TARSC as cluster lead of the “Equity Watch” work in EQUINET has been exploring urban health in east and southern African (ESA) countries, gathering diverse forms of evidence from literature review, analysis of quantitative data, internet searches on practices and a participatory validation amongst different social groups of youth. Lusaka District Health Authority (LDHO) has a history of over a decade of using participatory reflection and action (PRA) approaches to strengthen health literacy, working with TARSC and other organisations in EQUINET. In 2018, TARSC and LDHO colleagues involved with the Zambian health literacy programme identified that it would be important to explore the views of youth in the city on their health and wellbeing to better integrate this group within the health literacy programme. Involving Lusaka youth in a similar process as in Harare of identifying their experiences, perceptions and proposals on health and wellbeing added further grounded evidence in the work in EQUINET. Further, the Harare youth were interested in sharing experience with youth in Lusaka. A two day participatory process was thus held with young people from various social settings in Lusaka on 26-27 June 2018 hosted by LDHO and TARSC, with the objectives to: a. Hear from different groups of Lusaka urban youth their perceptions and experiences on urban health and wellbeing. b. Facilitate exchanges between Lusaka and Harare youth on urban health and wellbeing, and identify their similar and different experiences and priorities. c. Identify what implications the information gathered have for urban health literacy and urban primary health care, and share this with relevant authorities involved in health and wellbeing of urban youth in Lusaka. This report presents the proceedings of the meeting.
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TARSC as cluster lead of the “Equity Watch” work in EQUINET has been exploring these questions in east and southern African (ESA) countries, gathering diverse forms of evidence from literature review, analysis of quantitative data, internet searches on practices and a participatory validation amongst different social groups of youth in Harare and Lusaka. In Harare, TARSC worked with Civic Forum on Human Development (CFHD) and youth living in low density, medium income suburbs; in formal employment; in tertiary education; unemployed youth; youth in informal employment and in informal settlements. Briefs and reports capturing some of this work are available on the EQUINET website. This report compiles in one document the several rounds of participatory review and validation carried out in Harare with young people from low density, medium income suburbs; youth in formal employment; youth in tertiary education; unemployed youth; youth in informal employment and youth in informal settlements on their perceptions of health and wellbeing, the drivers of wellbeing in their areas, the approaches and practices that are and could be implemented to improve their wellbeing and the implications for urban services, including for health systems.
The workshop on participatory approaches to people centred health systems was held on the 22nd of September 2009 in Munyonyo Uganda before the EQUINET regional Conference held at the same venue on 23rd -25th of September 2009. This gave participants from the workshop an opportunity to engage with the wider regional community working on health equity, but also to feed input from the participatory work into the conference process and resolutions. The regional review workshop gathered researchers from the PRA research programme since 2005. The workshop reviewed the learning from, policy issues and knowledge gaps from the research studies, to inform planning of future work on empowerment and health and on people centred health systems in the ESA region and to explore the role of PRA approaches and community photography in advancing health equity. The workshop gathered those who had led the studies, community photographers and others involved with work on empowerment and health. This report documents the proceedings of the meeting.
On behalf of EQUINET, and as part of the EQUINET capacity building programme, the Centre for Health Policy, University of Witwatersrand, will host the third and final workshop in the current phase of the Policy Analysis Capacity Building Programme from March 30 to April 2nd in Johannesburg, South Africa. This programme was initiated in late 2003 with support from IDRC (Canada) and Rockefeller Foundation.
The objectives of this programme are :
* To promote investigation of health equity-related topics using policy analysis frameworks;
* To better understand the forces constraining decision-making on equity issues and shaping the achievement of equity goals in the health sector;
* To identify levers for equity-oriented advocacy and policy change within the health sector at national/regional/international levels;
* To build capacity in conducting health policy analyses;
* To strengthen the networks between those involved in this area of work.
Implementing any policy or intervention faces a range of challenges, especially for those seeking to benefit the poorest social groups. Much public health analysis focuses on the technical aspects of good policy design. However, experience shows that it can be more difficult to deal with the political and institutional barriers to implementation than to design new policies and programmes. Predicting and managing these political and institutional factors is essential to make the changes necessary to strengthen equitable health systems. This guidance brief outlines the frameworks and tools usedin health policy analysis for investigating and tackling these issues. It also presents a range of resources in Africa and elsewhere to support this key area of work in health.
In 2001 the Doha Declaration on TRIPS and Public Health provided a landmark political commitment reaffirming the option for World Trade Organisation (WTO) member states to use all flexibilities provided in the TRIPS Agreement to ensure access to affordable medicines, and to prevent patent monopolies stopping access to medicines where they are needed for public health. By 2006, many of these flexibilities are not yet exploited in Africa, despite the massive demand for cheap medicines. This brief outlines the opportunities that African countries have to use these flexibilities and the legal and other changes needed for this. It also outlines the challenges that we may face and the measures to respond to them.
An Economic Partnership Agreement (EPA) is being negotiated between east and southern African countries (ESA) and the European Union (EU). The final agreement is due to be signed in December 2007. The EPA is likely to impact on health, on public revenues for health and health care, including access to medicines, and to affect other inputs to health such as food security. Without a proper health impact assessment these impacts are not easily quantified and ESA countries are urged to take a precautionary approach and safeguard health in the EPA. This policy brief outlines the ways in which the EPA may affect health and the measures that ESA can take to protect health within the EPA. While it is focused on the EU-ESA EPA, these impacts and measures have wider general relevance to trade.
The growth of international trade has significant consequences for public health. The relationship between trade and health is not simple, nor is it unidirectional. In this brief we raise why trade issues need to be understood and managed to promote health and we highlight the main concerns arising from free trade agreements for public health. We draw attention to measures that governments and civil society in the region can take to achieve greater coherence between trade and health policies, so that international trade and trade rules maximize health benefits and minimize health risks, especially for poor and vulnerable populations.
Reviewing experience in selected countries in the region, this policy brief suggests that countries can strengthen equitable allocation of resources for health by increasing the overall share of government funding allocated to the health sector, bringing external aid and government funding into one pooled fund and allocating it through a single mechanism. Equitable resource allocation calls for governments to establish annual targets for equitable allocation of these public funds, and to collect information to monitor and report on progress in meeting these targets, including to parliaments and civil society. Resource allocation is a politicised process and requires careful management, including to plan, organise and provide incentives for redistributing health care staff to areas where health need is higher.
Devoting 15% of domestic public funds to the health sector is necessary - both to address the health and health care needs within east and southern Africa (ESA) and to ensure progress towards building a universal and comprehensive health system. The target of 15% is not unrealistic – it is very much in line with levels of public spending in other countries around the world. Achieving the 15% target demands that public funds not be consumed by debt servicing, so rapid implementation of debt cancellation is critical. The 15% is understood to mean domestic public spending on health, excluding external funding. This policy brief provides information on progress towards meeting the Abuja commitment in east and southern Africa, the obstacles and challengesto address,and the arguments for enhanced effort to prioritising health in national budgets.