Abstract
Social inequities have widened divisions between diverse population groups. Inequity is associated with social exclusion, structural and physical violence and reduced development, which in turn are linked to civil unrest, conflict and adverse health and social outcomes. Public services are key institutions through which social inequities are created and maintained, but evidence on viable interventions to reduce institutional exclusion is limited for low- and middle-income (LMIC) contexts. We identify common drivers of institutional exclusion across diverse populations in LMICs and inclusion strategies that could potentially work across populations, public service sectors and country contexts. Seven studies engaged with over 385 key stakeholders in healthcare, education and local government settings in Bangladesh, Kazakhstan, Kenya, Myanmar, Nepal, Nigeria and Vietnam. Participatory research, in-depth interviews, policy reviews and multi-stakeholder workshops focused on a range of disadvantaged groups. A multi-sector partnership co-produced recommendations at each site. Findings were synthesised to identify common themes and a framework for social inclusion across disadvantaged populations. The invisibility of disadvantaged communities in public service planning and delivery processes helped maintain their exclusion from opportunities and resources. A spectrum of neglect, restrictions and discriminatory practice reflected structural violence linked to poor life chances, illness, physical abuse and death. Key recommendations include the representation of disadvantaged groups in service staffing and decision-making and the transformation of public service policy and practice to develop inclusive, targeted, collaborative and accountable systems.