Governance and participation in health

Attitudes of Gatekeepers Towards Adolescent Sexual and Reproductive Health in Ghana
Kumi-Kyereme A, Awusabo-Asare K, Darteh EKM: African Journal of Reproductive Health 18(3), September 2014

Adults constitute gatekeepers on adolescent sexual and reproductive health (ASRH). This qualitative paper discusses the views of adults on ASRH problems and challenges based on 60 in-depth interviews conducted among adults in Ghana in 2005. Adults were purposively selected based on their roles as parents, teachers, health care providers and community leaders. The major ASRH problems mentioned were teenage pregnancy and HIV/AIDS. The results indicated a number of challenges confronting ASRH promotion including resistance from parents, attitudes of adolescents, communication gap between adults and adolescents and attitudes of health care providers. Among health workers three broad categories were identified: those who were helpful, judgmental and dictators. Some adults supported services for young people while others did not. Some served as mediators and assisted to ‘solve’ ASRH problems, which occurred in their communities. It is argued that exploring the views of adults about their fears and concerns will contribute to the development of strategies and programmes which will help to improve ASRH,

AU Summit reaches hard-won consensus on a new African Union Authority
African Union: July 2009

At their meeting in Sirte, Libya, held from 1–3 July, nearly half of the 53 African Union (AU) heads of state and government reached consensus to establish the African Union Authority to replace the African Union Commission. Libyan Leader Mouamar Kadhafi, supported by Senegal’s President Abdoulaye Wade, argued to speed up continental integration but others, notably Nigeria and Tanzania, argued against it. Commenting on the consensus reached, Jean-Marie Ehouzou, the Benin Foreign Minister noted, ‘African leaders are in agreement with ceding a little of their sovereignty to the AU Authority’. To enter into force, the AU Authority must be approved by the Parliaments of all AU countries. African leaders also discussed the integration of the New Partnership for Africa’s Development (NEPAD) into the organs of the AU and adopted a resolution ending cooperation with the International Criminal Court in the Hague. They also decided to reinforce agriculture and food security and to enlarge the powers of the AU Commission into foreign, trade and defence areas.

Barriers to the participation of people with psychosocial disability in mental health policy development in South Africa: a qualitative study of perspectives of policy makers, professionals, religious leaders and academics
Kleintjes S, Lund C and Swartz L: BMC International Health and Human Rights 13(17), 2013

This paper outlines stakeholder views on environmental barriers that prevent people who live with psychosocial disability from participating in mental health policy development in South Africa. The authors conducted 56 semi-structured interviews with national, provincial and local South African mental health stakeholders between August 2006 and August 2009. Respondents included public sector policy makers, professional regulatory council representatives, and representatives from non-profit organisations (NPOs), disabled people’s organisations (DPOs), mental health interest groups, religious organisations, professional associations, universities and research institutions. Respondents identified three main environmental barriers to participation in policy development: stigmatisation and low priority of mental health, poverty, and ineffective recovery and community supports. The authors conclude that a number of attitudes, practices and structures undermine the equal participation of South Africans with psychosocial disability in society. They call for a human rights paradigm and multi-system approach to enable full social engagement by people with psychosocial disability, including their involvement in policy development.

Better Aid: Civil society position paper for the 2008 Accra High Level Forum on Aid Effectiveness
International Civil Society Steering Group: e-CIVICUS 404, 29 August 2008

Civil society organisations (CSOs) were present in 2005 when the Paris Declaration (PD) on Aid Effectiveness was signed. Since then, diverse national and international CSOs have engaged in tracking this agreement, raised a range of issues and brought in different perspectives, to ensure the framework translates into effective and accountable development processes. In this paper, they argue that the only true measures of aid effectiveness are its contribution to the sustained reduction of poverty and inequality, and its support of human rights, democracy, environmental sustainability and gender equality. Ownership is essential, but must be democratic. They recommend putting an end to all donor-imposed policy conditionality. Donors and Southern governments must adhere to the highest standards of openness and transparency, and support reforms to make procurement systems more accountable, not more liberalised. Finally, the Accra Agenda for Action must recognise CSOs as development actors in their own right and acknowledge the conditions that enable them to play an effective role in development.

Beyond 2008: Global civil society tells UN to fix international drug policy
Drug War Chronicle 543, 18 July 2008

About 300 delegates representing organisations from across the drug policy spectrum met in Vienna for the Beyond 2008 NGO Forum, an effort to provide civil society input on global drug policy. Building on a series of regional meetings last year, the forum was part of an ongoing campaign to reshape the United Nations' drug policy agenda as the world organisation grapples with its next 10-year plan. The NGO meeting, which included drug treatment, prevention, education and policy reform groups, harm reduction groups and human rights groups from around the world, resulted in a resolution that will be presented to the UN Commission on Narcotic Drugs (CND) at its meeting in March 2009. At that meeting, the CND will draft the next UN 10-year global drug strategy.

Bridging the divide: Global governance of trade and health
Lee K, Sridhar D and Patel M: The Lancet, 373(9661):416-22, 31 January 2009

The main institutions responsible for governing international trade and health - the World Trade Organization (WTO), which replaced the General Agreement on Tariffs and Trade (GATT) in 1995, and WHO - were established after World War 2. For many decades the two institutions operated in isolation, with little cooperation between them. The growth and expansion of world trade over the past half century amid economic globalisation and the increased importance of health issues to the functioning of a more interconnected world, brings the two domains closer together on a broad range of issues. Foremost is the capacity of each to govern their respective domains, and their ability to cooperate in tackling issues that lie at the intersection of trade and health. This paper discusses how the governance of these two areas relate to one another, and how well existing institutions work together.

Bringing about a paradigm shift towards a just and sustainable world: Report of a CIDSE workshop
CIDSE: Brussels, 14-15 May 2013

CIDSE, an international alliance of Catholic development agencies, held a workshop in Brussels from 14-15 May 2013 to discuss ways of creating a new development agenda. This report contains the main findings from the workshop. Participants agreed that the new agenda should have a number of values and principles at its heart: human dignity, rights, freedom and responsibility; justice, equity, solidarity, and fair distribution; care for the earth; and participation and subsidiarity. To enable a paradigm shift towards a just and sustainable world, participants called for a prophetic new narrative of human well-being within creation, gender equity, and solidarity, with an economy at the service of society within planetary boundaries. They also called for transformation of the dominant GDP growth and development paradigm, towards just and sustainable societies and livelihoods. They argued for confrontation of unjust power structures, making common cause with those most affected by inequalities and unsustainability in both North and South. Bold actors for change are needed, those who challenge ourselves to deepen our partnerships, and to engage in alliances with those who share our goals of transformation.

Bringing change: Communicating to communities on sensitive themes like sexuality and domestic violence
Italian Association Amici (AIFO)

A new document has been published by the name of "Bringing a Change: Communicating to Communities on Sensitive Themes like Sexuality and Domestic Violence". This document is based on an international workshop organised by AIFO/Italy in October 2005.

Bringing Justice to Health: The Impact of Legal Empowerment Projects on Public Health
Open Society Foundations: October 2013

Bringing Justice to Health profiles 11 legal empowerment projects based in Indonesia, Kenya, Macedonia, Russia, South Africa, and Uganda. These projects were selected because they show the range of approaches to legal empowerment that they support in their broader effort to promote health-related human rights interventions. The report tells the personal stories of people around the world - such as sex workers, people who use drugs, palliative care patients, people affected by HIV, and Roma - for whom human rights violations are part of everyday life. Sexual violence, discrimination in housing, unwarranted dismissal from employment, unfair evictions, denial of child support, and police harassment are only a few such violations. The report shows how the non-governmental organisations (NGOs) that founded projects to address these issues set about resolving problems in a way that is designed to empower those who are often least able to exercise their rights.

Bringing stakeholders together for urban health equity: hallmarks of a compromised process
Katz A; Cheff R; O’Campo P: International Journal for Equity in Health 2015, 14(138), 2015

There is a global trend towards the use of ad hoc participation processes that seek to engage grassroots stakeholders in decisions related to municipal infrastructure, land use and services. The authors present the results of a scholarly literature review examining 14 articles detailing specific cases of these processes to contribute to the discussion regarding their utility in advancing health equity. They explore hallmarks of compromised processes, potential harms to grassroots stakeholders, and potential mitigating factors. The authors conclude that participation processes in urban areas often cut off participation following the planning phase at the point of implementation, limiting convener accountability to grassroots stakeholders, and, further, that where participation processes yield gains, these are often due to independent grassroots action. Given the emphasis on participation in health equity discourse, this study seeks to provide a real world exploration of the pitfalls and potential harms of participation processes that is relevant to health equity theory and practice.

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