EuropeAid organised a consultation meeting in June on the second Strategy Paper of the 2007–2013 European Union (EU) programme, the European Partnership for Democracy and Human Rights (EIDHR). Currently in draft form, this paper will provide the basis for European Community (EC) multi-annual programming and annual action programmes for the period 2011–2013. The European Commission (EC) identified specific changes in the new strategy as including: a stronger emphasis on difficult countries as apposed to difficult situations; a higher number of countries eligible for increased support; greater decentralisation of decision-making to EC delegations; a greater focus on links between thematic and geographical instruments; and more clarity on EC human rights priorities and their link to political dialogue. The Commission noted, however, that it does not plan to provide details on the draft EIDHR strategy ahead of its publication and, while written civil society submissions are welcome, only minor changes would be made at this stage since the EC considered it premature to undertake an evaluation of the programme.
Governance and participation in health
This study sought to determine the best approach of integrating community interventions for TB control. It evaluated the records of 3,110 new TB patients registered in three Local Service Areas (LSAs), from quarter 1 2004 to quarter 4 2005. It found that bacteriological coverage, smear conversion and treatment success rates dropped in the interventional LSA, while the control LSAs remained consistent. The defaulter rates dropped in all LSAs, while the proportion of unevaluated cases increased in the interventional LSA. However, patients registered in the clinics had better chance of successful treatment outcome compared to their hospital counterparts. The study concluded that community participation by itself is not adequate to improve the performance of a TB control programme. Enhancement of the program’s technical and organisational capacity is crucial, prior to engaging purely community interventions. Failure to observe this logical relationship would ultimately result in suboptimal performance. Therefore, the process of entrusting communities with more responsibility in TB control should be gradual and take cognisance of the various health system factors.
The overall objective of the study was to assess the effectiveness of health governance structures in enhancing equity of access and community participation in the delivery of health care services in Zambia. The specific objectives were to: (i) describe the status of health governance structures in Zambia; (ii) examine the linkages between the health governance structures and community; (iii) asses how the health governance structures represent and respond to community inters and needs; (iv) determine the extent to which the community is involved in the planning of health care services and resource allocation and (v) propose option for enhancing equity of access and community participation in the delivery of health care services.
Utilisation of long-lasting insecticide-treated bed nets (LLITNs) by under-five children has been reported as unsatisfactory in many sub-Saharan African countries due to behavioural barriers. Previous studies have focused exclusively on coverage and ownership of LLITNs, so to address this research gap, researchers examined the effect of skill-based training for household heads on net utilisation. The study included 22 villages in southwest Ethiopia, with totals of 21,673, 14,735 and 13,758 individuals at baseline, sixth and twelfth months of the project period. At the baseline survey, 47.9% of individuals in the intervention villages (which received training) and 68.4% in the control villages (which did not) reported that they had utilised a LLITN the night before the survey. At six months, 81% of individuals in the intervention villages and 79.3% in the control villages had utilised LLITNs. Among under-five children, net utilisation increased by 31.6% at six months and 38.4% at twelve months. The researchers conclude that household level skill-based training demonstrated a marked positive effect in the utilisation of LLITNs. The effect of the intervention steadily increased overtime. Therefore, distribution of LLITNs should be accompanied by a skill-based training of household heads to improve its utilisation.
The role of multilateral external funding agencies in global health is a new area of research, with limited research on how these agencies differ in terms of their governance arrangements, especially in relation to transparency, inclusiveness, accountability, and responsiveness to civil society. In this paper, the authors argue that historical analysis of the origins of these agencies and their coalition formation processes can help to explain these differences. They propose an analytical approach that links the theoretical literature discussing institutional origins to path dependency and institutional theory relating to proto institutions in order to illustrate the differences in coalition formation processes that shape governance within four multilateral agencies involved in global health. Two new multilateral donor agencies that were created by a diverse coalition of state and non-state actors, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI (‘proto-institutions’), were more adaptive in strengthening their governance processes. This contrasts with two well-established multilateral external funding agencies, such as the World Bank and the Asian Development Bank, what we call Bretton Woods (BW) institutions, which were created by nation states alone; and hence, have different origins and consequently different path dependent processes.
As the centre of global geo-politics continues to shift, much attention is being focused on the BRICS (Brazil, Russia, India, China, South Africa) group of emerging economies and the IBSA (India, Brazil and South Africa) group of emerging democracies as their power in global political and economic affairs has increased substantially, the author notes in this article. He calls attention to the implications of the growing power of BRICS and IBSA countries both individually and collectively for global civil society and development cooperation. From civil society’s point of view, concerns have been raised about the fact that while aid is offered to other developing countries by BRICS countries, there is an overall lack of information about the basis on which aid is given by them. Civil society is notably absent from BRICS meetings and summits. Additionally, there is the question of BRICS countries’ limited participation in ongoing multi-lateral processes to ensure harmonisation and transparency of aid. Traditionally, external funder countries have been involved in multiple processes and discussions to reduce aid overlap, faulty prioritisation and wastage. The author recommends greater south-south cooperation led by the democratic trio of IBSA countries. Their civil societies are active and also well placed to connect with their peers in the developing world to promote sustainable development underpinned by democratic values. But this will require some key foreign policy shifts for which civil society needs to lobby hard.
Globally, increasingly vigilant and vocal civil society groups - important actors in the new multilateralism - are demanding openness, transparency and citizen participation in the discourse and practice of governance, which includes the right to information. This movement is facilitated by new technologies in the form of social media platforms like Twitter and Facebook and sources like Wikileaks. A new generation of technology-enabled applications and innovations for open government is also being developed in the South. Numerous examples are emerging including the use of mobile phones, SMS (short message service) technologies and web-based platforms for providing feedback on services, reporting on corruption, and accessing services. For example, Global Voices, a virtual organization of bloggers, tracks and shares many of the more innovative applications, emerging in both middle-income and poorer countries. Although the impetus for openness comes from civil society, open government is, at its core, an enterprise of government transformation, the author of this article argues. The author believes that, eventually, citizens will be able to participate actively in the governance ecosystem, but only if governments create the right enabling environment for transparency through appropriate policies and disclosure rules for making information available, and if it creates the kinds of processes that enable citizens to participate in policy making.
In sub-Saharan Africa media coverage of reproductive health issues is poor due to the weak capacity and motivation for reporting these issues by media practitioners, the authors of this paper argue. They describe the experiences of the African Population and Health Research Centre and its partners in cultivating the interest and building the capacity of the media in evidence-based reporting of reproductive health issues in sub-Saharan Africa. The authors note that the Research Centre’s media strategy evolved over the years, including: enhancing journalists’ interest in and motivation for reporting on reproductive health issues through training and competitive grants for outstanding reporting; building the capacity of journalists to report reproductive health research and the capacity of reproductive health researchers to communicate their research to media through training for both parties and providing technical assistance to journalists in obtaining and interpreting evidence; and establishing and maintaining trust and mutual relationships between journalists and researchers through regular informal meetings between journalists and researchers, organising field visits for journalists, and building formal partnerships with professional media associations and individual journalists. The authors conclude that a sustained mix of strategies that motivate, strengthen capacity of, and build relationships between journalists and researchers can be effective in enhancing quality and quantity of media coverage of research.
CEHURD within the Coalition to Stop Maternal Mortality Due to Unsafe Abortion (CSMMUA) held a meeting in June 2017 with Uganda Women’s Parliamentary Association (UWOPA) to clarify on the legal and policy framework on sexual and reproductive health and to discuss evidence based approaches to address unsafe abortion even where the law is restrictive. In Uganda, unsafe abortion is one of the leading causes of maternal morbidity and mortality, contributing to approximately 26% of the estimated 6,000 maternal deaths every year and an estimated 40% of admissions for emergency obstetric care. The meeting was motivated by a conviction that as policy makers, Members of Parliament (MPs) have a role to play in law reform on sexual and reproductive health issues and to interact with communities in their various constituencies. The meeting paved a way for an open discussion on unsafe abortions as a public health issue and the different stakeholders’ and policy makers' roles in reducing abortion related deaths in Uganda.
This paper describes an innovative knowledge translation project involving researchers and key stakeholders commissioned by the World Health Organization (WHO) for the Commission on Social Determinants of Health (CSDH). The project aimed to develop 'cameo' reports of evidence-based policies and interventions addressing social determinants of health, intended for use by leaders and advocates, as well as policy and programme decision makers, to advance global action. The iterative process of developing the framework and content of the cameos, in the context of a limited evidence base, is described, and a number of issues related to the integration of multiple sources of evidence for knowledge translation action are identified.