This report documents the proceedings of a skills workshop on financing incidence analysis (FIA) that was held to review international experience on the social distribution of burdens of various financing sources and the methods used for assessing financing incidence, drawing on work that has been carried out in Africa. Specifically the workshop sought to: explore ways to realise additional funding from different progressive financing sources; draw input from the Health Economics Unit, University of Cape Town, on methodologies for analysing the progressivity and regressivity of different financing sources; draw lessons from international and local experiences on FIA of different financing sources; and answer questions on how to address challenges with data collection and analysis, review of tools, preliminary results and reporting.
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In July through various institutions EQUINET has participated in forums that are taking forward processes supporting equity in health in the region. In July 18-20, Open Society Foundation AMHI held a strategic convening on community monitoring for accountability in health in Johannesburg South Africa, bringing together experienced practitioners of community monitoring to facilitate networking, collaboration, and experience sharing for strengthening the field. In July 20 - 22 2011, the 3rd Meeting of the ECSA Health Community Regional Monitoring and Evaluation Expert Core Group met in Dar es Salaam Tanzania to review progress in implementing ministers resolutions, including report on progress on the Equity Watch work. In July 24-26, EQUINET contributed to discussions on framing IDRC work on strengthening equity through applied research capacity building in eHealth, with a focus on how the use of ICT (information technology) can influence health governance and health systems strengthening towards health equity outcomes. While these activities were hosted by different institutions and connected with different processes in EQUINET, they signalled a common concern with equity as outcome and a common preoccupation with the generation, control and exchange of information and evidence in addressing the imbalances in power and resources that underlie inequalities in health.
Gender inequalities are important social determinants of health. We set out to critically review the literature relating to gender equity and sexual and reproductive health (SRH) in Eastern and Southern Africa with the aim of identifying priorities for action. During November 2011, the authors identified studies relating to SRH and gender equity through a comprehensive literature search. Gender inequalities were found to be common across a range of health issues relating to SRH with women being particularly disadvantaged. Social and biological determinants combined to increase women’s vulnerability to maternal mortality, HIV, and gender-based violence. Health systems significantly disadvantaged women in terms of access to care. Men fared worse in relation to HIV testing and care with social norms leading to men presenting later for treatment. Gender inequity in SRH requires multiple complementary approaches to address the structural drivers of unequal health outcomes. These could include interventions that alter the structural environment in which ill-health is created. Interventions are required both within and beyond the health system.
This 2017 session within the Regional ECSA HC Best Practices Forum was convened by ECSA HC and EQUINET in line with HMC Resolution – ECSAHMC50/R2 and with proposals from the 2016 Regional meeting on GHD. The objectives of the meeting were to a. To share information on progress in the ECSA HC GHD programme and issues for policy dialogue and follow up work b. To present and discuss evidence supporting and proposals for harmonised regional standards on health in the extractive sector c. To review and discuss positions on selected agenda items in the 2017 World Health Assembly (WHA) agenda The meeting recommendations were further summarised and reviewed in the Best Practices Forum and then in the Directors Joint Consultative conference, where the outcome of what was formally recommended is separately reported by ECSA HC. Delegates were provided with specific background materials through distributed publications. The report is organised by theme, with the presentation and group discussions on each area shown together.
This 2016 regional meeting was convened by ECSA HC with EQUINET in line with HMC Resolution – ECSAHMC50/R2 to prepare and discuss issues on the 69th World Health Assembly (WHA) Agenda and Regional GHD work. The objectives of the meeting were to 1. Update participants from ECSA-HC member states on Global Health Diplomacy (GHD) and its health impact. 2. Share information and discuss, from a GHD perspective, selected WHA agenda items and related issues from other key global health platforms. 3. Present and discuss research findings, recommendations on effective engagement on GHD and proposals for future work. 4. Discuss proposals for strengthened regional co-ordination and communication on GHD and a framework for monitoring progress. The meeting included senior officials delegated or responsible for health diplomacy from ECSA HC member states and South Africa, diplomats from the Africa group from ECSA HC member states, technical personnel from EQUINET and other institutions, including regional organisations and partners.
Over the last couple of years EQUINET, through the Health Economics Unit University of Cape Town and the Centre for Health Policy at the University of the Witswaterand, have been running a program of work on Fair Financing in the health sector. Two calls for proposals sent out this year in line with this program of work are in resource allocation and resource mobilisation. The deadline for the proposals is 19 May 2006, with work expected to begin on 1 July 2006 and completed on 28 February 2007.
The Participatory Action Research Portal for resources on Participatory Action Research (PAR) on the EQUINET website has a growing number of resources on PAR related to training courses, training guides and reports of training activities; methods, tools and ethics; PAR work and journal publications on PAR. The portal is a resource for all those working with PAR and includes resources in any language. There is a form for people to send videos, photojournalism, organisations, journal papers, training guides and other resources for the portal. The url link shown here is in English but there is also a Spanish version at http://www.equinetafrica.org/content/portal-de-recursos-para-la-investigaci%C3%B3n-acci%C3%B3n-participativa-iap
The equitable allocation of limited public sector health care resources across population groups is a critical mechanism for promoting health system equity and efficiency. The population groups are often defined by geographic areas that correspond to administrative authorities. The use of a needs-based resource allocation formula to calculate target allocations for each province or region and each district is becoming increasingly popular in countries where health care is publicly funded and provided. Target allocations are defined according to the relative need for health services in each geographic area, quantified using indicators such as population size, demographic composition, levels of ill health and socio-economic status. EQUINET has supported the development of needs-based resource allocation formulae in a number of east and southern African countries in the past. The methods for developing such a formula are summarised in this paper. Our work in the region has persuaded us that it is necessary to supplement the development of a formula with other initiatives to support the successful implementation of the resource allocation processes. To facilitate the gradual shifting of resources, the equity target allocations calculated through the formula must be linked explicitly to national and local planning and budgeting processes.
On 25-26 March 2011, Section27 convened a meeting of 70 activists and experts from 16 countries, including from EQUINET, mostly from Southern Africa but also from India, Brazil, the United States and Europe. The meeting’s aim was to build a common vision, and if possible programme, for realising the right to health and to discuss how to mobilise and support new campaigns for health at local, national, regional and global levels. A further objective of the consultation was to explore and debate whether, in future, a Framework Convention on Global Health (FCGH) could be an effective international legal instrument for coordination of currently fragmented activities, sustainable and sufficient resource mobilisation and standard-setting to realise the right to health. The conference reinforced the view that there is a need to mobilise people from the grass-roots level to fight for their own rights to health by educating people on and popularising the right to health, and linking community and national movements into a truly global movement of for the right to health. Finally, it confirmed the importance of exploring the idea of a future FCGH as one component of this struggle.
A regional meeting was convened on 25-27 February 2009 in Windhoek Namibia by EQUINET and ECSA HC, hosted by the University of Namibia in co-operation with TARSC and University of Limpopo to: review the findings from this body of work and to explore the implications for policies and measures aimed at valuing and retaining health workers in ESA; develop proposals and guidelines for policy and action relevant to health worker deployment and retention; and identify knowledge gaps for follow up work. The meeting also reviewed work implemented within other EQUINET themes to explore the impact of migration on health systems in Kenya (carried out in co-operation with IOM and ECSA-HC), to explore the impact of AIDS financing on health worker retention (carried out in co-operation with WHO and ECSA-HC), and to examine the relationship between health workers and communities at primary care level (in a programme of work co-ordinated by TARSC and Ifakara Health Institute). The meeting, held at the Safari Hotel in Windhoek, brought together country partners, researchers, regional and national institutions involved with health workers. A set of recommendations were produced, particularly focusing on health worker retention.