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Original Research Article

Development of a Sex- and Gender-Based Analysis Plus (SGBA+) Tool to Assess the Equity of Public Policies

Virginia Gunn1,2,3orcid , Patricia O’Campo2,4orcid , Munira Adan2,5, Paneet Gill4, Tasneem Poonawala6orcid , Pearl Buhariwala2orcid , Flora I. Matheson2,4orcid , Farah N. Mawani2,7orcid , Carles Muntaner8,9orcid
Health Polit 2026;1(1):28-67. Published online: March 31, 2026
1Cape Breton University, School of Nursing, Sydney NS, Canada
2MAP Centre for Urban Health Solutions, Unity Health Toronto
3Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
4Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
5University of Ottawa, Interdisciplinary School of Health Sciences, Ottawa, ON
6North Dallas Research Associates, Dallas TX, USA
7Faculty of Health, University of Victoria, Victoria, BC
8Zhejiang Chinese Medical University, China
9Lawrence S. Bloomberg Faculty of Nursing Toronto, ON, Canada
Corresponding author:  Virginia Gunn,
Email: virginia_gunn@cbu.ca
Received: 31 January 2026   • Revised: 23 March 2026   • Accepted: 28 March 2026
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Background
Crisis-driven policymaking often unfolds under conditions of urgency and heightened political pressure, producing policies portrayed as neutral but embedding assumptions that obscure power asymmetries and deepen existing inequities. A literature review revealed a scarcity of policy analysis instruments capable of evaluating the gendered and intersectional equity-promoting potential of public policies.
Purpose
This paper describes the development of a sex- and gender-based analysis plus (SGBA+) tool designed to assess whether COVID-19 public policies meaningfully consider equity and inclusion.
Approach
The tool’s development followed an iterative process involving a mapping literature review, a structured planning and design phase, piloting with Canadian pandemic policies, and consultation with community organizations working with population groups facing marginalization or exclusion.
Findings
The resulting tool comprises 81 questions across six policy dimensions, with a scoring system that rates policies from “unequal” to “transformative” based on their responsiveness to gender and intersecting social identities. While validity and reliability have not yet been tested, the tool fills an identified gap in equity-oriented policy analysis.
Implications
With adjustments, the tool could be applied to public policies adopted in response to health, environmental, and economic crises. By making visible how policy design distributes resources and risks, SGBA+ approaches offer policymakers, advocates, and researchers a concrete means to interrogate decision-making and guide emergency governance toward greater equity.

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Development of a Sex- and Gender-Based Analysis Plus (SGBA+) Tool to Assess the Equity of Public Policies
Health Polit. 2026;1(1):28-67.   Published online March 31, 2026
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

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Development of a Sex- and Gender-Based Analysis Plus (SGBA+) Tool to Assess the Equity of Public Policies
Health Polit. 2026;1(1):28-67.   Published online March 31, 2026
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