Latest Equinet Updates

This plenary presentation at the Alternative Mining Indaba presented work taking place in EQUINET to raise health rights and duties in the extractive sector. Mining was noted to be a key vehicle linking African countries to neoliberal globalisation, with by 2008, developing countries reported to be transferring about a trillion dollars more a year to wealthy countries than they received in FDI. There is evidence of poor return for local wellbeing, with examples of districts with large EI projects having higher poverty and food insecurity and poorest improvements in these areas than those without, despite the wealth generated. The presentation raised the potential to better use the power of public health rights and laws in mining. Various international standards commit to protecting health in mining for workers and communities and the SADC UNECA harmonisation of policies and standards indicated that Member States should develop, adopt and enforce appropriate and uniform health, safety and environmental guidelines for the sector as an immediate milestone area. However, while there has been progress on doing this for TB and HIV and some attention is now being paid to chronic occupational diseases for ex mineworkers, there is as yet no comprehensive focus on public health in the mines. From an analysis of laws in the region no single country provides adequate legal protection, but different countries have good practice clauses that could be used for regional guidance on minimum standards. At regional level she observed that there is both a need and potential to harmonise rights and duties for health in SADC, to ensure health impacts are assessed and prevented before licenses are granted, mines provide living standards, incomes, health infrastructures and health services before people are resettled, the public health and health care of communities living in and around mines is invested in, including to address longer term impacts from mining that may persist even after mines close.

Cities concentrate opportunities, jobs and services, but they also concentrate risks and hazards for health. How fairly are these risks and opportunities distributed across different population groups but also across generations? How well are African cities promoting current and future wellbeing? How far are health systems responding to and planning for these changes? TARSC as cluster lead of the “Equity Watch” work in EQUINET explored these questions in 2016-7, for east and southern African (ESA) countries. This brief reports what we found from analysis of data on indicators of wellbeing. Detail on the methods, findings and analyses of data can be found in full in Loewenson R, Masotya M (2018) Inequalities in health and wellbeing in urban areas in east and southern Africa: what does the data tell us? EQUINET Discussion paper 114, TARSC, EQUINET, Harare. Available at ht tps://tinyurl.com/y9nwy9oh. A number of holistic frameworks were found in the literature. They challenge the equation of progress in development with economic growth, when this is at the cost of intense exploitation of nature and significant social inequality. They thus focus on basic needs, wellbeing and quality of life (material, social and spiritual) of the individual and community, and of current and future generations, as a common good. While context dependent and with different terms in different regions, the buen vivir paradigm, (‘living well’ or ‘wellbeing’) best captures their key features. The brief presents evidence from data in several online databases with comparable data across ESA countries to see how far they measured these dimensions of wellbeing. ESA countries face a challenge in tracking progress in wellbeing, with data missing for many of its dimensions, limited disaggregation by social group or area, and more common measurement of negative than positive outcomes.

Cities concentrate opportunities, jobs and services, but they also concentrate risks and hazards for health (WHO and UN Habitat 2010). How fairly are these risks and opportunities distributed across different population groups but also across generations? How well are African cities promoting current and future wellbeing? How far are health systems responding to and planning for these changes? TARSC as cluster lead of the “Equity Watch” work in EQUINET explored these questions in 2016-7, for east and southern African (ESA) countries. This brief covers the main features of practices found to be important for urban youth wellbeing from the literature, data and participatory validation reported in Briefs 1-3. In particular it explores practices relating to education, and ensuring access and responsiveness of the curriculum to youth needs; job creation and the measures to support job creation for youth; enterprise creation, and support of how health promoting activities support youth entrepreneurship; the creative and green economy, how it is being developed and organised to support youth employment and wellbeing; shelter/social conditions, including youth access to shelter and non-violent enabling community environments; information and communication, how youth are influencing debates, norms and practices and using social media to promote wellbeing, gender equality and solidarity and participatory government. The brief discusses what these findings suggest for urban primary health care systems to promote health and address the health and wellbeing of urban youth.

By 2050, urban populations in Africa will increase to 62%. The World Health Organisation (WHO) and UN Habitat in their 2010 report ‘Hidden Cities’ note that this growth constitutes one of the most important global health issues of the 21st century. TARSC as cluster lead of the ‘Equity Watch’ work in EQUINET implemented a multi-methods approach to gather and analyse diverse forms of evidence and experience of inequalities in health and its determinants within urban areas, and on current and possible responses to these urban conditions, from the health sector and the health-promoting interventions of other sectors and communities. We aimed to build a holistic understanding of the social distribution of health in urban areas and the responses and actions that promote urban health equity. The different stages and forms of evidence are presented in a set of reports and briefs and a final synthesis document. This report presents the findings of the separate search on holistic paradigms relevant to urban wellbeing, and an analysis of statistical evidence on health and wellbeing in east and southern Africa (ESA) countries using indicators drawn from these approaches. The findings indicated that ESA countries face a challenge if they seek to track progress in the multiple dimensions of wellbeing or to build an understanding from the quantitative data gathered. First, there are no data measured across the 16 ESA countries for many dimensions of a more holistic approach to wellbeing. Second, in ESA countries, the indicators that are measured are more commonly those of negative rather than positive wellbeing outcomes. This turns the focus away from the assets in society. It points out where the problems are, but not the progress in achievement of positive or affirmative goals. Third, where data do exist, they are poorly disaggregated to show urban areas separately or to show intro-urban inequalities or levels in specific social groups. Finally and importantly, the subjective views of people on their life satisfaction do not always match measured data, and needs to be elicited and taken into account more directly in planning for urban wellbeing, including for interpreting, validating, adding to or even challenging quantitative data.