There is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE). A systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as ‘PROGRESS-Plus’: Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized. This review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on “occupation” component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on “workers” such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to “worker focused” policy documents, most of the ‘whole population focused’ policy documents didn’t have a PROGRESS-plus equity component rendering them equity limiting for the society. Our review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.

中文翻译：

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使用 PROGRESS-plus 框架评估遏制 COVID-19 的口罩/个人防护装备政策中的健康公平考虑：系统评价

越来越多的证据表明，新冠肺炎 (COVID-19) 揭示了全球健康不平等的真实严重程度。事实证明，控制感染和减少 COVID-19 相关死亡的政策和指导是有效的，但这些政策在多大程度上考虑了健康不平等因素尚不清楚。本研究的目的是通过关注有关佩戴口罩和个人防护装备 (PPE) 的全球政策格局，衡量 COVID-19 相关政策在多大程度上反映了公平考虑。在六个数据库中对有关 COVID-19 和口罩/个人防护装备的已发表文件进行了系统搜索：PubMed、EMBASE、CINAHL、ERIC、ASSIA 和 Psycinfo。审查内容包括与 COVID-19 和口罩/个人防护装备相关的审查、政策文件、简报。为了评估政策文件中纳入公平性的程度，采用了名为“PROGRESS-Plus”的指导框架：居住地、种族/族裔、职业、性别/性别、宗教、教育、社会经济地位、社会资本、Plus（年龄、残疾等）被利用。此次审查共涉及212份政策文件。在 212 份政策文件中，190 份政策文件（89.62%）至少包含一项 PROGRESS+ 内容。大多数政策文件（n = 163，85.79%）重点关注 PROGRESS-plus 的“职业”部分，其次是与歧视相关的个人特征（n = 4；2.11%）、居住地（n = 2；1.05%） ）和教育（n = 1；0.53%）。亚组分析显示，大多数政策文件（n = 176，83.01%）都聚焦于“工人”，如医护人员、太平间工作人员、学校工作人员、运输工作人员、基本工作人员等。在其余的政策文件中，大多数都是针对“工人”的面向全体人口（n = 30；14.15%）。与“以工人为中心”的政策文件相反，大多数“以全民为中心”的政策文件没有进步加公平成分，这使得它们对社会的公平产生了限制。我们的审查强调，即使政策在设计/实施过程中考虑了健康不平等，这种考虑本质上往往是一维的。此外，在确定相关的公平相关障碍后，应仔细设计和实施全民政策，以便为整个社会带来更好的结果。