Research has shown that mHealth initiatives, or health programs enhanced by mobile phone technologies, can foster womens empowerment. Yet, there is growing concern that mobile-based programs geared towards women may exacerbate gender inequalities. A systematic literature review was conducted to examine the empirical evidence of changes in men and women?s interactions as a result of mHealth interventions. Out of the 173 articles retrieved for review, seven articles met the inclusion criteria and were retained in the final analysis. Most mHealth interventions were SMS-based and conducted in sub-Saharan Africa on topics relating to HIV/AIDS, sexual and reproductive health, health-based microenterprise, and non-communicable diseases. Several methodological limitations were identified among eligible quantitative and qualitative studies. The current literature suggests that mobile phone programs can influence gender relations in meaningfully positive ways by providing new modes for couples health communication and cooperation and by enabling greater male participation in health areas typically targeted towards women. MHealth initiatives also increased womens decision-making, social status, and access to health resources. However, programmatic experiences by design may inadvertently reinforce the digital divide, and perpetuate existing gender-based power imbalances. Domestic disputes and lack of spousal approval additionally hampered women?s participation. Efforts to scale-up health interventions enhanced by mobile technologies should consider the implementation and evaluation imperative of ensuring that mHealth programs transform rather than reinforce gender inequalities. The evidence base on the effect of mHealth interventions on gender relations is weak, and rigorous research is urgently needed.
Governance and participation in health
This report aims to shed light on the way innovative solutions have arisen to address local sustainable development challenges, examining the determinants of success and the scope for replication. The report focuses on the African experience. The volume is composed of ten case studies, selected for their truly innovative nature, effective implementation, significant outputs and generation of real social welfare improvements, grouped under five headings: enhancement of agriculture and fisheries, protection of ecosystems, water management, health improvement and sustainable tourism. Practical conclusions drawn from the case studies include: sustainable projects need to link environmental goals to income generation, draw upon local knowledge and ideas, ensure effective buy-in from stakeholders through local community involvement in project design and implementation, and employ financially self-sustaining business models external forces which impact on a project and affect conditions for success, including international markets and national legislation. In some cases though, local success can provide arguments for more accommodating national policies to facilitate replication and scaling up simplicity in project design. Committed seed capital and integration of local traditions and cultural heritage appear to be important success factors for innovative local initiatives.
An interactive learning tool on participatory processes at the national level for the Poverty Reduction Strategy (PRSP) and other government strategies and actions to reduce poverty is currently under development. It is designed to provide staff from country governments, World Bank and the Fund, and civil society leaders guidance on participatory processes and outcomes at the national level through the 4 building blocks: poverty diagnostics, public expenditure management, macroeconomic reform and monitoring implementation and results of policies. This interactive learning guide on participation was prepared by the Action Learning Team of the Participation Thematic Group in the Social Development Department of ESSD Network. Please send your feedback and share your learning experiences with us: the Participation Group, Social Development Department, the World Bank.
In this interview with Gino Govender, who recently joined Amnesty International’s International Mobilisation team, Govender reveals that Amnesty International has decided to grow in the global south and move closer to the communities and rights holders with whom the human rights organisation works. One of the outcomes of an extensive consultative process is the development of an Africa Growth Strategy, which involves the creation of three regional offices, one of which will be located in and responsible for Southern Africa. With regard to the current state of civil society in the Southern African Development Community (SADC) region and in South Africa in particular, Govender is optimistic, arguing that, regionally, civil society is undergoing an important stage of evolution. However, within SADC there are important political, social and economic challenges still to be confronted if the vision of a people-centred regional community that is thriving on the values of solidarity, social justice, equality, dignity, freedom, democracy and production that meets basic human needs are to be realised. He points to a general consensus on the need for a strong and effective civil society in the region and argues that collective leadership united under a common vision for the region is the key. The future for civil society in the region lies in a blend between historically vital sectors that have a wealth of organisational knowledge and experience - like the labour movement, faith-based organisations, womens’ organisations and intellectuals – and newly established organisations that are dedicated to a single campaign.
This article explores the inversion of roles between the state and citizens, by exploring its historical roots and current implications for processes of social accountability in Mozambique, particularly in the health sector. This is a practice-based reflection grounded in the evidence collected through the implementation of community scorecards in the health sector in 13 districts of Mozambique. The evidence reveals a transfer of responsibilities from local governance institutions and service providers to the communities; diluting the frontiers between the state and citizens’ duties and rights, resulting in the inversion of roles. This inversion results in the minimisation of the state’s performance of its duties and accountability in the health sector to respond to local communities’ needs, allegedly due to the lack of financial resources. The authors suggest that it leads to the overburdening of local communities, who assume the responsibility of meeting their own demands, risking participation fatigue.
As public health professionals devoted to global health equity, the authors express our deep concern with the The Lancet Commission Global health 2035: a world converging within a generation (Dec 7, p 1898),1 a re-run of the 1993 World Development Report, whose policies contributed to the shrinkage of government institutions and massive privatisation and fragmentation of health-care systems, effectively decreasing coverage and accessibility. The authors observe that its recommendations are based on the principle of return on investment, not on health equity, while creating a double standard: one for the rich and another for the rest of us. Any policy for the poor is by definition a poor policy. The Lancet Commission's recommendations are argued to not represent the global health community and are fundamentally flawed by neglecting the principle of the right to health. The report analyses Millennium Development Goals progress without reference to stagnant levels of health inequity: 20 million deaths each year, more than a third of all deaths, are avoidable and caused by socio-economic injustice—a number and a proportion that have not changed for the past 40 years. Every individual, organisation, or government working to promote heath equity and WHO's objective of enjoyment by all peoples of the best attainable level of health should be on their guard.
This study, from the Horizons programme, examines the potential of trained members of anti-AIDS clubs to contribute to care, support and stigma-reduction activities and attempts to determine the impact of their involvement in these activities on HIV-related beliefs and behaviours. The findings suggest that youth can be empowered to confront the realities of HIV in their own lives and communities and to confront the barriers of stigma, denial and ignorance, while serving as a resource to people in their communities. The study also demonstrates that organisations and youth clubs working in isolated rural and semi-urban areas can achieve high levels of participation.
In this statement, issued before the United Nations Conference on Sustainable Development (Rio+20), held in Brazil from 20-22 June 2012, CIVICUS affirms that the Zero Draft outcome document for Rio+20 must advance a rights-based approach to sustainable development that reaffirms past political commitments, and in particular, the need to protect civil society space, ensure maximum public participation and advance democratic freedoms, by establishing legally binding commitments which support the three dimensions of sustainable development: social justice, environmental sustainability and economic development. CIVICUS argues that the reason why global governance is failing so badly is partly because we have multinationals whose operations are now global beyond the national jurisdiction of any one government to regulate, police or manage. States have reneged on the democratic values they committed themselves to uphold, and governments have become less accountable to the people. Universal norms and standards are being ignored or sidestepped by new rules that favour markets. To achieve and maintain sustainable development, CIVICUS urges UN member states to commit to improve continuously the implementation and enforcement of environmental policies and legislation, with no regression on environmental protection. Commitments to the principle of non-regression at all levels should be a major objective of Rio+20.
The concept of social cohesion is increasingly being used in local and international policy discourse and scholarship. The idea of collective efficacy, defined as ‘social cohesion among neighbours combined with their willingness to intervene on behalf of the common good’, has been posited as having an important protective effect against violence. This article investigates the relevance of international framings of social cohesion and collective efficacy, - largely conceptualised and tested in the global North - to the conditions of social life and violence prevention in a city in the global South. These circumstances are interrogated through an ethnographic study conducted in Khayelitsha township in the Western Cape, where a major internationally funded and conceptualised violence prevention intervention, Violence Prevention through Urban Upgrading (VPUU), has been implemented. The ethnographic material contests some of the key assumptions in international discourses on social cohesion and the manner in which social cohesion has been interpreted and effected in the violence prevention initiatives of the VPUU. Khayelitsha communitarian world views support forms of mutual sociality that are underpinned by a philosophy of ubuntu in which personhood is achieved through social relations rather than through individual empowerment. However, these communitarian networks and ‘ways of life’ are argued to be under social and structural strain and can be conduits not only for reciprocity, but also for violence.
Distinguishing between ‘(good) governance’ as a process and an outcome, this paper examines both the processes and outcomes of governance in the context of the European Union’s (EU) relationship with African, Caribbean and Pacific (ACP) States within the period of the Cotonou Agreement (CA). It discusses and assesses a variety of governance mechanisms, including the European Commission’s use of the governance concept, economic partnership agreements (EPAs), manifestations of partner preferences, the revision of the CA, and Fisheries Partnership Agreements. Specific examples of the wielding of each mechanism are assessed based upon two criteria: the extent to which the wielding of the mechanism by the EU is a manifestation of ‘good governance’, and the extent to which the EU’s wielding of the mechanism has resulted, or is likely to result, in the sustainable development of and reduction of poverty in ACP countries. The examples are chosen to illustrate contradictions between rhetoric and practice and the consequential negative (actual and potential) impact upon development in ACP States. The final section offers suggestions for improving the EU’s governance processes and their outcomes for development.