic factor that affected equity is ethnicity. Therefore, HSD in area health was crucial in enhancing health promotion equity in different areas, specific diseases, and target patients.