Operationalising and measuring equity in implementation science for global health

Equity in research—that is, ensuring fair participation, power-sharing, and benefit across the research process—has become a central ambition in global health as part of wider efforts to reach health equity.1 Since 2015, implementation science has attempted to place equity at the core of health programmes to benefit both patients and health systems. Yet, in practice, equity remains an afterthought and is often considered after interventions have been designed or evaluated.2 As a result, local expertise might be marginalised, opportunities for adaptation are lost, and interventions that cannot accommodate real-world complexity risk failure at the point of delivery.