Is context considered in health inequity research and why? An examination of current trends in Ethiopia

Abstract Background Health equity research requires a comprehensive understanding of the historical, social, and political factors that contribute to health disparities. Ethiopia is a nation with a long political and economic history and a diverse culture, encompassing multiple health knowledge systems and traditional healing practices. This background context is essential for research, as the country faces significant health inequities among individuals and across community groups. This study aims to examine the consideration of context in health inequities research, with a focus on Ethiopia. Method This study used a Systematic Review Literature followed by Critical Interpretive Synthesis (CIS). Using a systematic search, we identified potential texts for inclusion. We searched three electronic databases, PubMed, HINARI, and Google Scholar, for publications up to June 30, 2023. Then, through systematic analysis followed by critical interpretive synthesis and conceptual translation, we developed a synthesizing argument about the trends in health inequities research. Findings Our systematic analysis and CIS reveal that a decontextualized approach dominates health inequity research in Ethiopia. This approach heavily relies on quantitative methods and repeatedly emphasizes wealth, education, and geographic location as key variables. Such emphasis obscures the underlying structural and political causes of inequity. Additionally, this decontextualized research is supported by a political economy of knowledge production that mainly depends on international funders and secondary data, which may prioritize measuring equality over pursuing meaningful equity. Conclusion The dominant research approach on Ethiopia focuses on quantitative methods and lacks contextual insight. This approach yields evidence that is inadequate for addressing the root causes of health inequality and inequity, as it unintentionally reinforces the very disparities it aims to eliminate by prioritizing technocratic solutions over transformative ones. Therefore, a crucial shift in epistemology toward contextually grounded, mixed-methods research supported by interdisciplinarity and multidisciplinarity is necessary to generate the knowledge required for meaningful and equitable change in Ethiopia and similar LMICs.