The EQUINET-ECSA-HC programme in 2007-8 is supporting research and dialogue on strategies for managing health worker migration and for use of incentives for health worker retention in east and southern Africa (ESA). This work is being co-ordinated by University of Namibia, Health Systems Trust South Africa with the EQUINET Secretariat at TARSC and the ECSA HC Secretariat and Technical Working Group on Human Resources for Health. This report outlines the proceedings of a regional meeting of the programme held in March 2007 in Arusha Tanzania to review the aims and protocols for the programme of work.
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This report is of the proceedings of a training workshop on policy engagement and advocacy to promote health in trade agreements held in Bagamayo, Tanzania, August 31 and Sep 1 2007. The workshop covered general issues of trade and health, and a deeper review of TRIPS and use of TRIPS flexibilities, the EU-ESA EPA, and health services liberalisation.
EQUINET in co-operation with ECSA-HC have, with government and researchers in five countries, carried out review and field studies on the implementation of incentives for health worker retention and of their impact on the adequacy and distribution of health workers. A regional meeting will be held in February 2009 to review this work and other work on health worker migration and distribution in EQUINET in Windhoek Namibia, locally hosted by the University of Namibia. If you are interested in this meeting please contact us at admin@equinetafrica.org, using "HCW Retention meeting" in the subject line.
TARSC, through COPASAH and EQUINET, are holding a regional workshop on Participatory Approaches to Strengthening People Centred Health Systems in the east and southern African region. The workshop will explore how to raise community voice in strengthening the resourcing and functioning of primary health care systems through the use of participatory approaches to build community roles in accountability and action. The workshop is targeted at civil society organisations, NGOs, community leaders, health workers, academics, researchers and others involved in work with communities and health workers in the east and southern African region. Applications to be mailed to info@tarsc.org by 3 September.
The objective of this consultation was ‘to speed up and scale up country responses to the human resource needs of both the UN Global Strategy for Women’s and Children’s Health (Every Woman Every Child), and the Global Plan towards the Elimination of New HIV Infections Among Children by 2015 and Keeping their Mothers Alive (Global Plan) as a key aspect of both plans’. The intended outcomes of this consultation were broadly stated as: identification of concrete opportunities for progress as well as obstacles to such progress; and documentation of experiences on successes and failures. Through a combination of interactive sessions, the Consultation reviewed progress at country level, what technical support exists, and good practices within the countries. Participants at the Consultation underscored the need for ministries of health, continental mechanisms such as the AUC, regional organisations such as ECSA HC, SADC, WAHO and OCEAC, development partners, faith-based organisations, funding agencies, academic and research institutions, and civil society organisations to give priority to efforts towards increasing access to health workers at the frontline for better maternal and child survival and provided a communique of recommendations on actions to achieve this.
This workshop was designed to provide the Ministry of Health in Mozambique with support on practical approaches to achieving a more equitable distribution of public health sector resource allocation outlays. Based on communication with officials of the Mozambican Ministry of Health, there have been concerns around the inequitable distribution of public health care resources, with areas of higher socio-economic status and relatively lower levels of disease burden receiving higher health care allocations. The key problems for the Ministry of Health were: how to empirically show that the current resource allocation outlays are inequitable and how to design a formula that allows for the shift of resources to ensure a more equitable distribution.
The EQUINET and MRC meeting on Food Security and Nutrition in east and southern Africa sought to bring together case study writers and expert facilitators that have been working on nutrition initiatives, policies, and to update them on the prevailing situation, current interventions, equity and policies on food security. The meeting took a focus on how health systems can advance and encourage food sovereignty, including community control and enhanced gender equity in food production. The meeting established the framework for a series of case studies that demonstrate and examine health system approaches to food sovereignty that will be implemented in 2006.
The meeting briefly:
* reviewed evidence, current programmes and priority areas for future work to support retention and manage migration of HRH from national and regional level;
* planned a regional programme of work to support national HRH planning, monitoring and evaluation; and
* discussed institutional mechanisms for guidance and review of the follow up work programme.
An exploratory discussion was also held to map priority areas of work to gather, analyse and review evidence on costs and benefits of HRH migration out of east and southern Africa, and to assess and support policy measures aimed at managing HRH migration.
The ECSA Secretariat organised the first Regional Monitoring and Evaluation Expert Core Group meeting in Harare Zimbabwe from 12th to 16th July 2010. The participants came from Member States of Tanzania, Kenya, Lesotho, Zimbabwe, Zambia, Uganda, Malawi, Mozambique and Mauritius and international partners, namely EQUINET, UNICEF, ESARO, WHOIST/ESA and USAID-EA. The meeting deliberated and agreed on the Terms of Reference for the regional M&E Expert Group. The meeting also updated the HMC Monitoring tool, adopted with amendments the Regional Core set of indicators that will be used to monitor progress towards the Millennium Development Goals (MDGs), finalised the M & E Framework, developed indicators to monitor the implementation of the HMC resolutions and included indicators to monitor health equity in order to address inequalities in health in the region. In addition, the meeting resolved that it was necessary to monitor other codes, protocols and conventions such as the WHO Global Code of Practice on the International recruitment of health personnel. The indicators and the monitoring tools agreed upon by the expert core group will not only make it easier to compare member states in progress towards achieving the MDGs, addressing equity issues in health and implementation of the HMC resolutions, but also will be valuable in evaluation of in country changes from the baseline. The meeting also discussed, reviewed and adopted the Equity watch work in east and southern African countries.
This meeting provided an opportunity for discussion of evidence in the draft Zimbabwe equity watch from the perspective of people from community and primary health care levels of the health system. Evidence in the Zimbabwe equity analysis provided input to civil society plans within the CWGH and to the resolutions from the CWGH meeting. The discussion on the Zimbabwe equity analysis was a build up to the launch of the book ‘Reclaiming resources for health: A regional analysis for equity in Health in East and Southern Africa’. The event was attended by more than hundred people from Parliament (MPs), Ministry of Health, Ministry of education, academics, representatives from the Health Service Board, private sector, civil society, health worker unions, labour movement, and delegates from the region (Uganda, Malawi, South Africa).
