This report presents the proceedings of a meeting held on March 13 and 14 a regional meeting was convened with objectives to i. Present and discuss the findings from the EQUINET research programme and from related research in Africa, and the implications for policy, negotiations and programmes in east and southern Africa; ii. Review methods and challenges for implementing research and analysis on global health diplomacy for policy relevance, from review of research and experience of the work; iii. Discuss and propose areas for follow up policy, action and research, within ESA and through south-south collaboration. It included senior officials involved in health from national and regional organisations, health diplomats, researchers from the EQUINET work and others working on health diplomacy and on south-south co-operation in the region and internationally.
Latest Equinet Updates
This report explores the health equity issues in Malawi, as a country equity analysis and contribution to the regional picture. It explores the current equity situation in Malawi through a review of literature and a meeting of local institutions, and proposes areas of focus for future work. It addresses the potential to promote equity in health through a strong network of equity actors whose voice would advocate for equitable access to basic quality health care in Malawi.
In 2017 EQUINET (through TARSC working with Maldaba a web design company) is developing a web platform for participatory action research (PAR) that would allow us to connect across countries on areas of local community level work and action on areas of health, health determinants and health systems that have wider regional and global relevance or relate to global policies being applied across our countries. In doing this we are building a new tool that will allow us to share, discuss, analyse and design actions across countries in the same way we have done so using PAR at local level, that we can use in future for many purposes. TARSC has opened a call for people with experience of PAR working in east and southern Africa who may be interested in being involved in this process. We will be taking forward the web platform for PAR between July 2017 and December 2019 working with eight sites and health workers and community members in a primary care facility in the site. We will be exploring how disease programme or funding targets such as for performance based financing are affecting health workers professionals roles and team work; health workers relationships with communities and the ability to deliver comprehensive primary health care. We invite people to apply to join the programme as country PAR facilitators. To participate in this programme we invite people who work in an organisation/ programme in a country in an east and southern African country; have had some exposure to PAR approaches; have access to internet; have ongoing work or interaction with at least one primary care centre and with the health workers and community members in it, such as through health centre committees, health literacy or other programmes; have primary care level services that are implementing some form of target driven funding or service delivery, such as in performance based financing or specific disease programmes, and are available for the activities, in the time frames and for the duration noted in the process above. If you are interested please email EQUINET at admin@equinetafrica.org by July 7th 2017 with your name, organisation, country and email address for communication, and: (1) list of any prior training received on PAR, with the course, institution providing the course and year; (2) A list of any PAR work you have implemented, with a line for each on what it was about and the year; (3) Confirmation that you have direct access to internet and what it costs you for a one hour session (if provided institutionally through your organisation please indicate this). (4) The name, location and urban/ rural location of a primary care centre that you regularly interact with, including with the health workers and community members, and whether the health workers and / or community members at this centre have access to the internet (not essential but useful). (5) The form of target driven funding or service delivery being implemented at the primary care service, (ie. performance based financing or specific disease programmes specify for what) and (6) Confirmation that you are available for the activities, in the time frames and for the duration noted in the process above. We will provide feedback to applicants who provide the full information above by last week of July.
This paper outlines how for ESA countries, COVID-19 has exposed the weakness in being dependent on research and production outside the region of commodities that are needed in good time for communities and services across the region. This not only relates to current demand, like test kits. It forewarns that African countries will be last in the queue when COVID-19 treatments and vaccines are approved. Tariff reductions and reduced protections for domestic industry have suited a global strategy of ‘lowest-cost-production’ but leave ESA countries vulnerable in the global competition for products. The author also notes that COVID-19 has pointed to resources in the region that could play a more significant role in public health. The Ebola experience showed that an effective response demands collaborative work that involves communities and is supported by professionals, governments and accessible, capable public services. This is the same lesson learned from the gains made in health by applying primary health care strategies in the region, despite their being weakened by underfunding of public services. In contrast, the response to COVID-19 has often generated a self-protective response across countries in global trade and a command-and-control response within countries. Yet neither are effective strategies for a global pandemic that demands distributed local capacities and action. Noting the UN call to use COVID-19 as an opportunity “to rebuild differently and better, the author observes that this begins with how we respond to COVID-19 today, and raises what this implies.
This paper represents the first phase of a Canadian initiative on intersectoral action for health and provides an overview of approaches to intersectoral action at the global, sub-regional, national, sub-national, and community levels. It is intended to contribute to the World Health Organisation’s Commission on Social Determinants of Health (SDH) and is the result of collaboration between EQUINET, the Health Systems Knowledge Network of the Commission on SDH and the Public Health Agency of Canada. Experiences documented by academics, policy-makers and practitioners in more than 15 countries are examined in an attempt to improve understanding of questions relating to: the types of problems addressed through intersectoral action (IA); the conditions that shape horizontal and interjurisdictional collaboration; tools, mechanisms and approaches to support IA; and roles played by the health sector and other actors.
A descriptive study of debates on health and health equity matters in the Zimbabwean National Assembly was conducted to identify key issues raised, the positions taken within the key areas of parliamentary functions, legislative, budgetary oversight, policy oversight and representation. The work also tracked how issues were responded to in parliament, and how they were followed through by parliament. The research drew information from recordings of parliament in the Hansards.
This report provides a legal analysis of the provisions for institutional management of earmarked funds in health, drawing on the laws in Zimbabwe in terms of: 1. The legal definition and current law covering public funds; 2. Obligations in relation to the establishment of funds; 3. The oversight and governance of funds, including the powers, duties and responsibilities of the different parties involved in the control, management, protection and recovery of public funds, in relation to governance of funds and the measures and sanctions related to financial misconduct; 4. The collection, pooling, allocation and expenditure of funds, including duties and responsibilities in relation to collection, receipt, custody, control, issue or expenditure of public money, and in relation to management, audit and obligations of officers managing public funds; and 5. The reporting on funds and measures for transparency and accountability
Health Centre Committees (HCCs) have provided one vehicle for social participation and accountability in health systems in east and southern Africa (ESA). Recognising this contribution and building on prior work on HCCs, EQUINET held a regional meeting involving those working with HCCs in ESA countries to exchange experiences and information on the laws, roles, capacities, training and monitoring systems that are being applied to HCCs in the ESA region. The meeting gathered 20 delegates representing seven countries from the region, all involved in training and strengthening HCCs. An interim desk review of existing published literature on HCCs was prepared for the meeting. The desk review covered all 16 ESA countries covered by EQUINET, that is Angola, Botswana, Democratic Republic of Congo (DRC), Kenya, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Delegates validated and added to the evidence presented. This discussion paper combines the evidence from the desk review and the further evidence that was presented at the regional meeting. It covers the legal frameworks, roles, composition, capacities and monitoring of HCCs in ESA countries.
Training and Research Support Centre (TARSC) as cluster lead of the “Equity Watch” work in EQUINET is following up on the findings of the 2012 Regional Equity Watch and the country Equity Watch reports with a deeper systematic analysis of available evidence on inequalities in health and its determinants within urban areas and the responses to urban inequalities from the health sector and through health promoting interventions of other sectors and communities acting on public health and the social determinants of health. This document presents evidence from 105 published papers in English post 2000 on patterns of and responses to urban inequalities in health in east and southern African countries. The evidence is presented in an annotated bibliography and analysis. It is being used to identify key areas of focus and parameters for deeper review and analysis. The picture presented in the literature is not a coherent one- it is rather a series of fragments of different and often disconnected facets of risk, health and care within urban areas. There is also limited direct voice of those experiencing the changes and limited report of the features of urbanisation that promote wellbeing. The literature found was significantly more focused on the challenges than on the solutions. The papers sourced confirmed the relevance of primary care and community-based approaches, with CHWs, to carry out participatory assessments, promote new PHC approaches, use social media and support service uptake to address urban determinants. However the documented interventions made weak links between PHC services, urban public health and the work of other sectors. The rapid, diverse and multifactorial changes taking place in urban areas, some of which are poorly documented, also call for participatory approaches that include the direct voice of those experiencing urban life.
This document provides the detailed legal frameworks and relevant legal clauses from 16 East and Southern African countries for Diss paper 108: Corporate responsibility for health in the extractive sector in East and Southern Africa (ESA) produced by EQUINET through Training and Research Support Centre to inform policy dialogue to improve the legal frameworks for the duties and corporate social responsibility of extractive industries in the ESA region.