This review is part of EQUINET's programme of work on Contributions of global health diplomacy in east and southern Africa. Access to essential medicines is one of the key requirements for achieving equitable health systems and better public health in east and southern Africa (ESA). One constraint to this is that the region’s medicine production capacity remains weak. In May 2007, the African Heads of State and Government adopted the Pharmaceutical Manufacturing Plan for Africa (PMPA) to maintain a sustainable supply of quality essential medicines to improve public health and promote industrial and economic development in Africa. The PMPA includes six priority areas: mapping productive capacity; situation analysis; developing a manufacturing agenda; addressing intellectual property issues; political, geographical, economic considerations; and financing. This review compiles from existing literature bottlenecks to local medicine production in the region. It seeks to inform follow-up case study work on the extent to which relationships and agreements with Brazil, India and China are addressing the bottlenecks identified in the African Union (AU), SADC and EAC plans for pharmaceutical manufacturing.
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This review is part of EQUINET's programme of work on Contributions of global health diplomacy in east and southern Africa. This includes work on the WHO Global Code on Ethical Recruitment of Health workers. The research seeks to explore the extent to which the policy interests of African countries were carried (or not carried) into the Code in the negotiations around the code and the perceived factors affecting this; the extent to which countries in east and southern Africa view and implement the Code as an instrument for negotiating foreign policy interests concerning health workers; and the motivations, capabilities and preparations for monitoring the Code to engage on African policy interests concerning health workers. The paper presents a review of published and grey literature on relevant codes of practice on health workers and on bilateral and multilateral agreements on the health workforce. The information was analysed using the policy analysis triangle to capture the changing context, processes, content and major actors in the development of the WHO Code, and documentation on its progress and implementation since its adoption. It raises issues that are being followed up through field research.
Performance-based funding (PBF) has become increasingly popular in global health financing. It is defined essentially as the transfer of resources (money, material goods) for health on condition that measurable action will be taken to achieve predefined health system performance targets such as particular health outcomes, the delivery of effective interventions (such as HIV prophylaxis), utilisation of services (like HIV counselling and testing), or quality care. This annotated literature review has been prepared for work on global health diplomacy and the role of African actors in global health governance in relation to PBF. The review highlights the theoretical thinking behind and strengths and weaknesses associated with PBF schemes in their use in Africa. It reviews documented evidence of the role of African actors in diplomacy and decision-making surrounding PBF. The review highlights that while national governments are generally involved in the design, implementation and evaluation of PBF schemes, some national actors and regional actors appear to be marginalised when it comes to the design and global decision-making process for performance-based funding schemes, even if they are heavily involved in their implementation.
The COVID-19 pandemic has strained the already stretched health systems in East and Southern Africa (ESA) countries, and was affected by previous levels of public leadership and engagement with the private sector. The response involved a range of collaborations between the public and private sectors. Country plans were public sector-led, in co-operation with international development partners, with partnerships between the public and private sectors in the response both in and beyond the health sector. This desk review commissioned by EQUINET presents evidence from online materials and EQUINET steering committee key informants on features of the public and private sector health system roles in the response to COVID-19. The work differentiates the private for-profit sector from the private not-for-profit sector. The review explores the equity implications of these responses, and suggests implications for (re)investing in strengthened public health system preparedness and functioning and private sector co-ordination in ESA countries.
This desk review reports available published information relating to youth mental health in east and southern Africa (ESA). It was implemented within and informs collaborative work on youth mental health in the region in EQUINET between Training and Research Support Centre (TARSC), the International Working Group for Health Systems Strengthening (IWGHSS) and the pra4equity and PAROnline network, specifically Country Minders for Peoples Development (CMPD), Malawi, and the Centre for Youth Driven Development Initiative (CFYDDI), Uganda. The desk review explored patterns and determinants of youth mental health in the region; how the coronavirus (COVID-19) pandemic and responses to it have affected this; where youth seek and obtain support for mental health needs and the perceived challenges and gaps. It presents recommendations for improving the responses to mental health challenges. The COVID-19 lockdown and social distancing measures led to difficulties, with online learning and loss of work and rising costs intensifying some factors and increasing mental stress, as well as suicidal ideas and substance and alcohol abuse among youth. Youth mental health is a pertinent issue for the ESA region, more so due to the impact of the pandemic, but is not well recognised by formal services and policy. The review evidence points to a need, intensified by COVID-19, to co-create with young people strategies for preventing and responding to youth mental illness and its drivers and consequences.
The Regional analysis of Equity in Health in East and Southern Africa presents a synthesis of the evidence gathered from a range of sources: published literature on and from the region, reviews of current evidence, where available, data drawn primarily from government, intergovernmental, particularly Africa Union and UN sources and the less commonly documented and heard experience within the region, found in grey literature, in interviews and testimonials and gathered through participatory processes. The report is written for many audiences. For the diverse community involved in health equity within east and southern Africa, it provides a source book of evidence and analysis to support and advance work.
In 2012 EQUINET initiated a three year policy research programme working with government officials, researchers, diplomats and others in the ESA region on the role of health diplomacy and international co-operation in health, including south –south diplomacy, in addressing selected key challenges to health and strengthening health systems. We aimed to use the evidence and learning to inform African policy actors and stakeholders within processes of health diplomacy. The work was done in association with the Strategic Initiative of Global Health Diplomacy co-ordinated by the East Central and Southern Africa Health Community (ECSA-HC). The research reports and policy briefs have been produced and are included in the EQUINET publications on this website. A March 2015 workshop included senior officials 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. The workshop discussed the evidence from the EQUINET research and from research on GHD from other institutions with a particular focus on east and southern Africa and proposed areas for follow up policy, action and research, within ESA and through south-south collaboration. The meeting report is on this website. EQUINET is now taking forward the proposals from this meeting in association with a consortium of institutions in the region, and is working with the ECSA Health Community in its Strategic initiative on global health diplomacy to share evidence and analysis for key global processes, including in the forthcoming regional workshop on GHD hosted by the ECSA HC with EQUINET.
This document compiles twenty one editorials of the newsletter of the Regional Network for Equity in Health in East and southern Africa from January 2007 to April 2008 translated into Portuguese. The issues covered range from debates and policy positions on financing for health to the public health impacts of criminalising HIV transmission. The editorial content reflects a range of authors from academic, professional and civil society groups and not the views of the EQUINET steering committee.
All abstracts for the EQUINET conference must be submitted on or before January 30 2009. The Third EQUINET Regional Conference on Equity in Health in east and southern Africa will be held at Speke Conference Centre, Munyonyo, Kampala, Uganda September 23rd -25th 2009. The conference theme is 'Reclaiming the Resources for Health: Building Universal People Centred Health Systems in East and Southern Africa'.
The themes are listed in the EQUINEt website. Sessions will be 2-3 hours in length and interactive in nature. Presenters may be asked to present verbally, using Power-oint, or using a visual presentation of a paper using charts, photos, drawings and/or text mounted on a poster board. The sessions will include brief summary presentations of the accepted abstracts on the theme and aim to give adequate time for full facilitated discussions of work and the issues raised. The Abstract submission form and registration form can be downloaded at the conference website.
Abstracts are a maximum of 400 words and typed at MS Word documents in Arial 11pt font. The title should be no more than 50 characters including punctuation, but long enough to identify the nature of the study. Ensure the abstract provides information on the findings. Accepted abstracts will appear in print in a bound abstract book distributed at the conference, and may also be posted on the conference web site.
Primary Health Care (PHC) has inspired and galvanized action on health. PHC affirms that health is a state of complete physical, mental and social wellbeing and not merely the absence of disease and that health is a fundamental human right. In the past decade, global institutions have promoted and channeled external funds through performance-based financing (PBF), as a strategy to improve service delivery and access. While there have been studies on whether these particular services targeted under PBF have improved, there has been little systematic evaluation of its system-wide effects, nor of its impacts on comprehensive PHC. In EQUINET, we thus saw it to be important to ask: How is the use of targets in PBF affecting health workers’ professional roles, work and interaction with communities and their ability to deliver comprehensive PHC? In 2018-2019 the PAR involved 21 online participants from seven sites in five ESA countries, including health workers from primary health cent res, community members in HCCs and country site facilitators from seven national health civil society organisations in the region, referred to in this brief collectively as the ‘online participants’. We also included offline local discussions with an average of 19 community members and 15 health workers per site. Four major areas of action and ten proposals were made within them for PBF to enable and not detract from PHC. These are 4 briefs each of which present the general findings and proposals from the work with separate final points in the first brief for local level; in the second for district and national level; in the third brief for regional level agencies and in the fourth brief for international agencies. The link is to one of the briefs but all four are on the website.