The International Center for Equity in Health (ICEH) at the Federal University of Pelotas was born in 2009 with a clear mission: to monitor the progress in reproductive, maternal, newborn, child and adolescent health, especially in LMICs. This mission was prompted by the lack of equity-disaggregated health data in these regions. The ICEH's inception was closely tied to the Countdown to 2015 initiative, a global effort to track countries' progress towards achieving the MDGs, in which the center's founders were already involved. Since then, ICEH has been committed to supporting evidence-based decision-making among policymakers and stakeholders in LMICs. The group was established and operates on three fundamental pillars: a comprehensive health equity database, dissemination and capacity strengthening, and scientific impact.
Most of the work developed in the ICEH relies on data from national surveys, primarily Demographic Health Surveys and Multiple Indicator Cluster Surveys. These surveys gather information through face-to-face interviews using self-report questionnaires and objective measurements. They generate a standardized set of indicators related to fertility, reproductive health, maternal and child health, mortality, nutrition, and health behaviors. What sets ICEH apart is the equity-focused approach. The team routinely breaks down this data by several inequality dimensions, including income, region, area of residence, education level, and gender. This is done continuously, incorporating new survey data as they become available. For instance, when examining the proportion of children who received Polio immunization, ICEH not only provides a national estimate. We also provide estimates for the poorest to the wealthiest families, less to more educated mothers, rural and urban areas, boys and girls, and more. For specific projects, ethnicity, religion, women's empowerment and other dimensions are also investigated.
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ICEH’s fundamental pillars
Global health equity database
One of our key contributions is the creation of a comprehensive database from the re-analysis of DHS and MICS data. It comprises data collected from over 460 surveys conducted across 122 countries. Recognizing the critical importance of open data access and collaboration, the ICEH has been maintaining a long-term partnership with the World Health Organization (WHO), which led to the recognition of the ICEH as a WHO Collaborating Centre. This database is publicly available through the Health Equity Assessment Toolkit (HEAT) and the Health Inequality Data Repository.
Dissemination and capacity strengthening
The ICEH has been dedicated to building capacity since its beginning, often collaborating with the Countdown to 2015 initiative, in the early days, and recently with the Countdown to 2030 initiative. ICEH members engage in workshops, courses, and country case studies across various locations. These activities consist of lectures and hands-on sessions, emphasizing the vital role of assessing inequalities in reproductive, maternal, neonatal, child, and adolescent health. The group hosted two workshops in Pelotas and have attended over 15 events, mostly across Africa and Latin America and the Caribbean. Recent activities have encompassed an analytical training as part of the Countdown 2030 for Women’s, Children’s, and Adolescents’ Health (CD2030) Fellowship Program, and a workshop to strengthen analytical capacities and evidence use for the Track20 initiative partnered with the Countdown to 2030.
Science
The ICEH is located at the Federal University of Pelotas in southern Brazil, within the Post-Graduate Program in Epidemiology. Honoring its academic roots, the group has been fostering post-graduate students since its inception, guiding the academic training of more than 30 master's and PhD students, and post-doctoral fellows. The group’s scientific contributions primarily come from articles published in peer-reviewed journals and input provided for reports from international organizations such as UNICEF, WHO, and PAHO, among others. In its nearly 15-year existence, the group has authored over 160 scientific publications. While their core focus remains on addressing disparities in reproductive, maternal, newborn, and child health, the ICEH has extended its research to topics such as intimate partner violence, water, sanitation and hygiene, and gender-related indicators.
In addition to the three pillars that guide ICEH’s routine work, the center participates in and coordinates several other projects and collaborations.
Health Facility Data analysis
Since 2022, ICEH has been closely collaborating with Countdown 2030 to analyze health facility data from low- and middle-income countries in Sub-Saharan Africa. As part of this collaboration, ICEH is developing and improving several statistical codes to convert the absolute production numbers collected in health services from Sub-Saharan Africa into coverage estimates. This information is crucial for informing policymakers and stakeholders.
Support to Sub-Saharan African countries
Researchers from ICEH participate in regular meetings and workshops to closely assist partners from other Sub-Saharan African countries in making better use of their data. This support includes performing health facility data and survey analyses, capacity strengthening, and training to empower partners to interpret and translate findings into actionable strategies in their countries. ICEH is closely supporting two countries as part of this collaboration: Mozambique and Zambia.
Monitoring inequalities in Brazil
ICEH, in collaboration with the Brazilian Ministry of Health, the Pan-American Health Organization, and the UMANE association, is focusing on monitoring health-related social inequalities in Brazil. To achieve this, ICEH is utilizing publicly available data from Brazilian information systems to conduct analyses that can inform key stakeholders on how to address and reduce gaps in access and coverage to health services.