The paper reviewed evidence from published and grey (English language) literature on the use of non-financial incentives for health worker retention in sixteen countries in east and southern Africa (ESA): Angola, Botswana, DRC, Kenya, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. There is a growing body of evidence on health worker issues in ESA countries, but few studies on the use of incentives for retention, especially in under-served areas.
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Discussion paper 44: A review of non-financial incentives for health worker retention in east and southern Africa
Dambisya YM
Discussion Paper 45: The impact of food aid on food markets and food security in Malawi
Jere, Paul, Malawi
This paper is part of a series exploring the role of health systems in promoting food sovereignty in Africa being implemented in EQUINET through Health Science Research Council, South Africa. The paper explores the effect of food aid on Malawi’s food security and on the domestic market for food. The paper highlights the impact of food aid interventions on domestic food markets and argues for food aid interventions to be designed and implemented in a way that takes domestic market operations into account. This needs a supportive policy framework, a social protection programme that responds to both transitory and chronic food insecurity, functional markets that support household food production and strengthened rols of national vulnerability assessment committees to support evidence based identifcication of vulnerable groups.
Discussion paper 46: School feeding in east and southern Africa: Improving food sovereignty or photo opportunity
Tomlinson M
This report examines two case studies of school feeding schemes in South Africa and Malawi, viz the Primary School Nutrition Programme (PSNP) established in South Africa in 1994 and the World Feeding Program (WFP) feeding schemes in Malawi, in the context of policy outlined by the New Partnership for Africa’s Development (NEPAD). The report notes that school feeding programmes largely take the form of a vertical intervention programme, rather than a comprehensive nutritional programme, weakening their likely sustained impact on children's nutritional status.
Discussion paper 47: Food sovereignty and nutrition in east and southern Africa: A synthesis of case study evidence
Chopra M, Tomlinson M
In 2006, the Regional Network for Equity in Health in East and Southern Africa (EQUINET) and the Health Systems Research Unit of the Medical Research Council (MRC) of South Africa commissioned a series of country case studies on existing food security and nutrition programmes in East and Southern Africa that promote food sovereignty and equity. This paper gives an overview of the findings from the case studies on three important nutrition responses in ESA:
• food aid in Malawi;
• HIV/AIDS-related nutrition interventions in ESA; and
• School feeding programmes in Malawi and South Africa.
Discussion Paper 48: A review of nutrition and food security approaches in HIV and AIDS programmes in Eastern and Southern Africa
Panagides, D; Graciano, R; Atekyereza, P; Gerberg, L; Chopra, M (2007)
The purpose of this paper is to explore the interface between HIV and AIDS and food and nutrition security, and the policy and programme implications for a comprehensive strategy to address these issues synergistically. Specifically, this paper examines and compares the policies and programmes related to HIV and AIDS and food and nutrition security that are currently in place in three Eastern Africa countries (Kenya, Tanzania and Uganda) and three Southern Africa countries (Mozambique, South Africa and Zimbabwe) and concludes with elements of a comprehensive approach. This paper is based on a desk review of exisiting policies and programs in each of the six study countries. In addition, key informat interviews were conducted with persons from various government departments, United Nations (UN) agencies and non-governmental organisations (NGOs).
Discussion paper 49: The costs and benefits of health worker migration from East and Southern Africa (ESA): A literature review
Robinson, R
This report commissioned by EQUINET / HST in co-operation with the ECSA-HC presents a review of literature on the methods for analysis costs and benefits of the migration of health workers from East and Southern African (ESA) countries.
Discussion paper 51: Deprivation-based resource allocation criteria in the Zambian health service: A review of the implementation process
Chitah BM and Masiye F (2007)
This study reviews the Zambian deprivation-based health resource allocation formula and assesses how the deprivation-based resource allocation formula has been implemented in terms of achieving the initial desired goals of resource – re-distribution. It further considers the extent of converge or divergence in the equity goals relating to resource re-distribution through the allocation of funding to the districts.
Discussion paper 51: Deprivation-based resource allocation criteria in the Zambian health service: A review of the implementation process
Chitah BM, Masiye F, University of Zambia
This study reviews the Zambian deprivation-based health resource allocation formula and assesses how such a formula has been implemented in terms of achieving the initial desired goals of resource – re-distribution. It further considers the extent of converge or divergence in the equity goals relating to resource re-distribution through the allocation of funding to the districts.
Discussion paper 52: Progress towards equitable health care resource allocation in east and Southern Africa
McIntyre D, Chitah B, Mabandi L, Masiye F, Mbeeli T, Shamu S
There are large disparities in the health care resources available to different districts, regions and provinces within individual countries. Using a resource allocation formula, that is based on indicators of the relative need for health care within each geographic area, has been found to be helpful in overcoming historical allocation patterns. This report, implemented under the fair financing theme in the Regional network for equity in health in east and southern Africa (EQUINET) assesses whether there has been progress towards equitable resource allocation in four Southern African countries which have adopted such formulae (Namibia, South Africa, Zamibia and Zimbabwe). Researchers in Namibia, South Africa, Zambia and Zimbabwe provided information on implementation progress in their countries.
Discussion Paper 53: Private medical pre-payment and insurance schemes in Uganda: What can the proposed SHI policy learn from them?
Zikusooka CM, Kyomuhangi R
Over the last two decades there has been growing interest in the potential of social health insurance (SHI) as a health financing mechanism in low and middle-income countries. However, few countries in Africa have implemented SHI. Uganda is currently designing its own SHI scheme, in preparation for its imminent implementation. It is hoped that SHI will bring additional resources for the Ugandan health sector and that its introduction will improve equity in access. Very little was known about the Insurance market in Uganda before this study was undertaken, so one of our main objectives was to provide quantitative and qualitative data that could be used by the Ugandan Ministry of Health as a basis for designing this scheme and for future SHI policy-making.