The Tanzanian public health sector is losing workers to internal and external migration. This paper examines the implementation of policies to govern non-financial incentives to retain health workers. It outlines a range of non-financial incentives set in policy in Tanzania, including training; leave; promotion; housing; and a safe and supportive working environment. It also examines the systems for managing personnel and the implementation of incentives as a factor in retention, including the participatory personnel appraisal system; worker participation in discussing their job requirements and welfare; supervision; recognition and respect. Drawing on a review of policy, published and grey literature and on a field study of seven districts, including five underserved districts, the paper finds that while a number of incentives exist in policy, their sustainability is eroded by the absence of special earmarked funding for their implementation.
Latest Equinet Updates
This document is published in Portuguese. ‘Observatório de Equidade’ é um meio de monitoria do progresso da equidade na saúde através da recolha, organização, análise de dados e elaboração de relatórios sobre a equidade na saúde. Este relatório explora as dimensões da inequidade que precisam de ser resolvidas para garantir melhorias no desempenho económico para conduzir à erradicação da pobreza e ao alcance de melhorias sustentáveis no desenvolvimento humano. Dá enfoque às determinantes sociais da saúde e às características do sistema de saúde que provaram fazer a diferença na redução das inequidades sociais, incluindo na saúde, e faz a seguinte pergunta: Que progresso estamos a fazer? O relatório analiza os resultados positivos alcançados até agora, os níveis actuais e os constrangimentos prevalecentes, no contexto da resposta nacional em relação à inequidade. Apresenta recomendações baseadas numa análise da informação disponível.
Parliaments play an important role in health. Generally and through their specialised committees they can scrutinise public spending to ensure that it meets national policy goals, debate and pass laws that institutionalise social goals and provide leadership, representation and space for public participation in health. Parliaments can also provide oversight of the executive in terms of how this arm of government is implementing national policy. This brief is the first in a series jointly produced be EQUINET and SEAPACOH with institutions in the EQUINET network. This brief explores how these parliamentary roles can be applied to strengthen equitable health systems responses to AIDS. Copies of the leaflet and a feedback form on it can be obtained from the EQUINET secretariat at admin@equinetafrica.org.
Parliaments play an important role in health. Generally and through their specialised committees, they can scrutinise and ensure that national budgets meet national policy goals, debate and pass laws that institutionalise social goals and provide leadership, representation and space for public participation in health. Parliaments can also provide oversight of the executive in terms of how this arm of government is implementing national policy. This brief is the second in a series jointly produced be EQUINET and SEAPACOH with institutions in the EQUINET network. It explores how these parliamentary roles can be applied to strengthen the fair financing of health systems. Copies of the leaflet and a feedback form on it can be obtained from the EQUINET secretariat at admin@equinetafrica.org.
Parliaments have a significant role to play in ensuring that people are able to access the right to health, that health rights are enshrined in national laws, and that national governments make proper provisions for implementing health rights. This brief sets out the international legal framework for the right to health and the responsibilities of national legislatures in making that right to health real. Parliaments and their committee structures play a key role in the oversight of international human rights commitments, passing and reviewing laws to implement these commitments, overseeing the executive and monitoring implementation of these laws, and in including civil society in such processes.
Public policy can make a difference to people’s health. Health improves with increased wealth. But countries with low per capita national incomes have been able to achieve very high health outcomes when they have directed resources towards primary health care and district health services. Parliaments can contribute to these health outcomes in their debate on, review and approval of government budget allocations and oversight of public spending by the executive. This function is often seen as separate to the legislative role of parliament. But this leaflet argues that in fact, rights and their expression in law can be a powerful tool for parliamentarians when they are arguing the case for increased budget allocations, especially for health, and for these resources to be directed at the areas of health that matter most for equity.
In the 21st century there is a growing demand to channel collective energy towards justice and equity in health, and to better understand the social processes that influence health and health systems. Communities,frontline health workers and other grass-roots actors play a key role in responding to this demand, in raising critical questions, building new knowledge and provoking and carrying out action to transform health systems and improve health. There is a widening array of methods, tools and capacities – old and new – to increase social participation and power in generating new knowledge through participatory research. At the same time, we need to be clear about exactly what participatory research is and what it can offer. This reader promotes understanding of the term ‘participatory action research’ (PAR) and provides information on its paradigms, methods, application and use, particularly in health policy and systems. This reader was produced through the Regional Network for Equity in Health in East and Southern Africa (EQUINET), with Alliance for Health Policy and Systems Research (AHPSR) and International Development Research Centre (IDRC) Canada and is being launched at the Third Global Symposium on Health Systems Research in South Africa September 30 2014 after which the full reader will replace this leaflet. The result of team work, the reader draws on experience and published work from all regions globally and explains:
• key features of participatory action research and the history and knowledge paradigms that inform it;
• processes and methods used in participatory action research, including innovations and developments in the field and the ethical and methods issues in implementing it; and
• communication, reporting, institutionalization and use of participatory action research in health systems.
Immediately following the 2014 Global Symposium on Health Systems Research, a one day workshop was held, convened by Training and Research Support Centre (TARSC) (www.tarsc.org) and the pra4equity network in the Regional Network for Equity in Health in east and southern Africa (EQUINET) with Asociación Latinoamericana de Medicina Social (ALAMES). The workshop was held to deepen the discussion on the use of participatory action research (PAR) in health policy and people centred health systems, including in acting on the social determinants of health. While there are many forms of participatory research, the workshop specifically focused on PAR, that is on research that transforms the role of those usually participating as the subjects of research, to involve them instead as active researchers and agents of change, where those affected by the problem are the primary source of information and the primary actors in generating, validating and using the knowledge for action, and that involves the development, implementation of, and reflection on actions as part of the research and knowledge generation process. PAR seeks to understand and improve the world by changing it, but does so in a manner that those affected by problems collectively act and produce change as a means to new knowledge. The one day workshop was open to delegates from all regions globally to foster cross regional exchange and to include people from the pra4equity network in east and southern Africa. This report presents the proceedings of the workshop.
Training and Research Support Centre offer a one day workshop on September 26 2009 for 30 people at the EQUINET Conference in September 2009. The workshop draws on experiences from TARSC and other partners in the field of Youth Reproductive Health, with a particular emphasis on the relationship between youth and health workers. In exploring ways to strengthen the gap between the two, this workshop will offer insight and adaptable strategies that can be used to facilitate dialogue, using participatory approaches including use of the ‘Auntie Stella’ toolkit. Deliberations will include:
• The importance of health worker and youth relations in building a more people-centred health system
• A discussion on the barriers to youth-health worker relations
• How these barriers can be overcome, with a particular focus on participatory approaches
• Discussion on how the interactive toolkit, ‘Auntie Stella’: Teenagers talk about sex, life and relationships can be used and adapted to strengthen youth-health worker understanding and communication (See www.tarsc.org/auntiestella for more information about ‘Auntie Stella’.)
The workshop will be interactive and will introduce a number of participatory tools that participants can use in their work with youth. At the end of the workshop we will also share with the participants follow up activities To register fill in the registration form available on the EQUINET conference site at www.equinetafrica.org/conference2009/index.php giving the name of the workshop and email us on admin@equinetafrica.org
This is a report of a workshop for a project that TARSC and Country Minders for People’s Development (CMPD), under the auspices of EQUINET, undertook as a pilot to explore options for participatory communications with the community-based organisations and some of the orphans and vulnerable children in Monkey Bay, Tanzania.