In recent years, academics and health and humanitarian organizations are calling for ‘people-centered’ approaches, making beneficiaries’ preferences central to decisions making. While substantial progress has been made in capturing beneficiaries’ needs in resource allocation models, the approach to equity remains essentially ‘top-down’. That is, while diversity in needs is captured, the diversity in equity perceptions is not acknowledged. In this article, we argue there is a need for a complementary ‘bottom up’ view on equity, taking the perspective of the beneficiary. This will help academics and organizations to better account for the diversity in culture, experience, and social status present in most beneficiary populations. We present the 3P framework (People, Past, and Present) to help systematically think of drivers of beneficiaries’ distributional preferences. Furthermore, we illustrate how these preferences can be integrated into utility-based modeling and why accounting for preferences is important.