BACKGROUND Equity seems inherent to the pursuance of universal health coverage (UHC), but it is not a natural consequence of it. We explore how the multidimensional concept of equity has been approached in key global UHC policy documents, as well as in country-level UHC policies. METHODS We analysed a purposeful sample of UHC reports and policy documents both at global level and in two Western African countries (Benin and Senegal). We manually searched each document for its use and discussion of equity and related terms. The content was summarised and thematically analysed, in order to comprehend how these concepts were understood in the documents. We distinguished between the level at which inequity takes place and the origin or types of inequities. RESULTS Most of the documents analysed do not define equity in the first place, and speak about "health inequities" in the broad sense, without mentioning the dimension or type of inequity considered. Some dimensions of equity are ambiguous - especially coverage and financing. Many documents assimilate equity to an overall objective or guiding principle closely associated to UHC. The concept of equity is also often linked to other concepts and values (social justice, inclusion, solidarity, human rights - but also to efficiency and sustainability). Regarding the levels of equity most often considered, access (availability, coverage, provision) is the most often quoted dimension, followed by financial protection. Regarding the types of equity considered, those most referred to are socio-economic, geographic, and gender-based disparities. In Benin and Senegal, geographic inequities are mostly pinpointed by UHC policy documents, but concrete interventions mostly target the poor. Overall, the UHC policy of both countries are quite similar in terms of their approach to equity. CONCLUSIONS While equity is widely referred to in global and country-specific UHC policy documents, its multiple dimensions results in a rather rhetorical utilisation of the concept. Whereas equity covers various levels and types, many global UHC documents fail to define it properly and to comprehend the breadth of the concept. Consequently, perhaps, country-specific policy documents also use equity as a rhetoric principle, without sufficient consideration for concrete ways for implementation.

中文翻译：

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在全民健康保险中如何实现公平？贝宁和塞内加尔的全球和国家政策文件分析。

背景技术公平似乎是追求全民健康覆盖（UHC）所固有的，但这并不是自然而然的结果。我们探讨了关键的全球UHC政策文件以及国家/地区级UHC政策如何处理多维的公平概念。方法我们在全球范围和两个西非国家（贝宁和塞内加尔）分析了有目的的UHC报告和政策文件样本。我们手动搜索了每个文档，以了解其用法以及对权益和相关术语的讨论。对内容进行了总结和主题分析，以了解如何在文档中理解这些概念。我们区分了不平等发生的程度和不平等的起源或类型。结果大多数分析的文档都没有首先定义股权，并从广义上讲“健康不平等”，而没有提及所考虑的不平等的范围或类型。股权的某些方面是模棱两可的，尤其是覆盖范围和融资。许多文件将公平吸收到与UHC紧密相关的整体目标或指导原则上。公平的概念通常还与其他概念和价值观（社会正义，包容，团结，人权-以及效率和可持续性）联系在一起。关于最经常考虑的股权水平，获取（可用性，覆盖范围，准备金）是最常引用的维度，其次是财务保护。关于考虑的平等类型，最常提及的是社会经济，地理和性别差异。在贝宁和塞内加尔，UHC政策文件明确指出了地理上的不平等，但具体的干预措施主要针对穷人。总体而言，两国的UHC政策在公平方法上非常相似。结论虽然在全球和特定国家的UHC政策文件中广泛提到了公平，但公平的多重维度导致对该概念的相当夸张的利用。尽管公平涉及各种级别和类型，但许多全球UHC文件未能正确定义和理解概念的广度。因此，也许针对特定国家的政策文件也将公平作为修辞原则，而没有充分考虑具体的实施方式。就公平方法而言，两国的UHC政策非常相似。结论虽然在全球和特定国家的UHC政策文件中广泛提到了公平，但公平的多重维度导致对该概念的相当夸张的利用。尽管公平涉及各种级别和类型，但许多全球UHC文件未能正确定义和理解概念的广度。因此，也许针对特定国家的政策文件也将公平作为修辞原则，而没有充分考虑具体的实施方式。就公平方法而言，两国的UHC政策非常相似。结论虽然在全球和特定国家的UHC政策文件中广泛提到了公平，但公平的多重维度导致对该概念的相当夸张的利用。尽管公平涉及各种级别和类型，但许多全球UHC文件未能正确定义和理解概念的广度。因此，也许针对特定国家的政策文件也将公平作为修辞原则，而没有充分考虑具体的实施方式。许多全球UHC文件未能正确定义它并理解该概念的广度。因此，也许针对特定国家的政策文件也将公平作为修辞原则，而没有充分考虑具体的实施方式。许多全球UHC文件未能正确定义它并理解该概念的广度。因此，也许针对特定国家的政策文件也将公平作为修辞原则，而没有充分考虑具体的实施方式。