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This paper describes an evaluation experiment conducted in China between 2013 and 2016 to use evaluative thinking and evaluation approaches to help build the salience of health equity as a performance measure for health systems. This project was informed by a realist evaluation approach that sought to understand the context, mechanisms, and outcomes underlying health inequities. This chapter describes a theory of change that includes descriptions of the key actors involved in the project, the mechanisms of impact, and short- and long-term outcomes. Key questions that could help assess the impact of this project are also discussed. This paper contributes to the literature on building evaluation capacity for health inequities. [ABSTRACT FROM AUTHOR]

This paper discusses the development and implementation of structured guidelines that contained a fixed set of questions as part of a project in building evaluation capacity for addressing health inequities in the health sector in China. The ambition of the guidelines was to test whether a structured process of questions could aid teams that did not have a strong background in evaluation to complete equity-focused evaluations and also help raise the salience of health equity as an important goal of health systems reform among the participants of the project. The guidelines were informed by multiple perspectives that included the literature on social determinants of health, realist evaluation, and utilization/influence perspectives. One noteworthy aspect of this project was that the participants in this capacity-building project were local and national policymakers, practitioners, and university researchers. Our original goal was to test these guidelines in equity-focused policy interventions in three separate provinces of China. One key insight from this project was that there is a need to move away from a testing perspective to a developmental approach in formulating evaluation guidelines that can work across multiple organizational and country contexts and also closely reflect the needs of practitioners and policymakers in evaluation capacity-building efforts. [ABSTRACT FROM AUTHOR]