Equity Blind Spots: How Health Programmes Fail Marginalized Populations Despite Good Policy Intentions.

This paper presents a conceptual analytical examination of why health programmes frequently fail to achieve equitable outcomes for marginalized populations despite explicit equity-oriented policy intentions. Drawing on contemporary health equity and health systems scholarship, the paper identifies recurring systemic mechanisms—termed “equity blind spots”—through which inequities are reproduced across the policy–practice continuum. Rather than evaluating a specific intervention or presenting new empirical data, the analysis focuses on how assumptions, organisational practices, and system design features shape differential access to care. By reframing equity as an analytical dimension of policy effectiveness rather than an aspirational principle, the paper contributes to critical discussions on health policy, governance, and public health systems performance.